title: Simple pain measures reveal psycho-social pathology in patients with Crohn's disease.
abstract: OBJECTIVE
  To determine whether pain has psycho-social associations in adult Crohn's disease (CD) patients.
  
  
  METHODS
  Patients completed demographics, disease status, Patient Harvey-Bradshaw Index (P-HBI), Short Form Health Survey (SF-36), Short Inflammatory Bowel Disease Questionnaire (SIBDQ), and five socio-psychological questionnaires: Brief Symptom Inventory, Brief COPE Inventory, Family Assessment Device, Satisfaction with Life Scale, and Work Productivity and Activity Impairment Questionnaire. Pain sub-scales in P-HBI, SF-36 and SIBDQ measures were recoded into 4 identical scores for univariate and multinomial logistic regression analysis of associations with psycho-social variables.
  
  
  RESULTS
  The cohort comprised 594 patients, mean age 38.6 ± 14.8 years, women 52.5%, P-HBI 5.76 ± 5.15. P-HBI, SF-36 and SIBDQ broadly agreed in their assessment of pain intensity. More severe pain was significantly associated with female gender, low socio-economic status, unemployment, Israeli birth and smoking. Higher pain scores correlated positively with psychological stress, dysfunctional coping strategies, poor family relationships, absenteeism, presenteeism, productivity loss and activity impairment and all WPAI sub-scores. Patients exhibiting greater satisfaction with life had less pain. The regression showed increasing odds ratios for psychological stress (lowest 2.26, highest 12.17) and female gender (highest 3.19) with increasing pain. Internet-recruited patients were sicker and differed from hardcopy questionnaire patients in their associations with pain.
  
  
  CONCLUSIONS
  Pain measures in P-HBI, SF-36 and SIBDQ correlate with psycho-social pathology in CD. Physicians should be aware also of these relationships in approaching CD patients with pain.
authors.affiliation: Shmuel Odes, Terri Singer, Department of Gastroenterology, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba 84105, Israel.
authors.forename: Shmuel
authors.initials: S
authors.lastname: Odes
authors.affiliation: Shmuel Odes, Terri Singer, Department of Gastroenterology, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba 84105, Israel.
authors.forename: Michael
authors.initials: M
authors.lastname: Friger
authors.affiliation: Shmuel Odes, Terri Singer, Department of Gastroenterology, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba 84105, Israel.
authors.forename: Ruslan
authors.initials: R
authors.lastname: Sergienko
authors.affiliation: Shmuel Odes, Terri Singer, Department of Gastroenterology, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba 84105, Israel.
authors.forename: Doron
authors.initials: D
authors.lastname: Schwartz
authors.affiliation: Shmuel Odes, Terri Singer, Department of Gastroenterology, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba 84105, Israel.
authors.forename: Orly
authors.initials: O
authors.lastname: Sarid
authors.affiliation: Shmuel Odes, Terri Singer, Department of Gastroenterology, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba 84105, Israel.
authors.forename: Vered
authors.initials: V
authors.lastname: Slonim-Nevo
authors.affiliation: Shmuel Odes, Terri Singer, Department of Gastroenterology, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba 84105, Israel.
authors.forename: Terri
authors.initials: T
authors.lastname: Singer
authors.affiliation: Shmuel Odes, Terri Singer, Department of Gastroenterology, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba 84105, Israel.
authors.forename: Elena
authors.initials: E
authors.lastname: Chernin
authors.affiliation: Shmuel Odes, Terri Singer, Department of Gastroenterology, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba 84105, Israel.
authors.forename: Hillel
authors.initials: H
authors.lastname: Vardi
authors.affiliation: Shmuel Odes, Terri Singer, Department of Gastroenterology, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba 84105, Israel.
authors.forename: Dan
authors.initials: D
authors.lastname: Greenberg
authors.affiliation: Shmuel Odes, Terri Singer, Department of Gastroenterology, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba 84105, Israel.
authors.lastname: Israel Ibd Research Nucleus
mesh_terms: D000041:Absenteeism; D000223:Adaptation, Psychological; D000328:Adult; D003424:Crohn Disease / Q000150:complications / Q000523:psychology*; D003430:Cross-Sectional Studies; D004526:Efficiency; D005195:Family Relations; D005260:Female; D006801:Humans; D007557:Israel; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010146:Pain / Q000150:complications / Q000523:psychology*; D010147:Pain Measurement; D000069597:Presenteeism; D011788:Quality of Life; D012720:Severity of Illness Index; D012737:Sex Factors; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000209:etiology*; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Crohn’s disease; Pain; Psycho-social pathology