Mental Distress and Chronic Pain

Abstract

Background and aims: We present preliminary findings from a quality assurance project at an outpatient pain clinic at the University Hospital of North Norway, identifying key factors associated with mental distress. Methods: Patients admitted 2010 - 2012 (n= 300) completed measures of pain (Numerical Rating Scale NRS), number of pain locations, sleep disturbance, mental distress (Hopkins Symptom Checklist HSCL-25), catastrophizing (Coping Strategies Questionnaire CSQ) and demographics. Results: Mean age was 45 (15-87), 59 % female, 70 % not working. Mean pain intensity 8.49 (SD = 5.89), 68% > 5 locations of pain, and 37% >10 years of pain. Mean HSCL was 1.99 (SD = 0.59), 62% > cut-off (1.75). 34% reported severe sleep problems. 47% reported that personal economy was inflicted by their health. The mean of the CSQ items was 3.8 (SD 1.4). In a stepwise regression analysis, mental distress was predicted by catastrophizing, sleep disturbance, personal economy inflicted by health, and number of pain locations (F (291) = 42.3, p=.000). The model explained 37% of the variance. Conclusion: Mental distress is frequent among patients with chronic pain, and associated with a range of psychosocial factors. The effect of pain intensity was mediated by the other factors in the regression model. The results support a multidisciplinary treatment of chronic pain, including an awareness of psychosocial issues.