title: Premorbid psychosocial factors are associated with poor health-related quality of life in subjects with new onset of chronic widespread pain - results from the EPIFUND study.
abstract: Chronic widespread pain (CWP) is associated with poor health-related quality of life (HRQoL). It is unclear whether pain itself is the cause of poor HRQoL or other factors play a role. We hypothesised that new onset of CWP was associated with poor physical and mental HRQoL but that psychosocial risk markers for CWP onset would explain this relationship. A prospective population-based survey measured pain and psychosocial status at baseline. Subjects free of CWP at baseline were followed up 15 months later, when pain status, threatening life events and HRQoL (SF-12) were assessed. The risk associated with the new onset of CWP and reporting poor SF12-MCS and SF12-PCS was quantified using multinomial logistic regression (relative risk ratios (RRRs) with 95% confidence intervals (95% CI)), adjusted for age and gender. 3000 subjects (77%) free of CWP at baseline participated at follow-up. 2650 subjects (88%) provided full SF-12 and pain data and formed the cohort for this analysis. 9.4% of subjects (n=248) reported new CWP. New CWP was associated with an increased risk of having the poorest SF12-MCS (RRR=2.3; 95% CI 1.6-3.2) and SF12-PCS (RRR=8.0; 95% CI 5.4-11.8) scores. After adjusting for baseline psychosocial status, the relationship between CWP onset and SF12-MCS was attenuated (RRR=1.2; 95% CI 0.8-1.8), although the association with SF12-PCS remained (RRR=4.8% CI 3.1-7.47). New onset of CWP is associated with poor mental and physical HRQoL. However, the relationship with mental HRQoL is explained by psychosocial risk markers.
authors.affiliation: Arthritis Research Campaign Epidemiology Unit, School of Translational Medicine, University of Manchester, Stopford Building, Oxford Road, Manchester M13 9PT, UK. Barbara.Nicholl@manchester.ac.uk
authors.forename: B I
authors.initials: BI
authors.lastname: Nicholl
authors.forename: G J
authors.initials: GJ
authors.lastname: Macfarlane
authors.forename: K A
authors.initials: KA
authors.lastname: Davies
authors.forename: R
authors.initials: R
authors.lastname: Morriss
authors.forename: C
authors.initials: C
authors.lastname: Dickens
authors.forename: J
authors.initials: J
authors.lastname: McBeth
mesh_terms: D000328:Adult; D002908:Chronic Disease; D018672:Community Health Planning; D005163:Factor Analysis, Statistical; D005260:Female; D005356:Fibromyalgia / Q000453:epidemiology / Q000523:psychology*; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000453:epidemiology / Q000523:psychology*; D010147:Pain Measurement; D017288:Pain Threshold; D011446:Prospective Studies; D011584:Psychology; D011594:Psychometrics; D011788:Quality of Life / Q000523:psychology*; D018434:Sickness Impact Profile; D012893:Sleep Wake Disorders; D013001:Somatoform Disorders / Q000150:complications / Q000523:psychology; D011795:Surveys and Questionnaires; D055815:Young Adult