Pain, daytime sleepiness, anxiety and depression levels of patients with chronic neuropathic pain syndromes

Abstract

Objective: The current study aims to determine pain, daytime sleepiness, anxietyand depression levels of patients with chronic neuropathic pain and compare different clinical conditions causing neuropathic pain in terms of these variables. Method: 241 patients (105 patients with diabetic neuropathy, 39 patients with fibromyalgia, 27 patients with carpal tunnel syndrome, 27 patients with radiculopathy, 22 patients with trigeminal neuralgia and 21 patients with postherpetic neuralgia) were included in the study. The assessments were performed using socio-demographic data form, Visual Analog Scale (VAS), Leeds Assessment of Neuropathic Symptoms and Signs (LANSS), Epworth Sleepiness Scale (ESS) and Hospital Anxiety and Depression Scale (HAD). Results: Evaluation of pain with VAS and LANSS showed no statistical difference among subgroups. Scores of LANSS and VAS were positively correlated with each other. ESS scores were found to be above the cut-off point (> 10) in all subgroups. LANSS, but not VAS scores were positively correlated with ESS scores. Depression scores were above the cut-off point (> 7) in diabetic neuropathy, fibromyalgia and trigeminal neuralgia groups and anxiety scores were above the cut-off point (> 10) in diabetic neuropathy, fibromyalgia, trigeminal neuralgia and carpal tunnel syndromegroups. No correlation was found between scores of both VAS and LANSS and scores of HADS. Depression scores correlated positively with ESS scores (r=0.153, p<0.05). Conclusions: Daytime sleepiness, depression and anxiety are associated comorbidities with different neuropathic pain syndromes. Neuropathic character, but not the intensity of pain is associated with daytime sleepiness. Pain intensity does not predict anxiety and depression levels. Depression, but not anxiety shows a positive correlation with daytime sleepiness. These results might have implications for the better understanding of comorbidities in different neuropathic pain syndromes.

Mevcut çalışmanın amacı farklı klinik durumlarda nöropatik ağrılı hastalarda ağrı, gündüz uykuları, kaygı ve depresyon düzeylerini belirlemek. Yöntem: 241hasta (105 hastalarda diyabetik nöropati, 39 hastalarda fibromiyalji, 27 hastalarda karpal tünel sendromu, 27 hastalarda radikülopati, 22 hasta trigeminal nevralji ve 21 hastalarda postherpetic neuralgia) çalışmaya alındı. Sonuçlar: Gruplar arasında Vizuel Analog Skor (VAS) ve LANSS değerlendirmesinde hiçbir fark istatistiksel fark yoktu. Epworth Sleep Skorları tüm alt gruplarda kesme noktası üzerinde ( >10) bulundu. Depresyon puanları 7 kesme noktası üzerinde ( >7) diyabetik nöropati, fibromiyalji ve trigeminal nevralji gruplarında ve anksiyete 10 kesme noktası üzerinde ( >10) diyabetik nöropati, fibromiyalji, trigeminal nevralji ve karpal tünel sendromu gruplarında yüksek bulundu. ESS ile depresyon puanları istatistiksel olarak olumlu ilişkili bulundu ( p< 0,05). Sonuçlar: Farklı nöropatik ağrılı sendromlara gündüz uykululuk, depresyon ve anksiyete eşlik edebilir. Depresyon, gün içi uykululuk ile pozitif yönde birliktelik gösterirken anksiyete ile ilişkisi gösterilememiştir.Bu sonuçlarla farklı nöropatik ağrı sendromlarında eşlik eden durumların daha iyi anlaşılması için etkisi olabilir.