Preoperative anxiety among patients and its correlation with their personality type and pain: A cross-sectional study

doi:10.5498/wjp.v16.i1.112129

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Jan 19, 2026 (publication date) through Dec 31, 2025

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World Journal of Psychiatry

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2220-3206

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World J Psychiatry. Jan 19, 2026; 16(1): 112129
Published online Jan 19, 2026. doi: 10.5498/wjp.v16.i1.112129

Preoperative anxiety among patients and its correlation with their personality type and pain: A cross-sectional study

Nariman Salem, Abdul Hadi Moursel, Ali Zahweh, Dana Shhadi, Fedaa Saad, Mahdi Reda, Mariam Mghames, Rami Roumieh, Rawan Tfaily, Salim M Ramadan, Bahaa Bou Dargham, Omar Rajab, Fatima Akel

Nariman Salem, Department of Anesthesia, Beirut Arab University, Beirut 1100, Beyrouth, Lebanon

Abdul Hadi Moursel, Ali Zahweh, Dana Shhadi, Fedaa Saad, Mahdi Reda, Mariam Mghames, Rami Roumieh, Rawan Tfaily, Salim M Ramadan, Fatima Akel, Internal Medicine, Beirut Arab University, Beirut 1100, Beyrouth, Lebanon

Bahaa Bou Dargham, Department of Anesthesiology, Hammoud University Hospital, Beirut 1100, Beyrouth, Lebanon

Omar Rajab, Department of Anesthesiology, Makassed General Hospital, Beirut 1100, Beyrouth, Lebanon

Author contributions: Salem N conceptualized the study, designed the methodology, and supervised the overall project; Moursel AH contributed to data collection, literature review, and drafting of the introduction; Zahweh A participated in data acquisition, patient recruitment, and critical manuscript revision; Shhadi D assisted with survey distribution, data entry, and drafting the results; Saad F contributed to questionnaire translation, statistical assistance, and manuscript editing; Reda M was involved in data collection, table preparation, and proofreading; Mghames M contributed to data management, analysis support, and references formatting; Roumieh R participated in patient enrollment, quality control, and data verification; Tfaily R contributed to data entry, manuscript drafting, and formatting; Ramadan SM assisted with data interpretation and writing the discussion; Bou Dargham B contributed to study design, patient access, and critical revisions; Ramadan SM and Rajab O conducted manuscript reviews; Rajab O supported data collection and provided clinical insights; Akel F contributed to statistical analysis, visualization, and final manuscript approval; and all authors read and approved the final manuscript.

Institutional review board statement: This study was approved by the Medical Ethics Committee of Makassed General Hospital, approval No. 160724; and Hammoud University Medical Center, approval No. 010824.

Informed consent statement: Informed consent was obtained from all subjects involved in the study. Participation was voluntary, and anonymity and confidentiality were ensured.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.

Data sharing statement: The datasets generated and analyzed during the current study are available from the corresponding author on reasonable request.

Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/

Corresponding author: Nariman Salem, Assistant Professor, Department of Anesthesia, Beirut Arab University, Hamra St., Ghazal Bldg, 3^rd Floor, Beirut 1100, Beyrouth, Lebanon. n.salem@bau.edu.lb

Received: July 18, 2025
Revised: August 20, 2025
Accepted: October 23, 2025
Published online: January 19, 2026
Processing time: 166 Days and 4.1 Hours

Abstract

BACKGROUND

Preoperative anxiety is a significant concern for patients, as it affects surgical outcomes, satisfaction, and pain perception. Although both anxiety and pain are common in surgical settings, their relationship with personality traits has not been previously investigated in the Lebanese population.

AIM

To examine the prevalence of preoperative anxiety, pain perception, and personality traits among Lebanese surgical patients, and to assess the associations between these factors.

METHODS

A descriptive cross-sectional study was conducted between April 2024 and January 2025 across Lebanese hospitals. A total of 392 adult patients were recruited through convenience sampling. Data were collected using a questionnaire that included sociodemographic, clinical, and surgical variables, the Amsterdam Preoperative Anxiety and Information Scale for anxiety, the Visual Analog Scale and Numerical Pain Rating Scale for preoperative pain, and the Ten-Item Personality Inventory for personality traits. Ethical approval was obtained from the Institutional Review Boards of Makassed General Hospital and Hammoud University Medical Center.

RESULTS

Overall, 25% of participants experienced preoperative anxiety, and 34.5% reported moderate pain. Personality assessment showed that the majority of participants had moderate extraversion (84.1%), moderate emotional stability (65.1%), high conscientiousness (61%), high agreeableness (54.1%), and moderate openness (49.2%). High conscientiousness was significantly associated with higher pain perception (P < 0.05), while high emotional stability was associated with lower levels of anxiety (P < 0.05). No significant association was found between preoperative anxiety and pain (P > 0.05).

CONCLUSION

This study challenges the assumption that preoperative anxiety and pain are directly correlated and highlights the role of personality traits in shaping patient experience. These findings support the potential value of integrating psychological profiling into preoperative care and lay the groundwork for developing personalized interventions to improve patient-centered surgical outcomes.

Keywords: Preoperative anxiety; Pain perception; Personality traits; Conscientiousness; Emotional stability; Lebanese hospitals; Surgical patients; Personalized care strategies

Core Tip: This study is the first in Lebanon to explore the relationship between preoperative anxiety, pain perception, and personality traits in surgical patients. Among 392 participants, emotional stability was inversely associated with anxiety, while conscientiousness correlated with higher pain perception. Surprisingly, no significant link was found between anxiety and pain. These findings underscore the value of psychological profiling in preoperative care and suggest that tailoring interventions based on personality traits may enhance patient outcomes and satisfaction.