title: Stress and psychopathology and its impact on quality of life in chronic anal fissure (CAF) patients.
abstract: BACKGROUND
  Chronic anal fissure (CAF) onset, exacerbation, and impact on quality of life are influenced by a host of psychological, physiological, and social factors. We aimed to investigate the difference in psychopathology and stress between normal and CAF groups.
  
  
  METHODS
  Thirty CAF patients and 20 age-sex matched healthy controls were evaluated for Axis I psychopathology, depression, anxiety, and stress with Hamilton and Hospital Depression-Anxiety Scales, Perceived Stress Scale, and SF-36.
  
  
  RESULTS
  With a mean age of 39.47, 83.3% of CAF patients were female. Anxiety-depression and stress scores were all significantly higher and functionality was lower in the CAF group compared to controls (p < 0.001); 36.7% of the patients had a triggering stress factor and 56.6% had an exacerbating stress factor; 56.7% of the patients had an ongoing Axis I psychopathology while 50% had a previous psychopathology. Pain (96.7% had pain (VAS = 6.55)) and bleeding (83.3% had bleeding (VAS = 4.14)) severity showed a negative impact on bodily pain and role limitations emotional subscales of SF36.
  
  
  CONCLUSIONS
  There is a high comorbidity of psychopathology in the CAF patients and depression and anxiety severities show a negative impact on the quality of life. Stress acts as both a triggering and an exacerbating factor in CAF.
authors.affiliation: Department of Psychiatry, Abant İzzet Baysal University, Bolu, Turkey.
authors.forename: Özden
authors.initials: Ö
authors.lastname: Arısoy
authors.affiliation: Department of General Surgery, Abant İzzet Baysal University, Bolu, Turkey. nerimansengul@hotmail.com.|Department of Gastrointestinal Surgery, Abant İzzet Baysal University, Bolu, Turkey. nerimansengul@hotmail.com.
authors.forename: Neriman
authors.initials: N
authors.lastname: Şengül
authors.affiliation: Department of Gastrointestinal Surgery, Abant İzzet Baysal University, Bolu, Turkey.
authors.forename: Affan
authors.initials: A
authors.lastname: Çakir
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D002908:Chronic Disease; D003710:Demography; D005260:Female; D005401:Fissure in Ano / Q000523:psychology*; D006801:Humans; D008297:Male; D011599:Psychopathology; D011788:Quality of Life; D013315:Stress, Psychological / Q000523:psychology*
keywords: Anal fissure; Anxiety; Depression; Quality of life; Stress