Stress and psychopathology and its impact on quality of life in chronic anal fissure (CAF) patients

Abstract

Background: Chronic anal fissure (CAF) onset, exacerbation, and impact on quality of life are influenced by a host of psychological, physiological, and social factors. We aimed to investigate the difference in psychopathology and stress between normal and CAF groups.

Methods: Thirty CAF patients and 20 age-sex matched healthy controls were evaluated for Axis I psychopathology, depression, anxiety, and stress with Hamilton and Hospital Depression-Anxiety Scales, Perceived Stress Scale, and SF-36.

Results: With a mean age of 39.47, 83.3% of CAF patients were female. Anxiety-depression and stress scores were all significantly higher and functionality was lower in the CAF group compared to controls (p < 0.001); 36.7% of the patients had a triggering stress factor and 56.6% had an exacerbating stress factor; 56.7% of the patients had an ongoing Axis I psychopathology while 50% had a previous psychopathology. Pain (96.7% had pain (VAS = 6.55)) and bleeding (83.3% had bleeding (VAS = 4.14)) severity showed a negative impact on bodily pain and role limitations emotional subscales of SF36.

Conclusion: There is a high comorbidity of psychopathology in the CAF patients and depression and anxiety severities show a negative impact on the quality of life. Stress acts as both a triggering and an exacerbating factor in CAF.

Keywords: Anal fissure; Anxiety; Depression; Quality of life; Stress.