Objective: Psychiatric backgrounds of mastalgia have been an intriguing subject for authors for many years. Anxiety disorders, especially generalized anxiety disorder, depressive disorders and somatization disorder have been commonly reported in women with mastalgia. It’s been shown that patients with poor response to treatment had more severe anxiety, depression and there is a powerful and significant relationship between the severity of mastalgia and severity of anxiety and depression. One of the major causes of disability in the patients with psychogenic chronic pain is exaggerated perception of pain due to anxiety. To be excessively afraid of pain may aggravate perception of pain and further lead to restriction of physical activities and increasing disability. Predispositions to anxiety differs largely among individuals. One of the important factors that explain these differences is personality. In this study, we planned to evaluate the personality features, anxiety and depression levels of the patients with mastalgia by comparing them to a healthy control group.
Method: Sixty premenopausal patients without an organic cause that explains mastalgia and 53 healthy premenopausal women, who were admitted to the Breast Diseases Polyclinic of our university have been included in the study. Both groups had been evaluated with Sociodemographic Data Form, Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), Cloninger’s Temperament and Character Inventory (TCI).
Results: Subjects were matched on age, education and marital status. Anxiety and depression scores in BAI and BDI were significantly higher in the mastalgia group (p<0.001). While harm avoidance, self-directedness and self-transcendence scores were significantly higher in the mastalgia group (all p<0.001); cooperativeness scores were significantly lower (p<0.001). We found correlations between anxiety scores and harm-avoidance (r=0.46, p<0.001), self-directedness (r=0.46, p<0.001), and self-transcendence scores (r=0.39, p<0.001); and also between depression scores and harm-avoidance (r=0.33, p<0.001), self-directedness (r=0.32, p<0.001), and self transcendence scores (r=0.30, p<0.001). Negative correlations were found between anxiety scores and cooperativeness (r=-0.46, p<0.001); and also between depression level and cooperativeness (r=-0.33, p<0.001).
Conclusion: Our study demonstrated that mastalgia is associated with personality features; it can lead to anxiety and depression, therefore psychiatric consultation is important in the patients with mastalgia.