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The complex interplay between pain intensity, depression, anxiety and catastrophizing with respect to quality of life and disability
Linköping University, Department of Clinical and Experimental Medicine, Rehabilitation Medicine . Linköping University, Faculty of Health Sciences.ORCID iD: 0000-0002-4385-428X
Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Rehabilitation Medicine .
Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Rehabilitation Medicine . Östergötlands Läns Landsting, Centre for Medicine, Pain and Rehabilitation Centre.
2009 (English)In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 31, no 19, 1605-1613 p.Article in journal (Refereed) Published
Abstract [en]

Purpose: To identify subgroups of chronic pain patients based on the occurrence of depression, anxiety, and catastrophizing and the duration of pain and pain intensity. In addition to this, to investigate the relationship between the subgroups with respect to background variables, diagnosis, pain-related disability, and perceived quality of life.

Methods: This study used 433 chronic pain patients including 47 patients with spinal cord injury related pain, 150 with chronic whiplash associated disorders, and 236 with fibromyalgia. The participants answered a postal questionnaire that provided background data, pain intensity and duration and psychological and health related items.

Results: Based on depression, anxiety, catastrophizing, pain intensity and duration, we identified subgroups of chronic pain patients that differed with respect to perceived quality of life, disability and diagnosis. The psychological factors, especially depression, significantly influenced perceived quality of life and disability. Pain intensity and duration play a minor role with respect to quality of life although pain intensity is associated contributes more to perceived disability.

Conclusions: The results of this study highlight the importance of not looking at chronic pain patients as a homogenous entity. A detailed assessment, including psychological factors with emphasis on depressive symptoms, might be essential for planning and carrying through treatment and rehabilitation.

Place, publisher, year, edition, pages
2009. Vol. 31, no 19, 1605-1613 p.
Keyword [en]
Chronic pain, catastrophizing, depression, anxiety, quality of life, disability
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-15689DOI: 10.1080/09638280903110079OAI: oai:DiVA.org:liu-15689DiVA: diva2:126946
Available from: 2008-12-04 Created: 2008-11-26 Last updated: 2013-09-03Bibliographically approved
In thesis
1. Relationships between Psychological Factors, Disability, Quality of Life and Health in Chronic Pain Disorders
Open this publication in new window or tab >>Relationships between Psychological Factors, Disability, Quality of Life and Health in Chronic Pain Disorders
2008 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Chronic pain is a very common condition with a prevalence of 40-65% in the community. The high prevalence of chronic pain causes a lot of human suffering but also high societal costs. The development and maintenance of chronic pain constitutes a complex interplay between neurobiological, psychosocial and genetic factors. A biopsychosocial model of chronic pain has been suggested to make a comprehensive context of the understanding of this issue.

The main aims of this thesis were to analyze the relationships of the different components of the biopsychosocial model of pain and to study the relative importance of pain, stress and different psychological factors on disability and health related quality of life.

The thesis is based on two groups of patients. One group consists of 275 patients with chronic Whiplash Associated Disorder (WAD) and one group comprise 433 patients with WAD, fibromyalgia (FM) and patients with chronic pain related to Spinal Cord Injury (SCI). The patients were investigated by questionnaires assessing different aspects of pain, depression, anxiety, catastrophizing, self-efficacy, disability and Health Related Quality of Life (HRQL).

The main results were that psychological factors (especially depression) correlated relatively strongly with perceived HRQL and disability. The degree of depression appeared to have the most important relationship to perceived HRQL. Despite the fact that the patients rated depression just mild or moderate, depression had a great importance for the outcome of HQRL and disability. Pain intensity and duration played, in the cross-sectional perspective, a minor role for perceived HRQL, whereas pain intensity related more to the outcome of perceived disability.

From a clinical point of view it is important to assess the complex and unique situation of each individual with respect to depression, anxiety, self-efficacy and pain when planning treatment and rehabilitation in order to optimise the outcome of such programmes.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2008. 75 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1079
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-15691 (URN)978-91-7393-797-9 (ISBN)
Public defence
2008-12-12, Originalet, Qulturumhuset, Länssjukhuset Ryhov, Jönköping, Sverige, Jönköping, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2008-11-26 Created: 2008-11-26 Last updated: 2013-09-03Bibliographically approved

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Börsbo, BjörnPeolsson, MichaelGerdle, Björn

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