title: Biopsychosocial functioning in liver patients of alcoholic etiology as a function of self-perceived pain level.
abstract: OBJECTIVE
  To compare the biopsychosocial functioning among liver transplantation and cirrhotic patients as a function of self-perceived pain level.
  
  
  METHODS
  We selected two groups of liver patients of the same gender (men) and disease etiology (alcoholic): there were 39 liver transplant recipients and 34 severe cirrhotic patients. The Hospital Anxiety and Depression Scale and the SF-36 Health Questionnaire were used. We applied analysis of covariance, with age and model end-stage liver disease (MELD) scores as covariates to assess the influence of two independent factors: (1) group (liver transplant recipients and cirrhotic patients), and (2) self-perception of pain (mild and high). We also calculated Cohen's d as an effect size index.
  
  
  RESULTS
  No interactive effects were found between factors group and self-perceived pain in any of the variables studied. With regard to the main effects, we found statistically significant differences in the following variables between: a) liver transplant recipients and cirrhotic patients: anxiety (P = .000), depression (P = .003), role-physical (P = .001), mental health (P = .016), general health (P = .000), vitality (P = .000), and physical functioning (P = .000); and b) liver patients with mild and high self-perceived pain: anxiety (P = .008), depression (P = .000), role-physical (P = .002), mental health (P = .000), vitality (P = .000), and physical functioning (P = .001). In all the indicated variables, with medium and large effect sizes (Cohen's ds from 0.58 to 1.64), the cirrhotic patients and patients with a high level of self-perceived pain had much poorer mental health and quality of life.
  
  
  CONCLUSIONS
  Alcoholic cirrhotic male patients with a high level of self-perceived pain had the greatest biopsychosocial impairment, even exceeding the clinical threshold in the anxiety and depression scales; and the highest biopsychosocial well-being was associated with liver transplant recipients with a mild level of self-perceived pain.
authors.affiliation: Faculty of Psychology, Department of Personality, Assessment, and Psychological Treatments, University of Seville, Seville, Spain. anperez@us.es
authors.forename: M A
authors.initials: MA
authors.lastname: Pérez-San-Gregorio
authors.forename: A
authors.initials: A
authors.lastname: Martín-Rodríguez
authors.forename: E
authors.initials: E
authors.lastname: Domínguez-Cabello
authors.forename: E
authors.initials: E
authors.lastname: Fernández-Jiménez
authors.forename: J
authors.initials: J
authors.lastname: Pérez-Bernal
mesh_terms: D001007:Anxiety / Q000175:diagnosis / Q000209:etiology / Q000523:psychology; D003863:Depression / Q000175:diagnosis / Q000209:etiology / Q000523:psychology; D004644:Emotions; D006304:Health Status; D006801:Humans; D008104:Liver Cirrhosis, Alcoholic / Q000150:complications / Q000175:diagnosis / Q000523:psychology*; D016031:Liver Transplantation / Q000009:adverse effects / Q000523:psychology*; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D010146:Pain / Q000175:diagnosis / Q000209:etiology / Q000523:psychology*; D058748:Pain Perception; D010149:Postoperative Pain / Q000175:diagnosis / Q000209:etiology / Q000523:psychology; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D012649:Self Concept; D012720:Severity of Illness Index; D012919:Social Behavior; D011795:Surveys and Questionnaires; D014850:Waiting Lists