Determinants of health-related quality of life in patients with persistent somatoform pain disorder.
BACKGROUND
Health-related quality of life (HRQOL) has been investigated widely in patients with chronic pain, but no study has focused particularly on the situation of patients with persistent somatoform pain disorder.


OBJECTIVE
To survey the impairments of patients with somatoform pain disorder (ICD-10: F45.4) and to predict pain-related impairments and HRQOL on the basis of coping styles.


METHODS
A consecutively recruited sample of 100 patients (65% female) was examined in a cross-sectional study. Questionnaires were administered to assess pain intensity (visual analogue scale), pain-related disabilities (Pain Disability Index), quality of life (Short-Form Health Survey-36), and ways of coping with pain (Coping Strategies Questionnaire). To predict pain-related impairments and HRQOL, a multiple linear regression analysis was carried out.


RESULTS
HRQOL of patients with somatoform pain is strongly and significantly reduced compared with the general population. Among the coping measures, Increasing Pain Behaviors and Catastrophizing have a negative influence on patients' pain-related impairments and the physical components of HRQOL. The mental component of HRQOL was predicted solely by Catastrophizing. No positive effect of active coping styles on health-related outcome variables could be observed.


CONCLUSIONS
Patients with persistent somatoform pain disorder feel severely impaired. A clear pattern emerges for negative effects of the coping styles Increasing Pain Behaviors and Catastrophizing, while the identification of beneficial coping failed.
Petrak
Frank
F
Department for Psychosomatic Medicine and Psychotherapy, Johannes Gutenberg-University, Mainz, Germany. petrak@psychosomatik.klinik.uni-mainz.de
Hardt
Jochen
J
Kappis
Bernd
B
Nickel
Ralf
R
Tiber Egle
Ulrich
U
D000223:Adaptation, Psychological; D000328:Adult; D002908:Chronic Disease; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011237:Predictive Value of Tests; D011788:Quality of Life / Q000523:psychology*; D013001:Somatoform Disorders / Q000523:psychology*; D011795:Surveys and Questionnaires