Examining the Complex Interplay of Pain Perception, Pain Anxiety, and Mental Health problems in Thalassemia Patients: A Mediational Analysis

Abstract

Background: Thalassemia is a heterogeneous genetic disorder globally that stems from diminished synthesis of alpha and beta chains of hemoglobin and results in accelerated destruction of red blood cells. This condition is linked to different mental health problems, including pain perception, mood, depression, and anxiety disorders, with pain being a predominant symptom. The present study aims to investigate the complex association among pain perception, perception of pain anxiety, depression disorder, anxiety disorder, and positive and negative affect in thalassemia patients. Moreover, it seeks to elucidate the possible mediating role of pain anxiety perception in the relationship between pain perception and depression disorder, anxiety disorder, and affective states in thalassemia patients.

Method: A purposive sampling technique and cross-sectional design were used in the present study. One hundred diagnosed thalassemia patients (males, n = 56, females, n = 44) whose ages ranged from 12 to 18 years were recruited from the thalassemia departments of the Jamila Sultana Foundation, the Federal Government Polyclinic (FGPC), and the Pakistan Thalassemia Welfare Society located in Rawalpindi and Islamabad in Pakistan from October 1, 2023, to January 1, 2024. Five standardized psychological instruments were employed to examine pain perception, pain anxiety, depression disorder, anxiety disorder, and positive and negative affect in thalassemia patients.

Results: The study's findings found that pain perception is significantly associated with pain anxiety, negative affect, depression, and anxiety disorders in thalassemia patients, while it is negatively correlated with positive affect. Gender differences exhibited that males display higher levels of negative affect as compared to females, with no significant differences in perceptions of pain anxiety, pain perception, positive affect, depression, or anxiety disorder. Moreover, pain anxiety acts as a mediator in the relationship between pain perception and depression disorder in patients with thalassemia.

Conclusions: This study suggests that the interplay between pain perception and pain anxiety significantly contributes to mental health problems in Pakistani thalassemia patients, specifically depression disorder. It highlights the importance of tailored psychosocial interventions developed collaboratively by researchers, healthcare providers, and mental health professionals to address mental health challenges and improve the overall quality of life for individuals with thalassemia.