Catastrophizing in patients with trigeminal neuralgia is associated
with pain intensity, anxiety, and neuropathic characteristics

Guilherme Machado Alvares de Lima; Vinicius Gonçalves Gomes Pereira; Nilo Souza Sampaio; Fernanda Pereira Hildebrandt; Nivaldo Ribeiro Villela; Maud Parise

doi:10.63231/2595-0118.e202551-en

Artigo Original

Catastrophizing in patients with trigeminal neuralgia is associated with pain intensity, anxiety, and neuropathic characteristics

Catastrofização em pacientes com neuralgia do trigêmeo está associada com a intensidade da dor, ansiedade e características neuropáticas

Guilherme Machado Alvares de Lima; Vinicius Gonçalves Gomes Pereira; Nilo Souza Sampaio; Fernanda Pereira Hildebrandt; Nivaldo Ribeiro Villela; Maud Parise

http://dx.doi.org/10.63231/2595-0118.e202551-en BrJP, vol.8, e202551, 2025

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Abstract

BACKGROUND AND OBJECTIVES: Trigeminal neuralgia (TN) is an intense, paroxysmal facial pain, triggered by innocuous stimuli. Although it is relatively rare, the impact on patients’ lives is profound. Pain catastrophizing in TN was investigated in a few studies. This study aimed to collect detailed clinical characteristics of patients with TN and examine the relationship between pain catastrophizing (PC), pain intensity, anxiety, depression, and sleep quality.

METHODS: Patients with a diagnosis of TN (according to the International Classification of Orofacial Pain criteria) were evaluated through the following scales: Pain Catastrophizing Scale (PCS), Hospital Anxiety and Depression Scale (HADS), Pittsburgh sleep quality index (PSQI), painDETECT and visual analog scale.

RESULTS: The study included 38 patients (26 women), with mean age of 64.4 ± 8 years. 28.9% had scores for anxiety (HAD_A ≥ 9), 34.2% had scores for depression (HAD_D ≥9), 86.8% had poor sleep quality (PSQI≥6) and 73.7% had scores for catastrophizing (PCS>20). Average pain intensity was correlated with depression (p=0,01), anxiety (p=0,04), and catastrophizing (p=0,03), especially helplessness (p<0,05). PC was also associated with anxiety (p=0,001) and neuropathic features (p=0,03). Moreover, magnification and helplessness were correlated with anxiety and depression. Rumination was correlated with poor sleep quality (p<0,05) and neuropathic features (p<0,05).

CONCLUSION: This study found high levels of catastrophizing and poor sleep quality in most patients with TN. Pain catastrophizing was related to pain intensity, anxiety, and neuropathic features while poor sleep quality was associated with rumination.

Keywords

Catastrophizing; Depression; Sleep initiation and maintenance disorders; Trigeminal neuralgia; Anxiety disorders

Resumo

JUSTIFICATIVA E OBJETIVOS: A neuralgia do trigêmeo (NT) é uma dor facial intensa e paroxística, desencadeada por estímulos inócuos. Embora seja relativamente rara, o impacto na vida dos pacientes é profundo. A catastrofização da dor (CD) na NT foi investigada em poucos estudos. Este estudo teve como objetivo coletar características clínicas detalhadas de pacientes com NT e examinar a relação entre catastrofização, intensidade da dor, ansiedade, depressão e qualidade do sono.

MÉTODOS: Pacientes com diagnóstico de NT (de acordo com os critérios da Classificação Internacional de Dor Orofacial) foram avaliados por meio das seguintes escalas: Escala de Catastrofização da Dor (PCS), Escala Hospitalar de Ansiedade e Depressão (HADS), Índice de Qualidade do Sono de Pittsburgh (PSQI), painDETECT e Escala Analógica Visual (EAV).

RESULTADOS: Foram incluídos no estudo 38 pacientes (26 mulheres), com idade média de 64,4 ± 8 anos. 28,9% tiveram escores para ansiedade (HAD_a≥9), 34,2% tiveram escores para depressão (HAD_d ≥9), 86,8% tiveram má qualidade do sono (PSQI ≥ 6) e 73,7% tiveram escores para catastrofização (PCS >20). A intensidade média da dor foi correlacionada com depressão (p=0,01), ansiedade (p=0,04) e catastrofização (p=0,03), especialmente desamparo (p<0,05). A CD também foi associada com ansiedade (p=0,001) e características neuropáticas (p=0,03). Além disso, amplificação e desamparo foram correlacionados com ansiedade e depressão. A ruminação foi correlacionada com má qualidade do sono (p<0,05).

CONCLUSÃO: Este estudo encontrou altos níveis de catastrofização e má qualidade do sono na maioria dos pacientes com NT. A PC foi relacionada à intensidade da dor, ansiedade e características neuropáticas, enquanto a má qualidade do sono foi associada à ruminação.

Palavras-chave

Catastrofização; Depressão; Distúrbios do início e da manutenção do sono; Neuralgia do trigêmeo; Transtornos de ansiedade

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Submetido em:
15/03/2025

Aceito em:
09/10/2025