Depression, Catastrophic Thinking Influence Pain

AUSTIN, Texas  — Clinicians should consider the total patient – including psychosocial variables – to best treat patients with chronic pain, according to the results of a study presented at the American Pain Society 2016 Meeting.

Jacob Baxter, of the University of Alabama, Tuscaloosa, Al. and colleagues examined data on 300 patients with chronic pain who were treated at low-income clinics in Alabama.. Most of the patients have very low income and more than half of the sample are African American.

The researchers looked at a variety of surrounding circumstances around the patients, including economic and educational issues like grade level reached in school, and psychosocial issues, including depression and pain catastrophizing.

The researchers concluded that psychosocial variables played a strong role in predicting those patients at risk for chronic pain.

 “Pain catastrophizing was a significant predictor of pain intensity (β = .386, p < .001) and pain interference (β = .336, p < .001); and depressive symptoms (β = -.415, p < .001) was a significant predictor for perceived disability based on physical functioning,” the researchers noted in the study abstract.

One of the authors on the paper, Beverly Thorn, PhD, explained in an interview with Clinical Pain Advisor that these data are important, because “patients with low SES and ethnic minorities have a larger disease burden across the board, including chronic pain, and they have less access to treatment.”

She said the take home message for clinicians is: “one might think that socio-economic factors might predict pain (and disability and pain interference) in these patients. But, similar to research with other populations, once again we see that depression and catastrophic thinking (psychological variables ) are the strongest predictors. This does not mean the pain is not real – it means that psychological treatments (such as cognitive behavioral therapy) must be part of the treatment package to help relieve the pain and disability these patients suffer from.”

Reference

Baxter J, Newman A, Torres C, Ever J, Thorn B. The role of psychosocial factors in the pain experience: the relationship between depression, catastrophizing and chronic pain. Abstract 492. Presented at: APS 2016. May 11-14, 2016; Austin, Tx.