The impact of subclinical depression on the postoperative perception of pain in general surgery patients

Aim-Background Postoperative pain is a significant cause of discomfort and interferes with the recovery and mobilization of surgical patients. Depression has been shown to sensitize patients to pain. We conducted this study in order to assess its effect on general surgery patients. Materials and methods We conducted a prospective study involving 400 consecutive patients who underwent general surgery. Various factors known to be associated with the perception of pain were recorded, including the level of depression as well as preoperative and postoperative pain for the first week. The psychological state was assessed using the Hospital Anxiety and Depression Scale (HADS). Results According to the results obtained from the HADS, there were 323 patients who did not have high scores for depression and 63 who had a level of depression. Patients with depression were older, had a longer scar, scored high in the HADS for anxiety, depression, and had a lower level of education. They had greater preoperative pain and higher level of early postoperative pain (1st PO day). No difference was identified in the type and quantity of the analgesia used. Patients over 60 years of age and of lower education were mostly affected. Conclusion Subclinical depression is a significant predictor of pain. Measures should be taken to identify this subgroup of patients and manage them accordingly in order to minimize the effect on the perception of pain. We propose assessment of all surgical patients according to the HADS, special consultation of such patients, and medications to alleviate the psychological state.