Objectives: Pain and psychological disorders are the 2 most commonly occurring symptom clusters in patients with postherpetic neuralgia (PHN). This study aimed to investigate the risk factors for anxiety and depressive disorders in patients with PHN. Methods: Retrospectively, we examined the potential risk factors of anxiety and depression among patients with PHN from the clinic medical records of the Third Affiliated Hospital of Sun Yat-Sen University from 2017 to 2019. The Chinese version of the Hospital Anxiety and Depression Scale was used to assess anxiety and depression. Patients were retrospectively allocated to 2 groups – PHN with and without anxiety/depression – and compared to identify the differential patient characteristics. Results: Cases of 661 patients who were diagnosed with PHN were included. Anxiety and depression developed in 69.0% (456/661) and 65.8% (435/661) of the enrolled patients with PHN, respectively. Results of univariate regression analyses showed that female sex, magnitude of pain intensity, time from onset of rash and extent of spread of rashes were significantly associated with anxiety and depression in patients with PHN. Multivariate analysis revealed that both anxiety and depression states significantly correlated with female sex, magnitude of pain intensity, and extent of spread of rashes. Conclusions: Anxiety and depression were not uncommon in patients with PHN. Women with PHN who experience severe pain and develop extensive rashes have a high risk of developing anxiety and depressive disorders.

1.
Johnson
RW
,
Rice
AS
.
Clinical practice. Postherpetic neuralgia
.
N Engl J Med
.
2014
Oct
;
371
(
16
):
1526
33
.
[PubMed]
0028-4793
2.
Thomas
SL
,
Hall
AJ
.
What does epidemiology tell us about risk factors for herpes zoster?
Lancet Infect Dis
.
2004
Jan
;
4
(
1
):
26
33
.
[PubMed]
1473-3099
3.
Lerman
SF
,
Rudich
Z
,
Brill
S
,
Shalev
H
,
Shahar
G
.
Longitudinal associations between depression, anxiety, pain, and pain-related disability in chronic pain patients
.
Psychosom Med
.
2015
Apr
;
77
(
3
):
333
41
.
[PubMed]
0033-3174
4.
Zhu
X
,
Hu
P
,
Fan
Z
,
Zhan
W
,
Wang
H
,
Yang
Y
, et al
Effects of mindfulness-based stress reduction on depression, anxiety, and pain in patients with postherpetic neuralgia
.
J Nerv Ment Dis
.
2019
Jun
;
207
(
6
):
482
6
.
[PubMed]
0022-3018
5.
Schlereth
T
,
Heiland
A
,
Breimhorst
M
,
Féchir
M
,
Kern
U
,
Magerl
W
, et al
Association between pain, central sensitization and anxiety in postherpetic neuralgia
.
Eur J Pain
.
2015
Feb
;
19
(
2
):
193
201
.
[PubMed]
1090-3801
6.
Kosson
D
,
Malec-Milewska
M
,
Gałązkowski
R
,
Rzońca
P
.
Analysis of anxiety, depression and aggression in patients attending pain clinics
.
Int J Environ Res Public Health
.
2018
Dec
;
15
(
12
):
2898
.
[PubMed]
1661-7827
7.
Dworkin
RH
,
Gnann
JW
 Jr
,
Oaklander
AL
,
Raja
SN
,
Schmader
KE
,
Whitley
RJ
.
Diagnosis and assessment of pain associated with herpes zoster and postherpetic neuralgia
.
J Pain
.
2008
Jan
;
9
(
1
Suppl 1
):
S37
44
.
[PubMed]
1526-5900
8.
Coen
PG
,
Scott
F
,
Leedham-Green
M
,
Nia
T
,
Jamil
A
,
Johnson
RW
, et al
Predicting and preventing post-herpetic neuralgia: are current risk factors useful in clinical practice?
Eur J Pain
.
2006
Nov
;
10
(
8
):
695
700
.
[PubMed]
1090-3801
9.
Zigmond
AS
,
Snaith
RP
.
The hospital anxiety and depression scale
.
Acta Psychiatr Scand
.
1983
Jun
;
67
(
6
):
361
70
.
[PubMed]
0001-690X
10.
Leung
CM
,
Ho
S
,
Kan
CS
,
Hung
CH
,
Chen
CN
.
Evaluation of the Chinese version of the Hospital Anxiety and Depression Scale. A cross-cultural perspective
.
Int J Psychosom
.
1993
;
40
(
1-4
):
29
34
.
[PubMed]
0884-8297
11.
Turk
DC
,
Dworkin
RH
,
Trudeau
JJ
,
Benson
C
,
Biondi
DM
,
Katz
NP
, et al
Validation of the hospital anxiety and depression scale in patients with acute low back pain
.
J Pain
.
2015
Oct
;
16
(
10
):
1012
21
.
[PubMed]
1526-5900
12.
Drolet
M
,
Brisson
M
,
Schmader
KE
,
Levin
MJ
,
Johnson
R
,
Oxman
MN
, et al
The impact of herpes zoster and postherpetic neuralgia on health-related quality of life: a prospective study
.
CMAJ
.
2010
Nov
;
182
(
16
):
1731
6
.
[PubMed]
0820-3946
13.
Naranjo
C
,
Del Reguero
L
,
Moratalla
G
,
Hercberg
M
,
Valenzuela
M
,
Failde
I
.
Anxiety, depression and sleep disorders in patients with diabetic neuropathic pain: a systematic review
.
Expert Rev Neurother
.
2019
Dec
;
19
(
12
):
1201
9
.
[PubMed]
1473-7175
14.
Irwin
MR
,
Miller
AH
.
Depressive disorders and immunity: 20 years of progress and discovery
.
Brain Behav Immun
.
2007
May
;
21
(
4
):
374
83
.
[PubMed]
0889-1591
15.
Muñoz-Quiles
C
,
López-Lacort
M
,
Orrico-Sánchez
A
,
Díez-Domingo
J
.
Impact of postherpetic neuralgia: A six year population-based analysis on people aged 50 years or older
.
J Infect
.
2018
Aug
;
77
(
2
):
131
6
.
[PubMed]
0163-4453
16.
Sato
K
,
Adachi
K
,
Nakamura
H
,
Asano
K
,
Watanabe
A
,
Adachi
R
, et al
Burden of herpes zoster and postherpetic neuralgia in Japanese adults 60 years of age or older: results from an observational, prospective, physician practice-based cohort study
.
J Dermatol
.
2017
Apr
;
44
(
4
):
414
22
.
[PubMed]
0385-2407
17.
Schmaling
KB
,
Nounou
ZA
.
Incident chronic spinal pain and depressive disorders: data from the national comorbidity survey
.
J Pain
.
2019
Apr
;
20
(
4
):
481
8
.
[PubMed]
1526-5900
18.
Gerrits
MM
,
van Oppen
P
,
van Marwijk
HW
,
Penninx
BW
,
van der Horst
HE
.
Pain and the onset of depressive and anxiety disorders
.
Pain
.
2014
Jan
;
155
(
1
):
53
9
.
[PubMed]
0304-3959
19.
Liu
XK
,
Xiao
SY
,
Zhou
L
,
Hu
M
,
Liu
HM
.
Different predictors of pain severity across age and gender of a Chinese rural population: a cross-sectional survey
.
BMJ Open
.
2018
Jul
;
8
(
7
):
e020938
.
[PubMed]
2044-6055
20.
Nasser
SA
,
Afify
EA
.
Sex differences in pain and opioid mediated antinociception: modulatory role of gonadal hormones
.
Life Sci
.
2019
Nov
;
237
:
116926
.
[PubMed]
0024-3205
21.
Cao
S
,
Song
G
,
Zhang
Y
,
Xie
P
,
Tu
Y
,
Li
Y
, et al
Abnormal local brain activity beyond the pain matrix in postherpetic neuralgia patients: a resting-state functional MRI study
.
Pain Physician
.
2017
Feb
;
20
(
2
):
E303
14
.
[PubMed]
2150-1149
22.
Saguil
A
,
Kane
S
,
Mercado
M
,
Lauters
R
.
Herpes zoster and postherpetic neuralgia: prevention and management
.
Am Fam Physician
.
2017
Nov
;
96
(
10
):
656
63
.
[PubMed]
1532-0650
23.
Gnann
JW
 Jr
,
Whitley
RJ
.
Clinical practice. Herpes zoster
.
N Engl J Med
.
2002
Aug
;
347
(
5
):
340
6
.
[PubMed]
0028-4793
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