Sexuality, Quality of Life, Anxiety, Depression, and Anger in Patients with Anal Fissure. A Case–Control Study
Abstract
:1. Introduction
2. Experimental Section
2.1. Material and Methods
2.1.1. Study Population
2.1.2. Study Design and Participants
- AF secondary to other diseases such as tuberculosis, syphilis, herpes, Crohn’s disease, HIV infection, agranulocytosis, carcinoma, leukemia, and hidden abscesses;
- functional alterations (incontinence or constipation), rectocele, or prolapse;
- previous surgical treatment for an anorectal disorder or birth trauma; and
- clinical diagnosis of severe psychiatric disorder, specifically, of depressive disorder or anxiety disorder.
2.1.3. Variables and Measurements
- Associated psychological factors: STAI (State–Trait Anxiety Inventory); a higher score in state and trait anxiety indicates greater anxiety symptoms in state and trait anxiety respectively [44,45,46,47,48]. HADS (Hospital Anxiety and Depression Score); a higher score in anxiety indicates greater anxiety symptoms; a higher score in depression indicates greater depression symptoms [49,50,51]. STAXI-2 (State–Trait Anger Expression Inventory); a higher score in state, trait and expression anger indicates greater anger symptoms in anger state or trait; or a higher level in its expression respectively [52,53,54].
CSFQ-14 (Changes in Sexual Functioning Questionnaire, short-form)
SF-12 (SF-12 Health Survey)
MQLI (Multicultural Quality of Life Index)
STAI (State–Trait Anxiety Inventory)
HADS (Hospital Anxiety and Depression Scale)
STAXI-2 (State–Trait Anger Expression Inventory)
2.1.4. Sample Size Calculation
2.1.5. Statistical Methods—Data Analyses
2.1.6. Ethics
3. Results
4. Discussion
Strengths, Limitations, and Future Research
5. Clinical Implications
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Acknowledgments
Conflicts of Interest
Appendix A. Questionnaires, Scales, and Subscales. These Instruments Were Used in Their Validated Spanish Version
CSFQ-14 (Changes in Sexual Functioning Questionnaire, short-form) CSFQ-T: Total CSFQ-P: Pleasure CSFQ-D: Desire CSFQ-E: Arousal CSFQ-O: Orgasm SF-12 (SF-12 Health Survey) SF12PF: Physical Functioning (PF) SF12RP: Role Physical (RP) SF12BP: Bodily Pain (BP) SF12GH: General Health (GH) SF12V: Vitality (V) SF12SF: Social Functioning (SF) SF12RE: Role Emotional (RE) SF12MH: Mental Health (MH) MQLI (Multicultural Quality of Life Index) 1. Physical well-being 2. Psychological/emotional well-being 3. Self-care and independent functioning 4. Occupational functioning 5. Interpersonal functioning 6. Social emotional support 7. Community and service support 8. Personal fulfillment 9. Spiritual fulfillment 10. Overall quality of life STAI (State–Trait Anxiety Inventory) STAI Anxiety A—State: A-State STAI Anxiety A—Trait: A-Trait HADS (Hospital Anxiety and Depression Score) HADS—Anxiety: HADS-A HADS—Depression: HADS-D STAXI-2 (State–Trait Anger Expression Inventory) STAXI-2 State Anger (S-Ang) STAXI-2 State Anger/Feeling (S-Ang/F) STAXI-2 State Anger/Physical (S-Ang/P) STAXI-2 State Anger/Verbal (S-Ang/V) STAXI-2 Trait Anger (T-Ang) STAXI-2 Trait Anger/Temperament (T-Ang/T) STAXI-2 Trait Anger/Reaction (T-Ang/R) STAXI-2 Anger Expression—Out (AX-O) STAXI-2 Anger Expression—In (AX-I) STAXI-2 Anger Control—Out (AC-O) STAXI-2 Anger Control—In (AC-I) STAXI-2 IEI: Index of the Frequency with which Anger is Expressed (AX Index) |
Appendix B
Variables | Total n = 67 n(%)/x ± s | Cases n = 35 (52.2%) n(%)/x ± s | Controls n = 32 (47.8%) n(%)/x ± s | p |
---|---|---|---|---|
Gender: Male Female | 36(53.7) 31(46.3) | 22(62.9) 13(37.1) | 14(43.8) 18(56.3) | 0.117 |
Age (years) | 52.2 ± 12.1 | 52.9 ± 12.7 | 51.4 ± 11.5 | 0.618 |
STAI Anxiety A—State | 19.1 ± 11.7 | 24 ± 11.8 | 13.8 ± 9.1 | <0.001 |
STAI Anxiety A–Trait | 16 ± 10.1 | 19.5 ± 11.3 | 12 ± 6.8 | 0.002 |
HADS—Anxiety | 7 ± 3.4 | 8.1 ± 3.4 | 5.9 ± 3 | 0.009 |
HADS—Depression | 4.2 ± 4.4 | 5.3 ± 5.2 | 2.9 ± 2.7 | 0.02 |
SF12PF: Physical Functioning (PF) | 4.9 ± 1.3 | 4.3 ± 1.4 | 5.5 ± 0.6 | <0.001 |
SF12RP: Role Physical (RP) | 3.3 ± 1 | 2.8 ± 0.9 | 3.9 ± 0.6 | <0.001 |
SF12BP: Bodily Pain (BP) | 2.6 ± 1.4 | 3.5 ± 1.1 | 1.6 ± 0.9 | <0.001 |
SF12GH: General Health (GH) | 3 ± 0.8 | 3.3 ± 0.8 | 2.7 ± 0.7 | 0.001 |
SF12V: Vitality (V) | 3.3 ± 1.3 | 3.7 ± 1.3 | 2.9 ± 1.3 | 0.007 |
SF12SF: Social Functioning (SF) | 3.8 ± 1.2 | 3.4 ± 1.2 | 4.2 ± 1 | 0.002 |
SF12RE: Role Emotional (RE) | 3.6 ± 0.8 | 3.4 ± 0.9 | 3.8 ± 0.7 | 0.051 |
SF12MH: Mental Health (MH) | 7.7 ± 1.1 | 7.7 ± 1.2 | 7.6 ± 0.9 | 0.567 |
CSFQ-T: Total | 43.7 ± 8.5 | 41.1 ± 8.9 | 46.7 ± 7.2 | 0.006 |
CSFQ-P: Pleasure | 2.8 ± 1.2 | 2.4 ± 1.1 | 3.2 ± 1.2 | 0.003 |
CSFQ-D: Desire | 14.5 ± 4 | 13.7 ± 4.3 | 15.3 ± 3.5 | 0.086 |
CSFQ-E: Arousal | 10.9 ± 2.9 | 10.7 ± 3.5 | 11.1 ± 2.2 | 0.57 |
CSFQ-O: Orgasm | 10.5 ± 2.5 | 9.7 ± 3.0 | 11.3 ± 1.5 | 0.008 |
STAXI-2 State Anger (S-Ang) | 17.1 ± 3.4 | 17.9 ± 4.0 | 16.2 ± 2.4 | 0.038 |
STAXI-2 State Anger/Feeling | 6.2 ± 2.2 | 7 ± 2.7 | 5.4 ± 1.0 | 0.003 |
STAXI-2 State Anger/Physical | 5.3 ± 0.9 | 5.4 ± 1.1 | 5.1 ± 0.5 | 0.231 |
STAXI-2 State Anger/Verbal | 5.8 ± 1.5 | 5.9 ± 1.6 | 5.6 ± 1.3 | 0.42 |
STAXI-2 Trait Anger (T-Ang) | 17.5 ± 6.1 | 19.3 ± 6.1 | 15.5 ± 5.6 | 0.01 |
STAXI-2 Trait Anger/Temperament | 7.3 ± 2.5 | 7.9 ± 2.6 | 6.7 ± 2.4 | 0.052 |
STAXI-2 Trait Anger/Reaction | 11 ± 4.6 | 12.2 ± 4.9 | 9.8 ± 3.8 | 0.024 |
STAXI-2 Anger Expression—Out | 9.9 ± 2.8 | 10.4 ± 3.3 | 9.4 ± 2.0 | 0.165 |
STAXI-2 Anger Expression—In | 12.1 ± 3.5 | 12.8 ± 3.5 | 11.4 ± 3.3 | 0.108 |
STAXI-2 Anger Control—Out | 17.8 ± 3.6 | 18.3 ± 3.6 | 17.2 ± 3.6 | 0.255 |
STAXI-2 Anger Control—In | 15 ± 4.3 | 14.8 ± 4.8 | 15.3 ± 3.9 | 0.651 |
STAXI-2 IEI. Index Anger Expressed | 24.9 ± 8.4 | 26.2 ± 8.6 | 23.6 ± 8.2 | 0.208 |
MQLI | 79.8 ± 12.1 | 74.9 ± 13 | 85.2 ± 8.3 | <0.001 |
Variables | OR | 95% CI | p | H–L test (p) | AUC | 95% CI | p |
---|---|---|---|---|---|---|---|
STAI Anxiety A—State | 1.10 | 1.04–1.17 | 0.001 | 0.920 | 0.77 | 0.65–0.88 | <0.001 |
STAI Anxiety A–Trait | 1.09 | 1.03–1.16 | 0.006 | 0.164 | 0.74 | 0.6–0.85 | 0.001 |
HADS—Anxiety | 1.27 | 1.04–1.53 | 0.016 | 0.777 | 0.69 | 0.56–0.82 | 0.004 |
HADS—Depression | 1.17 | 1.02–1.36 | 0.027 | 0.527 | 0.68 | 0.55–0.81 | 0.005 |
SF12PF: Physical Functioning (PF) | 0.28 | 0.13–0.57 | 0.001 | 0.210 | 0.81 | 0.7–0.92 | <0.001 |
SF12RP: Role Physical (RP) | 0.17 | 0.07–0.41 | <0.001 | 0.871 | 0.85 | 0.76–0.94 | <0.001 |
SF12BP: Bodily Pain (BP) | 4.13 | 2.23–7.65 | <0.001 | 0.699 | 0.91 | 0.84–0.97 | <0.001 |
SF12GH: General Health (GH) | 4.41 | 1.67–11.65 | 0.003 | 0.338 | 0.74 | 0.62–0.86 | <0.001 |
SF12V: Vitality (V) | 1.68 | 1.11–2.52 | 0.013 | 0.742 | 0.70 | 0.57–0.82 | 0.003 |
SF12SF: Social Functioning (SF) | 0.49 | 0.29–0.82 | 0.006 | 0.183 | 0.73 | 0.61–0.85 | 0.001 |
SF12RE: Role Emotional (RE) | 0.56 | 0.28–1.12 | 0.101 | 0.112 | 0.67 | 0.53–0.8 | 0.009 |
SF12MH: Mental Health (MH) | 1.16 | 0.73–1.84 | 0.543 | 0.150 | 0.60 | 0.45–0.74 | 0.082 |
CSFQ-T: Total | 0.88 | 0.80–0.96 | 0.004 | 0.763 | 0.75 | 0.63–0.87 | <0.001 |
CSFQ-P: Pleasure | 0.39 | 0.22–0.69 | 0.001 | 0.298 | 0.77 | 0.65–0.88 | <0.001 |
CSFQ-D: Desire | 0.84 | 0.72–0.99 | 0.038 | 0.097 | 0.71 | 0.58–0.83 | 0.002 |
CSFQ-E: Arousal | 0.85 | 0.68–1.07 | 0.167 | 0.817 | 0.65 | 0.52–0.79 | 0.015 |
CSFQ-O: Orgasm | 0.55 | 0.38–0.8 | 0.002 | 0.302 | 0.77 | 0.66–0.89 | <0.001 |
STAXI-2 State Anger (S-Ang) | 1.22 | 1.00–1.48 | 0.050 | 0.271 | 0.67 | 0.53–0.8 | 0.010 |
STAXI-2 State Anger/Feeling | 1.99 | 1.18–3.35 | 0.010 | 0.179 | 0.77 | 0.66–0.88 | <0.001 |
STAXI-2 State Anger/Physical | 1.60 | 0.67–3.83 | 0.290 | 0.067 | 0.59 | 0.44–0.73 | 0.108 |
STAXI-2 State Anger/Verbal | 1.18 | 0.83–1.68 | 0.363 | 0.205 | 0.62 | 0.48–0.76 | 0.047 |
STAXI-2 Trait Anger (T-Ang) | 1.13 | 1.03–1.25 | 0.014 | 0.468 | 0.72 | 0.59–0.85 | 0.001 |
STAXI-2 Trait Anger/Temperament | 1.23 | 1.00–1.51 | 0.055 | 0.405 | 0.68 | 0.55–0.81 | 0.006 |
STAXI-2 Trait Anger/Reaction | 1.15 | 1.01–1.32 | 0.040 | 0.973 | 0.70 | 0.58–0.83 | 0.002 |
STAXI-2 Anger Expression—Out | 1.18 | 0.97–1.43 | 0.102 | 0.235 | 0.64 | 0.5–0.77 | 0.027 |
STAXI-2 Anger Expression—In | 1.12 | 0.96–1.30 | 0.157 | 0.422 | 0.64 | 0.51–0.78 | 0.023 |
STAXI-2 Anger Control—Out | 1.07 | 0.92–1.23 | 0.386 | 0.544 | 0.63 | 0.49–0.77 | 0.036 |
STAXI-2 Anger Control—In | 0.96 | 0.85–1.08 | 0.465 | 0.574 | 0.61 | 0.47–0.75 | 0.064 |
STAXI-2 IEI. Index Anger Expressed | 1.05 | 0.99–1.12 | 0.115 | 0.250 | 0.66 | 0.53–0.8 | 0.011 |
MQLI | 0.91 | 0.85–0.96 | 0.002 | 0.683 | 0.77 | 0.66–0.89 | <0.001 |
Cases | Controls |
---|---|
STAI Anxiety A—State: A-State | |
STAI Anxiety A–Trait: A-Trait | |
HADS—Anxiety: HADS-A | |
HADS—Depression: HADS-D | |
SF12PF: Physical Functioning (PF) | |
SF12RP: Role Physical (RP) | |
SF12BP: Bodily Pain (BP) | |
SF12GH: General Health (GH) | |
SF12V: Vitality (V) | |
SF12SF: Social Functioning (SF) | |
SF12RE: Role Emotional (RE) | |
CSFQ-T | |
CSFQ-P | |
CSFQ-D | |
CSFQ-A | |
CSFQ-O | |
STAXI-2 State Anger (S-Ang) | |
STAXI-2 State Anger/Feeling (S-Ang/F) | |
STAXI-2 State anger/Verbal (S-Ang/V) | |
STAXI-2 Trait Anger (T-Ang) | |
STAXI-2 Trait Anger/Temperament (T-Ang/T) | |
STAXI-2 Trait Anger/Reaction (T-Ang/R) | |
STAXI-2 Anger Expression—Out (AX-O) | |
STAXI-2 Anger Expression—In (AX-I) | |
STAXI-2 Anger Control—Out (AC-O) | |
STAXI-2 IEI: Index Anger Expressed | |
MQLI |
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Variables | Total n = 67 n (%)/x ± s | Cases n = 35 (52.2%) n (%)/x ± s | Controls n = 32 (47.8%) n (%)/x ± s |
---|---|---|---|
Gender: | |||
Male | 36 (53.7) | 22 (62.9) | 14 (43.8) |
Female | 31 (46.3) | 13 (37.1) | 18 (56.3) |
Age (years) | 52.2 ± 12.1 | 52.9 ± 12.7 | 51.4 ± 11.5 |
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Navarro-Sánchez, A.; Luri-Prieto, P.; Compañ-Rosique, A.; Navarro-Ortiz, R.; Berenguer-Soler, M.; Gil-Guillén, V.F.; Cortés-Castell, E.; Navarro-Cremades, F.; Gómez-Pérez, L.; Pérez-Tomás, C.; et al. Sexuality, Quality of Life, Anxiety, Depression, and Anger in Patients with Anal Fissure. A Case–Control Study. J. Clin. Med. 2021, 10, 4401. https://doi.org/10.3390/jcm10194401
Navarro-Sánchez A, Luri-Prieto P, Compañ-Rosique A, Navarro-Ortiz R, Berenguer-Soler M, Gil-Guillén VF, Cortés-Castell E, Navarro-Cremades F, Gómez-Pérez L, Pérez-Tomás C, et al. Sexuality, Quality of Life, Anxiety, Depression, and Anger in Patients with Anal Fissure. A Case–Control Study. Journal of Clinical Medicine. 2021; 10(19):4401. https://doi.org/10.3390/jcm10194401
Chicago/Turabian StyleNavarro-Sánchez, Antonio, Paloma Luri-Prieto, Antonio Compañ-Rosique, Ramón Navarro-Ortiz, María Berenguer-Soler, Vicente F. Gil-Guillén, Ernesto Cortés-Castell, Felipe Navarro-Cremades, Luis Gómez-Pérez, Carla Pérez-Tomás, and et al. 2021. "Sexuality, Quality of Life, Anxiety, Depression, and Anger in Patients with Anal Fissure. A Case–Control Study" Journal of Clinical Medicine 10, no. 19: 4401. https://doi.org/10.3390/jcm10194401
APA StyleNavarro-Sánchez, A., Luri-Prieto, P., Compañ-Rosique, A., Navarro-Ortiz, R., Berenguer-Soler, M., Gil-Guillén, V. F., Cortés-Castell, E., Navarro-Cremades, F., Gómez-Pérez, L., Pérez-Tomás, C., Palazón-Bru, A., Montejo, A. L., & Pérez-Jover, V. (2021). Sexuality, Quality of Life, Anxiety, Depression, and Anger in Patients with Anal Fissure. A Case–Control Study. Journal of Clinical Medicine, 10(19), 4401. https://doi.org/10.3390/jcm10194401