Psychological status before and after surgery in patients with trigeminal neuralgia

•Most patients with trigeminal neuralgia still do not reach the significant level of clinically anxiety and depressiveness.•The risk of suicidal ideation in patients with atypical trigeminal neuralgia is higher than in typical and requires a more careful supervision.•The attitude to pain and some psychological features can influence the evaluation of the pain syndrome before and after surgical treatment.•The assessment of psychological status in patients with trigeminal neuralgia can objectify the pain scales, and clarify the indications for surgery.•After surgery due to changes in the social status, all patients need psychological help for social adaptation regardless of operation outcomes. To analyze the psychological status in patients with trigeminal neuralgia before surgery and in the early postoperative period after microvascular decompression of the trigeminal nerve. Psychological features of personality were studied in 56 patients aged from 28 to 80 years with trigeminal neuralgia. To study the psychological status, such scales as Hospital Anxiety and Depression Scale, Pain Catastrophizing Scale and Patient's Subjective Assessment of Treatment Effectiveness Scale (PSATES) were used with special attention paid to presence of suicidal thoughts. The signs of anxiety were clinically significant in 7%, absent - in 66 % of the patients. There were no signs of depression in 63 % of cases, while 7% of the patients suffered from clinically significant depression. Pain catastrophizing was observed in 76.8 % of patients. None of the patients rated the intervention as "excellent" on PSATES despite the complete pain relief in the majority of patients (78.6 %), and only 16.1 % of the patients rated it as "good". The aggravation factor had a significant influence on this evaluation (p = 0.01). General psychological status assessment can be used to objectify the indicators of the questionnaires and pain scales, as well as to determine the treatment tactics in this group, especially when it is necessary to clarify indications for an intervention and to decide on its proper time. Regardless of the outcome, the patients need time and psychological help for social adaptation due to changes in their social status.