Cleveland Clinic Center for Abdominal Core Health, Department of General Surgery, Cleveland Clinic Foundation, Cleveland, OH, USA.
Digestive Disease and Surgery Institute, Cleveland Clinic Foundation, Cleveland, OH, USA.
Hernia. 2023 Feb;27(1):35-40. doi: 10.1007/s10029-022-02662-2. Epub 2022 Aug 12.
Chronic postoperative inguinal pain (CPIP), a complication of inguinal hernia repair, may negatively affect mental health. The rates of psychological disorders in patients with CPIP are unknown. We aimed to describe the prevalence of psychological disorders coinciding with CPIP.
A retrospective chart review was performed of all patients seen at the Cleveland Clinic Center for Abdominal Core Health's inter-disciplinary Chronic Groin Pain Clinic. This clinic is unique in that all patients are evaluated by a surgeon, a sonographer and radiologist, and a behavioral medicine psychologist. Patient psychological history and treatment, Depression Anxiety and Stress Scale (DASS) scores, pain catastrophizing, and trauma or abuse history were captured.
From January 2018 to January 2022, 61 patients were evaluated and included in the study. Psychological treatment had been provided to 37 (61%) patients (present: 16 (27%), past: 21 (35%)). The most common psychological disorders represented were depression (N = 13, 22%), anxiety (N = 10, 17%), and post-traumatic stress disorder (N = 5, 8%). DASS scores indicated that 20 (33%) patients were reporting symptoms of depression and 16 (27%) patients were reporting symptoms of anxiety. Of the 40 patients assessed for pain catastrophizing, 28 (70%) reported rumination, 9 (23%) reported magnification, and 23 (58%) reported feelings of helplessness. A childhood history of emotional or physical abuse was reported by 11 (18%) patients.
An inter-disciplinary groin pain clinic has revealed that patients with CPIP frequently have pre-existing complex psychosocial issues. A multi-specialty approach to CPIP may improve preoperative assessments and identify patients who may benefit from further psychological evaluation and treatment.
慢性术后腹股沟疼痛（CPIP）是腹股沟疝修补术的一种并发症，可能对心理健康产生负面影响。患有 CPIP 的患者心理障碍的发生率尚不清楚。我们旨在描述 CPIP 并发心理障碍的患病率。
对克利夫兰诊所腹部核心健康跨学科慢性腹股沟疼痛诊所就诊的所有患者进行回顾性图表审查。该诊所的独特之处在于，所有患者均由外科医生、超声医生和放射科医生以及行为医学心理学家进行评估。记录了患者的心理病史和治疗、抑郁焦虑和压力量表（DASS）评分、疼痛灾难化和创伤或虐待史。
从 2018 年 1 月至 2022 年 1 月，共有 61 名患者接受了评估并纳入研究。37 名（61%）患者接受了心理治疗（目前：16 名[27%]，过去：21 名[35%]）。最常见的心理障碍分别为抑郁（N=13，22%）、焦虑（N=10，17%）和创伤后应激障碍（N=5，8%）。DASS 评分表明，20 名（33%）患者有抑郁症状，16 名（27%）患者有焦虑症状。在 40 名接受疼痛灾难化评估的患者中，28 名（70%）患者存在反刍，9 名（23%）患者存在放大，23 名（58%）患者感到无助。11 名（18%）患者报告有儿童时期情感或身体虐待史。
跨学科腹股沟疼痛诊所发现，CPIP 患者经常存在先前存在的复杂社会心理问题。CPIP 的多专业方法可能会改善术前评估，并确定可能受益于进一步心理评估和治疗的患者。
