title: Family dysfunction: A comparison of chronic widespread pain and chronic localized pain.
abstract: Previous studies have shown differences in the psychosocial factors related to chronic localized pain (CLP) and chronic widespread pain (CWP). However, no studies have done an evaluation of differences between CLP and CWP from the viewpoint of family functioning. We did a cross-sectional study in a tertiary care setting to investigate possible differences in the relation of CWP and CLP to family functioning.Patients with CLP (N = 126) or CWP (N = 75) were assessed for family functioning by the Family Assessment Device (FAD) and a comparison was done. Logistic regression analysis was used to estimate associations of family functioning subscales with pain status (CWP vs CLP), controlling for demographic variables, pain variables; pain duration, pain ratings, pain disability, and psychological factors; depression, anxiety, and catastrophizing. The odds ratios (ORs) for the presence of CWP were calculated.Compared to patients with CLP, patients with CWP showed a lower functional status for Roles and Affective Involvement. The ORs for CWP were significantly higher in lower functioning Roles (OR: 2.38, 95% CI: 1.21-4.65) and Affective Involvement (OR: 2.86, 95% CI: 1.56-5.24) after adjusting for demographic variables. The significant association of CWP to Roles and Affective Involvement remained after controlling for the pain variables and psychological factors.This study shows that the families of patients with CWP have poorer family functioning than those with CLP. Our findings suggest that early identification and interventions for the family dysfunction of chronic pain patients are important to the treatment and prevention of CWP.
authors.affiliation: Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University Department of Psychosomatic Medicine, Kyushu University Hospital, Fukuoka, Japan.
authors.forename: Chie
authors.initials: C
authors.lastname: Hayaki
authors.forename: Kozo
authors.initials: K
authors.lastname: Anno
authors.forename: Mao
authors.initials: M
authors.lastname: Shibata
authors.forename: Rie
authors.initials: R
authors.lastname: Iwaki
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kawata
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Sudo
authors.forename: Masako
authors.initials: M
authors.lastname: Hosoi
mesh_terms: D000328:Adult; D059350:Chronic Pain / Q000453:epidemiology*; D005190:Family / Q000523:psychology*; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D017116:Low Back Pain / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011602:Psychophysiologic Disorders / Q000453:epidemiology; D011795:Surveys and Questionnaires