Anxiety, depression predict pain, HRQoL in cirrhosis patients

Pain is prevalent among patients with cirrhosis who are undergoing liver transplant evaluation, a study has found. Anxiety and depression show a significant association with pain and appear to predict poor health-related quality of life (HRQoL) in this population.

Sixty-four patients were included in this study, which carried out four validated assessments to characterize pain (Brief Pain Inventory-Short Form, BPI-SF), anxiety (Generalized Anxiety Disorder-7), depression (Patient Health Questionnaire-8), and liver-specific HRQoL (Chronic Liver Disease Questionnaire). The BPI-SF screening question was utilized to determine the presence of pain.

The investigators identified demographic or clinical factors predictive of pain severity (PS) and interference (PI) using linear regression. They also explored the associations between pain, anxiety or depression, and HRQoL.

Of the participants, 71 percent reported pain, 26 percent had clinical depression, and 24 percent had moderate-to-severe anxiety. Pain (PS or PI) showed no significant association with liver disease severity or its complications, but anxiety and depression predicted pain on bivariate analysis.

In multivariate analysis, only depression remained a significant predictor of PS (b=0.28; p<0.05) and PI (b=0.30; p<0.05). HRQoL showed an inverse relationship with PS, PI, depression, and anxiety. However, in the adjusted model, only anxiety remained significantly associated with HRQoL (b=‒0.14; p=0.003).

“Evaluating and managing mental health comorbidities should be explored as a strategy to improve HRQoL in patients with cirrhosis and pain,” the investigators said.