PhD Scientific Days 2025

Mental Health Sciences III.

Psychogenic factors as predictors of perioperative pain and analgesic requirements

Name of the presenter

Máté-Horváth Nóra

Institute/workplace of the presenter

Department of Anesthesia and Perioperative Care, Semmelweis University, Budapest

Authors

Dr. Nóra Máté-Horváth¹, Gonda, Xenia²

1: Department of Anesthesia and Perioperative Care, Semmelweis University, Budapest
2: Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest

Text of the abstract

Background
Psychogenic factors show a strong correlation with perioperative analgesic needs. However, many of these factors are variable over time, as surgery approaches. Affective temperaments (ATs: depressive, hyperthymic, cyclothymic, irritable, anxious), in contrast, are genetically based traits that shape emotional and cognitive patterns, and are associated with many somatic conditions. We aimed to examine how psychological factors influence postoperative pain and analgesic requirements.

Methods
We enrolled 300 women undergoing non-obstetrical, non-oncological gynecological surgery and followed them with online tools during the first postop week. Surgical technique, anesthesia, and pain management were standardized. Psychological assessments were conducted at three time points: (1) five days preop, (2) one day postop, (3) seven days postop. Instruments included TEMPS-A (ATs), STAI-S/T (anxiety), PHQ-9 (depression), PCS (pain catastrophizing), and BPI (pain and QoL). Surgical duration, intraop vitals, opioid use, and postop analgesics were also recorded. Analyses included regression, correlation, and path modeling.
Results
Age and education negatively predicted pain. Depression and anxiety were strong predictors of pain on days 1 and 7. Anxious and cyclothymic temperaments showed initial associations with pain on both days, but their influence on day 1 diminished when controlled for other psychological factors. By day 7 however, anxious temperament regained its contribution to pain prediction. It is also interesting to note that hyperthymic temperament showed a small, non-significant protective effect on day 1 and 7.

Discussion
Our findings suggest that acute postoperative pain is more influenced by state-like psychological traits (e.g., anxiety, depression, pain catastrophizing), while trait-like factors (ATs), especially anxious temperament, play a larger role later in recovery. Understanding these dynamics may support targeted screening and individualized pain management strategies.
Funding
The study is self-founded, with no conflict of interests to declare.