title: The association of presurgery psychological symptoms with postsurgery pain among cancer patients receiving implantable devices for pain management.
abstract: OBJECTIVE
  Psychological symptoms are a common part of the cancer pain experience, yet little is known about how these factors relate to implantable device outcomes in patients with cancer pain. The purpose of this study was to examine how psychological symptoms relate to implantable device outcomes in cancer pain management.
  
  
  METHODS
  We retrospectively examined the medical records of 79 cancer patients, collecting information on psychological symptoms and pain, as assessed on the Edmonton Symptom Assessment System. Data were collected prior to and at three points following the implantation of either a spinal cord stimulator or an intrathecal pump.
  
  
  RESULTS
  Pain was correlated with both anxiety, r = 0.39 (n = 74, p < 0.01), and depression, r = 0.38, (n = 75, p < 0.01), at the presurgery baseline. Results of linear mixed model (LMM) analysis indicated that neither baseline anxiety nor baseline depression main effects were significantly associated with pain at postimplant assessments, when adjusting for baseline pain, demographics, and clinical factors. However, the group-by-time interaction was significant for anxiety (beta = 0.223, p value = 0.037). The trajectory of pain scores over time differed by baseline anxiety scores, with pain scores increasing over time at a higher rate for those with a high baseline anxiety score, compared to those with low baseline anxiety scores.
  
  
  CONCLUSIONS
  Presurgery psychological symptoms should be considered, along with other medical, psychosocial, and individual characteristics in multidisciplinary treatment planning. Multidisciplinary care which includes aspects of mood management or supportive psychotherapy would likely be beneficial to cancer patients presenting with high psychological symptoms.
authors.affiliation: Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA, cjaigner@mdanderson.org.
authors.forename: Carrie J
authors.initials: CJ
authors.lastname: Aigner
authors.forename: Mike
authors.initials: M
authors.lastname: Hernandez
authors.forename: Lakshmi
authors.initials: L
authors.lastname: Koyyalagunta
authors.forename: Diane
authors.initials: D
authors.lastname: Novy
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000700:Analgesics / Q000008:administration & dosage; D001007:Anxiety / Q000209:etiology; D003863:Depression / Q000209:etiology; D004343:Drug Implants / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology* / Q000601:surgery*; D059408:Pain Management; D010149:Postoperative Pain / Q000188:drug therapy / Q000523:psychology*; D057234:Preoperative Period; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000700:Analgesics; D004343:Drug Implants
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