Functional impairment, not pain, predicts anxiety and depression in Nigerian cancer patients: A cross-sectional study of nociceptive and neuropathic pain.

OBJECTIVES: To investigate the relationship between pain (including neuropathic pain [NP]), functional impairment, and anxiety/depression among Nigerian cancer patients. METHODS: This cross-sectional study enrolled 126 adult cancer patients at a Nigerian teaching hospital. Pain intensity, NP (painDETECT), functional impairment (Sheehan Disability Scale), and anxiety/depression (Hospital Anxiety and Depression Scale, HADS) were assessed. RESULTS: Prevalence rates were 37.3% for anxiety and 35.7% for depression. Pain was reported by 82% of patients (predominantly mild), while NP occurred in 23%. Bivariate and correlation analyses showed no significant association between pain (including NP) and anxiety/depression (p > 0.05). However, functional impairment was strongly correlated with both outcomes (HADS-A: r = 0.470; HADS-D: r = 0.675; p < 0.001). Multivariate regression identified functional impairment as the strongest independent predictor of anxiety (odds ratio [OR] = 7.537) and depression (OR = 8.625). Pain intensity and NP were not retained as significant predictors. SIGNIFICANCE OF RESULTS: Functional impairment, not pain nor NP, independently predicts anxiety and depression in Nigerian cancer patients. Routine functional screening may be more clinically useful than pain-focused assessments for identifying psychological distress in resource-limited oncology settings.