The Relations among Pain, Emotional and Cognitive-behavioral Factors in Chronic Musculoskeletal Pain Patients

만성 근골격계 통증 환자에서 통증과 정서 및 인지-행동 요인과의 관계

Lim, Kil-Byung;Kim, Ji-Yeong;Lee, Hong-Jae;Kim, Dug-Young;Kim, Jung-Min
임길병;김지영;이홍재;김덕영;김정민

  • Published : 20080000

Abstract

Objective: To investigate the relations among pain, emotional factors and cognitive-behavioral factors in chronic musculoskeletal pain patients. Method: This study was designed as a questionnaire survey. 73 patients who visited our outpatient clinics due to chronic musculoskeletal pain were evaluated. They checked visual analogue scale (VAS), pain site and frequency. Beck depression inventory (BDI) and state-trait anxiety index (STAI) were checked for evaluation of emotional factors. Somatization scale of symptom checklist-revised (SCL-R- 90) and pain catastrophizing scale (PCS) were checked for cognitive-behavioral factors. Correlations among each variable were evaluated by statistical analysis. Results: VAS was correlated with pain frequency (r=0.538, p<0.01), somatization and catastrophizing thought. Rumination thought was correlated with VAS (r=0.443, p<0.01), pain frequency (r=0.446, p<0.01) and static anxiety (r= 0.449, p<0.01). Magnification thought was correlated with depression (r=0.403, p<0.01) and static anxiety (r=0.447, p<0.01). Helpless thought was correlated with VAS (r= 0.442, p<0.01), pain frequency (r=0.429, p<0.01), depression (r=0.510, p<0.01), static anxiety (r=0.640, p<0.01) and somatization (r=0.504, p<0.01). Duration was not correlated with VAS, depression, anxiety, somatization and catastrophizing thought in chronic musculoskeletal pain patients (p>0.05). Conclusion: Cognitive-behavioral factors such as catastrophizing thought are strongly correlated with both pain aspects and emotional factors. Consideration of cognitive- behavioral factors as well as emotional factors may be important for management of chronic musculoskeletal pain. (J Korean Acad Rehab Med 2008; 32: 424-429)

Keywords

References

  1. Harter M, Reuter K, Weisser B, Schretzmann B, Aschenbrenner A, Bengel J. A descriptive study of psychiatric disorders and psychosocial burden in rehabilitation patients with musculoskeletal diseases. Arch Phy Med Rehab 2002; 83: 461-468 https://doi.org/10.1053/apmr.2002.30924
  2. Kang YK. Evaluation and management of chronic pain. J Korean Acad Fam Med 2003; 24: 103-111
  3. Shin YK, Lee CU. Depressive disorder in patients with chronic pain. Korean J Pain 2002; 15: 110-115
  4. Pattern SB, Williams JV, Wang J. Mental disorders in a population sample with musculoskeletal disorders. BMC Musculoskelet Disord 2006; 25: 7-37 https://doi.org/10.1186/1471-2474-7-7
  5. Koleck M, Mazaux JM, Rascle N, Bruchon-Schweitzer M. Psycho-social factors and coping strategies as predictors of chronic evolution and quality of life in patients with low back pain: a prospective study. Eur J Pain 2006; 10: 1-11 https://doi.org/10.1016/j.ejpain.2005.01.003
  6. Hart RP, Martelli MF, Zasler ND. Chronic pain and neuropsychological functioning. Neuropsychol Rev 2000; 10: 131-149 https://doi.org/10.1023/A:1009020914358
  7. Turner JA, Jensen MP, Romano JM. Do beliefs, coping and catastrophizing independently predict functioning in patients with chronic pain? Pain 2000; 85: 115-125 https://doi.org/10.1016/S0304-3959(99)00259-6
  8. Kim JK. A gestalt therapy approach to anxiety disorders integrating mindfulness meditation and cognitive behavioral therapy. Korean J Clin Psychol 2003; 22: 475-503
  9. Roth RS, Geisser ME, Theisen-Goodvich M, Dixon PJ. Cognitive complaints are associated with depression, fatigue, female sex, and pain catastrophizing in patients with chronic pain. Arch Phy Med Rehab 2005; 86: 1147-1154 https://doi.org/10.1016/j.apmr.2004.10.041
  10. Burton AK, Tillotson KM, Main CJ, Hollis S. Psychosocial predictors of outcome in acute and subchronic low back trouble. Spine 1995; 20: 722-728 https://doi.org/10.1097/00007632-199503150-00014
  11. Linton SJ, Buer N, Vlaeyen J, Hellsing AL. Are fearavoidance beliefs related to the inception of an episode of back pain?: a prospective study. Psychol Health 2000; 14: 1051-1059 https://doi.org/10.1080/08870440008407366
  12. Jensen MP, Turner JA, Romano JM. Correlates of improvement in multidisciplinary treatment of chronic pain. J Consult Clin Psychol 1994; 62: 172-179 https://doi.org/10.1037/0022-006X.62.1.172
  13. Rusu AC, Hasenbring M. Multidimensional pain inventory derived classifications of chronic pain: evidence for maladaptive pain-related coping within the dysfunctional group. Pain 2008; 134: 80-90 https://doi.org/10.1016/j.pain.2007.03.031
  14. Kim SJ, Kim WS, Kang YK, Lee SH, Cho SH. Influencing psychologic factors and stress in patients with chronic pain. J Korean Acad Rehab Med 2000; 24: 1161-1167
  15. Kim DH, Kim TH, Kim JL, Lee H, Kim SA, Oh KY. Screening test for depression using the SF-36 health survey in patients with chronic musculoskeletal pain. J Korean Acad Rehab Med 2007; 31: 434-439
  16. Seok H, Son BK, Ha YR, Ryu HH, Moon JH. Clinical influence of emotional depression on chronic low back pain. J Korean Acad Rehab Med 2003; 27: 568-574
  17. Sohn MK, Chae JM, Yune SH. Pain and psychometric characteristics related to disability evaluation in patients with chronic low back pain. J Korean Acad Rehab Med 2000; 24: 125-131
  18. Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry 1961; 4: 561-571 https://doi.org/10.1001/archpsyc.1961.01710120031004
  19. Han HM, Yum TH, Shin YW, Kim KH, Yoon DJ, Jung GJ. A standardization study of beck depression inventory in Korea. J Korean Neuropsychiatr Assoc 1986; 25: 487-500
  20. Kim JT, Shin DK. A study based on the standardization of the STAI for Korea. New Med J 1978; 21: 1223-1229
  21. Derogatis LR, Cleary PA. Factorial invariance across gender for the primary symptom dimension of the SCL-90. Br J Clin Psychology 1977; 16: 347-356 https://doi.org/10.1111/j.2044-8260.1977.tb00241.x
  22. Kim KI, Won HT, Lee JH, Kim KY. Standardization Study of Symptom Check List-90 in Korea I: Characteristics of normal responses. J Korean Neuropsychiatr Assoc 1978; 17: 449-458
  23. Sullivan MJL, Bishop SR, Pivik J. The pain catastrophizing scale: development and validation. Psychol Assess 1995; 7: 524-532 https://doi.org/10.1037/1040-3590.7.4.524