title: Mood and attitude predict pain outcomes following arthroscopic knee surgery.
abstract: BACKGROUND
  Decreased pain represents a clinically important outcome following arthroscopic knee surgery. However, little is known about preoperative mood and attitudinal factors and their potential relationship with pain outcomes.
  
  
  OBJECTIVE
  This prospective, longitudinal study investigated the influence of preoperative depression, stress, and optimism on pain severity and interference with functioning, controlling for relevant demographic and clinical factors 1 year postoperatively.
  
  
  METHODS
  Participants (N = 180, mean age = 48.2 years) completed scales assessing pain severity and interference both preoperatively and postoperatively. Demographics, depression, stress, optimism, and body mass index were assessed preoperatively. Physicians assessed extent of knee osteoarthritis during surgery.
  
  
  RESULTS
  Hierarchical regression analyses controlling for relevant demographic and clinical variables revealed that optimism and stress were significant predictors of pain severity at 1 year but not pain interference. Extent of osteoarthritis predicted pain interference.
  
  
  CONCLUSIONS
  These findings support that optimism and stress are important predictors of patient-rated pain severity. They do not, however, predict the extent to which pain interferes with daily functioning.
authors.affiliation: VA Connecticut Healthcare System, 950 Campbell Avenue, Psychology 116B, West Haven, CT 06516, USA. patricia.rosenberger@va.gov
authors.forename: Patricia H
authors.initials: PH
authors.lastname: Rosenberger
authors.forename: Robert
authors.initials: R
authors.lastname: Kerns
authors.forename: Peter
authors.initials: P
authors.lastname: Jokl
authors.forename: Jeannette R
authors.initials: JR
authors.lastname: Ickovics
mesh_terms: D000293:Adolescent; D000328:Adult; D000339:Affect; D000368:Aged; D001182:Arthroscopy / Q000009:adverse effects* / Q000523:psychology*; D001290:Attitude; D005260:Female; D006801:Humans; D007717:Knee / Q000601:surgery*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000150:complications / Q000523:psychology*; D011184:Postoperative Period; D011446:Prospective Studies; D013315:Stress, Psychological; D016896:Treatment Outcome