title: Pain is independently associated with reduced health related quality of life in people with psychosis.
abstract: The objective was to investigate the relationship between pain and health related quality of life (HRQOL) in people with psychosis. The study utilised a cross-sectional design including individuals with established psychosis from five Mental Health Trusts across England. Participants were classified as having pain or not and HRQOL was determined with the EQ-5D-3L. Covariates considered include the Positive and Negative Syndrome Scale (PANSS), the Montgomery Asberg Depression Rating Scale (MADRS) and Global Assessment of Functioning (GAF). Hierarchical multiple linear regression analyses were conducted. The final sample included 438 individuals with psychosis (47.5 years, SD 10.1, 193 females (42.9%)). 160 participants reported pain (36.5%) and compared to the non-pain group (N=278) they had significantly higher depressive symptoms (MADRS 14.91 vs 8.68), total (51.8 vs 47.9) and general PANSS scores (26.8 vs. 23.5) and lower overall HRQOL (54.7 vs 68.3). The final regression analysis (n=387) demonstrated that lower levels of pain were a predictor of better HRQOL (β=.173) after adjusting for the PANSS, MADRS and GAF. Depressive symptoms were the largest predictor of HRQOL (β=-.486). Only 1-2% of the sample were in receipt of analgesic medication suggesting pain is greatly overlooked despite its wider deleterious impact on HRQOL.
authors.affiliation: Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, United Kingdom. Electronic address: brendonstubbs@hotmail.com.
authors.forename: Brendon
authors.initials: B
authors.lastname: Stubbs
authors.affiliation: Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.
authors.forename: Poonam
authors.initials: P
authors.lastname: Gardner-Sood
authors.affiliation: Institute of Psychiatry, Psychology and Neuroscience, King's College London and Consultant Psychiatrist, South London and Maudsley NHS Foundation Trust, London, United Kingdom.
authors.forename: Shubulade
authors.initials: S
authors.lastname: Smith
authors.affiliation: Institute of Psychiatry, Psychology and Neuroscience, King's College London and Consultant Liaison Psychiatrist at King's College Hospital NHS Foundation Trust, United Kingdom.
authors.forename: Khalida
authors.initials: K
authors.lastname: Ismail
authors.affiliation: School of Psychology, University of Sussex, Brighton and Early Intervention in Psychosis Service, Sussex Partnership NHS Foundation Trust, West Sussex, United Kingdom.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Greenwood
authors.affiliation: Centre for Primary Care and Public Health, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.
authors.forename: Anita
authors.initials: A
authors.lastname: Patel
authors.affiliation: Physiotherapy Department, South London and Maudsley NHS Foundatio n Trust, Denmark Hill, London, United Kingdom; School of Health and Social Work, University of Hertfordshire, College Lane, HATFIELD AL10 9AB, United Kingdom.
authors.forename: Ross
authors.initials: R
authors.lastname: Farmer
authors.affiliation: Physiotherapy Department, South London and Maudsley NHS Foundatio n Trust, Denmark Hill, London, United Kingdom; National Psychosis Service, South London and Maudsley NHS Foundation Trust, Senior Lecturer, Institute of Psychiatry, Psychology and Neuroscience and the Biomedical Research Centre, BRC Nucleus, Maudsley Hospital, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, United Kingdom.
authors.forename: Fiona
authors.initials: F
authors.lastname: Gaughran
mesh_terms: D000328:Adult; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology*; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000453:epidemiology*; D011618:Psychotic Disorders / Q000453:epidemiology*; D011788:Quality of Life / Q000523:psychology*
keywords: Pain; Physical health; Psychosis