Öndeş B, Gökdere OG, Uğur K, Kanat BH. Psychological burden of hemorrhoidal disease: Association with depression, anxiety, and quality of life impairment. World J Psychiatry 2026; 16(7): 120390 [DOI: 10.5498/wjp.120390]
Corresponding Author of This Article
Burhan H Kanat, MD, Associate Professor, Department of General Surgery, Malatya Turgut Özal University, Battalgazi, Malatya 44090, Türkiye. burhankanat@hotmail.com
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Gastroenterology & Hepatology
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research-article
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Öndeş B, Gökdere OG, Uğur K, Kanat BH. Psychological burden of hemorrhoidal disease: Association with depression, anxiety, and quality of life impairment. World J Psychiatry 2026; 16(7): 120390 [DOI: 10.5498/wjp.120390]
World J Psychiatry. Jul 19, 2026; 16(7): 120390 Published online Jul 19, 2026. doi: 10.5498/wjp.120390
Psychological burden of hemorrhoidal disease: Association with depression, anxiety, and quality of life impairment
Bahadır Öndeş, Osman G Gökdere, Kerim Uğur, Burhan H Kanat
Bahadır Öndeş, Osman G Gökdere, Burhan H Kanat, Department of General Surgery, Malatya Turgut Özal University, Malatya 44090, Türkiye
Kerim Uğur, Department of Psychiatry, Malatya Turgut Özal University, Malatya 44090, Türkiye
Author contributions: Kanat BH and Öndeş B designed the research study and performed the statistical analyses; Öndeş B and Gökdere OG collected the data; Uğur K performed the psychiatric evaluations; Öndeş B drafted the manuscript; Kanat BH critically revised the manuscript for important intellectual content; all authors read and approved the final manuscript.
AI contribution statement: AI tools were used only for limited editorial support to improve spelling, grammar, and readability. AI tools were not involved in the design of the study, the interpretation of the data, or the generation of scientific conclusions, none of the images or figures in the article were generated using AI.
Institutional review board statement: The study was reviewed and approved by the Clinical Research Ethics Committee of Malatya Turgut Özal University (Approval No. E-30785963-020-295980).
Informed consent statement: Written informed consent was obtained from all participants prior to inclusion in the study.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
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 anonymized dataset used during the current study is available from the corresponding author on reasonable request.
Corresponding author: Burhan H Kanat, MD, Associate Professor, Department of General Surgery, Malatya Turgut Özal University, Battalgazi, Malatya 44090, Türkiye. burhankanat@hotmail.com
Received: February 26, 2026 Revised: March 15, 2026 Accepted: March 30, 2026 Published online: July 19, 2026 Processing time: 121 Days and 2.9 Hours
Abstract
BACKGROUND
Hemorrhoidal disease (HD) is one of the most common benign anorectal conditions worldwide. It is typically diagnosed by physical symptoms such as pain, bleeding, pruritus, and discomfort; however, its psychological and psychosocial impact is not well understood. Chronic anorectal symptoms often cause psychological distress driven by pain-related anxiety, embarrassment, and social withdrawal. While psychological comorbidities are well-documented in other gastrointestinal conditions, there is limited evidence directly investigating the impact of depression, anxiety, and quality of life (QoL) in patients with HD.
AIM
To investigate the association between HD and depression, anxiety, and QoL.
METHODS
This cross-sectional case-control study included 74 patients with grade I-II HD and 74 age- and sex-matched healthy controls at Malatya Training and Research Hospital. Participants completed the Beck Depression Inventory, Beck Anxiety Inventory, and World Health Organization Quality of Life Instrument-Short Form questionnaire. Group comparisons were performed using parametric or non-parametric tests as appropriate. Spearman correlation and path analysis were used to evaluate the associations between HD and psychological outcomes.
RESULTS
Patients with HD demonstrated significantly higher depression (11.92 ± 10.48 vs 5.54 ± 4.16) and anxiety (11.76 ± 10.13 vs 6.77 ± 5.07) scores compared with healthy controls (P < 0.001 for both). QoL analysis revealed significantly lower scores in the general health, physical, and social domains (P < 0.05). No significant differences were observed in the psychological or environmental domains. Correlation analysis demonstrated that HD had a low-to-moderate positive correlation with anxiety and depression, while inversely correlating with specific aspects of QoL. Path analysis confirmed significant direct effects of HD on depression, anxiety, and several QoL domains.
CONCLUSION
HD is associated with increased depression and anxiety and reduced QoL, highlighting the importance of psychosocial assessment in clinical management.
Core Tip: Hemorrhoidal disease (HD) is commonly evaluated based on physical symptoms, whereas its psychological burden remains underrecognized. In this cross-sectional case-control study, patients with early-stage HD exhibited significantly higher depression and anxiety scores, assessed using the Beck Depression Inventory and Beck Anxiety Inventory, along with reduced quality of life as measured by the World Health Organization Quality of Life Instrument-Short Form, compared with healthy controls. Path analysis demonstrated significant associations between HD status and adverse psychosocial outcomes, supporting the integration of mental health screening into routine colorectal care.
