title: Pain catastrophizing in borderline morbidly obese and morbidly obese individuals with osteoarthritic knee pain.
abstract: OBJECTIVE
  There is limited information about how morbidly obese osteoarthritis (OA) patients cope with the pain they experience. Pain catastrophizing is an important predictor of pain and adjustment in persons with persistent pain. This may be particularly relevant in the morbidly obese (body mass index [BMI] of 40 kg/m(2) or greater) OA population at risk for increased pain. The present study first examined whether borderline morbidly obese and morbidly obese OA patients report higher levels of pain catastrophizing than a sample of OA patients in the overweight and obese category (BMI between 25 kg/m(2) and 34 kg/m(2)). Next, it examined how pain catastrophizing is related to important indexes of pain and adjustment in borderline morbidly obese and morbidly obese OA patients.
  
  
  METHODS
  Participants included 43 individuals with knee OA who were borderline morbidly obese or morbidly obese (BMI of 38 kg/m(2) or greater). Participants completed self-report measures of pain catastrophizing, pain, psychological distress, quality of life, binge eating and eating self-efficacy.
  
  
  RESULTS
  The sample of borderline morbidly obese and morbidly obese OA patients reported significantly higher levels of pain catastrophizing (P=0.007) than a comparison sample of overweight and obese OA patients. Results suggested that patients who engaged in a high level of pain catastrophizing reported having much more intense and unpleasant pain, higher levels of binge eating, lower self-efficacy for controlling their eating and lower weight-related quality of life (P<0.05 for all).
  
  
  CONCLUSIONS
  Pain catastrophizing is related to pain and adjustment in borderline morbidly obese and morbidly obese OA patients. Clinicians working with this population should consider assessing pain catastrophizing in the patients they treat.
authors.affiliation: Duke University Medical Center, Durham, NC 27708, USA.
authors.forename: T J
authors.initials: TJ
authors.lastname: Somers
authors.forename: F J
authors.initials: FJ
authors.lastname: Keefe
authors.forename: J W
authors.initials: JW
authors.lastname: Carson
authors.forename: J J
authors.initials: JJ
authors.lastname: Pells
authors.forename: L
authors.initials: L
authors.lastname: Lacaille
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D015992:Body Mass Index; D052018:Bulimia Nervosa / Q000150:complications / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000523:psychology*; D020370:Osteoarthritis, Knee / Q000150:complications / Q000523:psychology*; D010146:Pain / Q000209:etiology / Q000523:psychology*; D010147:Pain Measurement; D011581:Psychological Tests; D011788:Quality of Life; D020377:Self Efficacy; D013315:Stress, Psychological / Q000523:psychology; D011795:Surveys and Questionnaires