title: Cognitive complaints are associated with depression, fatigue, female sex, and pain catastrophizing in patients with chronic pain.
abstract: OBJECTIVE
  To examine the relation between demographic, pain-related, psychosocial, affective, and treatment factors and complaints of cognitive dysfunction among patients with chronic pain.
  
  
  METHODS
  Cross-sectional survey.
  
  
  METHODS
  A university hospital outpatient multidisciplinary chronic pain program.
  
  
  METHODS
  Chronic pain patients (N=222; 135 women, 87 men) completed a battery of psychometric questionnaires as part of an initial evaluation on referral to the program.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Cognitive impairment was assessed with items from the Brief Symptom Inventory; measures of depressive symptoms, pain intensity, posttraumatic stress disorder (PTSD), and pain catastrophizing were obtained from the Beck Depression Inventory (negative affect, negative self, somatic/physical function), McGill Pain Questionnaire, Modified Posttraumatic Chronic Pain Test, and Coping Strategies Questionnaire, respectively; and measures of subjective sleep disturbance, fatigue, opiate use, compensation/litigation status, pain location, and relevant demographic data were obtained from an open-ended questionnaire.
  
  
  RESULTS
  Correlational analysis indicated that female sex, pain intensity, PTSD symptoms, depressive symptoms, catastrophizing, pain location (neck), and fatigue were all positively related to cognitive complaints. Simultaneous regression analysis showed that all factors combined accounted for 52% of the variance in self-report of cognitive difficulties and that 6 variables had a significant unique contribution to the report of cognitive complaints in the following order of importance: depression-negative affect (beta=.28, P <.05), fatigue (beta=.17, P <.05), depression-somatic/physical function (beta=.16, P <.05), depression-negative self (beta=.14, P =.05), pain catastrophizing (beta=.12, P =.08), and female sex (beta=.12, P <.05).
  
  
  CONCLUSIONS
  Complaints of cognitive impairment among chronic pain patients appear to be associated with multiple factors, with particular attention to depressive symptoms, fatigue, and catastrophizing. Our results also suggest that women with chronic pain are particularly vulnerable to cognitive dysfunction.
authors.affiliation: Department of Physicsal Medicine and Rehabilitation, University of Michigan Health System, Ann Arbor, MI 48109, USA. randyr@umich.edu
authors.forename: Randy S
authors.initials: RS
authors.lastname: Roth
authors.forename: Michael E
authors.initials: ME
authors.lastname: Geisser
authors.forename: Mary
authors.initials: M
authors.lastname: Theisen-Goodvich
authors.forename: Pamela J
authors.initials: PJ
authors.lastname: Dixon
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D002908:Chronic Disease; D003072:Cognition Disorders / Q000523:psychology*; D003430:Cross-Sectional Studies; D003863:Depression / Q000523:psychology; D005221:Fatigue / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D010146:Pain / Q000523:psychology*; D012044:Regression Analysis; D012737:Sex Factors; D012803:Sick Role; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology; D011795:Surveys and Questionnaires