The complex interplay between pain intensity, depression, anxiety and catastrophising with respect to quality of life and disability.
OBJECTIVE
To identify subgroups of patients with chronic pain based on the occurrence of depression, anxiety and catastrophising and the duration of pain and pain intensity. In addition to this, the relationship between the subgroups with respect to background variables, diagnosis, pain-related disability and perceived quality of life are investigated.


METHODS
This study used 433 patients with chronic pain including 47 patients with spinal cord injury-related pain, 150 with chronic whiplash associated disorders and 236 with fibromyalgia. The participants answered a postal questionnaire that provided background data, pain intensity and duration and psychological and health-related items.


RESULTS
On the basis of depression, anxiety, catastrophising, pain intensity and duration, we identified subgroups of patients with chronic pain that differed with respect to perceived quality of life, disability and diagnosis. The psychological factors, especially depression, significantly influenced perceived quality of life and disability. Pain intensity and duration play a minor role with respect to quality of life, although pain intensity is associated to perceived disability.


CONCLUSIONS
The results of this study highlight the importance of not looking at patients with chronic pain as a homogenous entity. A detailed assessment, including psychological factors with emphasis on depressive symptoms, might be essential for planning and carrying through treatment and rehabilitation.
Rehabilitation Medicine, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping, Sweden. bjorn.borsbo@liu.se
Björn
B
Börsbo
Michael
M
Peolsson
Björn
B
Gerdle
D000328:Adult; D001007:Anxiety / Q000150:complications*; D002908:Chronic Disease / Q000523:psychology; D003863:Depression / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000145:classification / Q000523:psychology*; D010147:Pain Measurement; D011788:Quality of Life / Q000523:psychology*