The Effect of Pain, Anxiety and Depression in Patients with Anal Fissure: The Role of Surgical Treatment in Psychological Outcomes

Objective: To perform an extensive evaluation of the relationship between anxiety and depression levels in patients diagnosed with anal fissure, the effects of acute pain on psychiatric disorders, and the impact of surgical treatment on those psychological effects. Methods:One hundred five patients diagnosed with anal fissure between January 2022 and June 2024 and 99 healthy controls were included in the study.The Hospital Anxiety and Depression Scale (HADS) was employed for psychiatric evaluation and a visual analogue scale (VAS) for pain severity.The data were analyzed using the Mann-Whitney U test, the chi-square test, and Spearman's correlation analysis.Results: Depression (HADS-D) scores were significantly higher in the patient group than in the control group (p<0.01).Although anxiety (HADS-A) scores were also higher in the patient group, the difference was not statistically significant (p=0.129).Both anxiety and depression scores were significantly higher in women than in men (p<0.05).No powerful correlation was observed between VAS scores and anxiety or depression (r=0.68,p<0.001).Surgical treatment produced significant improvement in pain and anxiety (p<0.01),but a need for additional measures for depression management was observed (p>0.05). Conclusion:High rates of depression and anxiety and an association with pain severity were determined in patients with anal fissure.Surgical treatment plays an important role in the therapeutic process, particularly with its positive effects on pain and anxiety.These findings emphasize the need for a multidisciplinary approach.