title: Preoperative coping mechanisms have no predictive value for postoperative pain in breast cancer.
abstract: OBJECTIVE
  This study evaluated the relationship between psychological coping mechanisms and symptoms of anxiety and depression in the preoperative and postoperative periods in relation to the intensity of postoperative pain among patients undergoing breast cancer surgery.
  
  
  METHODS
  Female patients who were scheduled to receive immediate surgical treatment for breast cancer were invited to participate, and answered the following questionnaires: The Hospital Anxiety and Depression Scale (HADS), the Self Report Questionnaire (SRQ-20), the Coping Strategies Questionnaire (CSQ), and the visual analogue scale (VAS).
  
  
  RESULTS
  Of the 139 patients, 122 (87.8%) had an aggressive procedure. Eighty-five patients (61.2%) had a history of preoperative pain while 54 (38.7%) had not. There was no difference in VAS scores between patients subjected to aggressive or non-aggressive surgery. Only the CSQ subscale catastrophizing showed correlation with VAS at 24 hours and with HADS/D postoperatively. The HADS scores indicated both anxiety and depression, but did not distinguish patients subjected to aggressive or non-aggressive surgery.
  
  
  CONCLUSIONS
  The majority of patients did not exhibit depression and anxiety. Coping mechanisms and pain in the preoperative period did not have a strong predictive value for additional postoperative pain, but those with a higher anxiety score had greater pain.
authors.affiliation: School of Medicine, Universidade de Pernambuco, RecifePE, Brazil.
authors.forename: Maria Luiza
authors.initials: ML
authors.lastname: Alves
authors.affiliation: School of Medicine, Universidade de São Paulo, São PauloSP, Brazil.
authors.forename: Joaquim Edson
authors.initials: JE
authors.lastname: Vieira
authors.affiliation: Department of Anesthesiology, Hospital Central da Irmandade de Misericórdia da Santa Casa de São Paulo, São PauloSP, Brazil.
authors.forename: Lígia Andrade Silva Telles
authors.initials: LA
authors.lastname: Mathias
authors.affiliation: Department of Anesthesiology, Hospital Central da Irmandade de Misericórdia da Santa Casa de São Paulo, São PauloSP, Brazil.
authors.forename: Judymara Lauzi
authors.initials: JL
authors.lastname: Gozzani
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000368:Aged; D001007:Anxiety / Q000209:etiology; D001943:Breast Neoplasms / Q000523:psychology* / Q000601:surgery; D003863:Depression / Q000209:etiology; D005260:Female; D006801:Humans; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000523:psychology*; D011182:Postoperative Care; D011300:Preoperative Care; D011795:Surveys and Questionnaires; D055815:Young Adult