Comorbidity between pain and mental illness – Evidence of a bidirectional relationship

Bondesson, Elisabeth; Pardo, Fabian Larrosa; Stigmar, Kjerstin; Ringqvist, Åsa; Petersson, Ingemar F; Jöud, Anna; Schelin, Maria E C

doi:10.1002/ejp.1218

Cited by 78 publications

(45 citation statements)

References 30 publications

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“…This work draws its relevance from the fact that chronic pain is a prominent health issue that reportedly affects up to one-fifth of the world's population 23 with a bidirectional influence of similar magnitude of pain and mental illness. 4 Bearing in mind that depression has been reported to be one of the leading contributors to the global disease burden 11 , 44 and contributes to pain deterioration, patients with a chronic pain condition clearly require special attention amid the expected psychological impact of the pandemic.…”

Section: Discussionmentioning

confidence: 99%

The early influence of COVID-19 pandemic-associated restrictions on pain, mood, and everyday life of patients with painful polyneuropathy

Kersebaum¹,

Fabig²,

Sendel³

et al. 2020

PR9

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Section: Discussionmentioning

confidence: 99%

The early influence of COVID-19 pandemic-associated restrictions on pain, mood, and everyday life of patients with painful polyneuropathy

Kersebaum¹,

Fabig²,

Sendel³

et al. 2020

PR9

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“…13 A likely mediator of greater pain severity resulting from high-stress situations is psychological distress, 14 which critically impacts on the perception of pain, physical disability 15 and overall quality of life. [16][17][18] For example, anxiety augments neural processes modulating the perception of pain. [19][20][21] In addition, the fear-avoidance model of chronic pain 22,23 points to the theoretical importance of pain-related fear and catastrophising as contributors to decreased mood and physical activity, which in turn exacerbate pain symptoms.…”

Section: Introductionmentioning

confidence: 99%

Adverse effects of COVID-19-related lockdown on pain, physical activity and psychological well-being in people with chronic pain

Fallon

Brown

Twiddy

et al. 2020

British Journal of Pain

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Countries across the world imposed lockdown restrictions during the COVID-19 pandemic. It has been proposed that lockdown conditions, including social and physical distancing measures, may disproportionately impact those living with chronic pain and require rapid adaptation to treatment and care strategies. Using an online methodology, we investigated how lockdown restrictions in the United Kingdom impacted individuals with chronic pain (N = 431) relative to a healthy control group (N = 88). Data were collected during the most stringent period of lockdown in the United Kingdom (mid-April to early-May 2020). In accordance with the fear-avoidance model, we hypothesised lockdown-related increases in pain and psychological distress, which would be mediated by levels of pain catastrophising. Responses indicated that people with chronic pain perceived increased pain severity, compared to their estimation of typical pain levels prior to lockdown (p < .001). They were also more adversely affected by lockdown conditions compared to pain-free individuals, demonstrating greater self-perceived increases in anxiety and depressed mood, increased loneliness and reduced levels of physical exercise (p ⩽ .001). Hierarchical regression analysis revealed that pain catastrophising was an important factor relating to the extent of self-perceived increases in pain severity during lockdown (β = .27, p < .001) and also mediated the relationship between decreased mood and pain. Perceived decreases in levels of physical exercise also related to perceptions of increased pain (β = .15, p < .001). Interestingly, levels of pain intensity (measured at two time points at pre and during lockdown) in a subgroup (N = 85) did not demonstrate a significant change. However, individuals in this subgroup still reported self-perceived pain increases during lockdown, which were also predicted by baseline levels of pain catastrophising. Overall, the findings indicate that people with chronic pain suffer adverse effects of lockdown including self-perceived increases in their pain. Remote pain management provision to target reduction of pain catastrophising and increase health behaviours including physical activity could be beneficial for this vulnerable population.

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“…Anxiety disorders can be: (a) psychological consequences of being ill and/or having continuous treatment, (b) direct metabolic/endocrine result of the specific physical illness, (c) present independently as the result of genetic factors, (d) present independently as the result of psychosocial factors (e) a special combination of the factors listed from (a)–(d) sub-points [13,14]. Anxiety can worsen physical illness directly by decreasing immune function and/or with an indirect mechanism by decreasing patient compliance [5,13,14]. …”

Section: Introductionmentioning

confidence: 99%

Comorbidity of Physical and Anxiety Symptoms in Adolescent: Functional Impairment, Self-Rated Health and Subjective Well-Being

Balázs

Miklósi

Keresztény

et al. 2018

IJERPH

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Physical disorders and anxiety are frequently comorbid. This study investigates the characteristics of physical disorders, self-rated heath, subjective well-being and anxiety in adolescents. Data were drawn from the Saving and Empowering Young Lives in Europe cohort study. From 11 countries 11,230 adolescents, aged 14–16 years were included. Zung Self-Rating Anxiety Scale (SAS), WHO-5 Well-Being Index and five questions prepared for this study to evaluate physical illnesses and self-rated heath were administered. Anxiety levels were significantly higher in adolescents who reported having physical disability (p < 0.001, Cohen’s d = 0.40), suffering from chronic illnesses (p < 0.001, Cohen’s d = 0.40), impairments associated to health conditions (p < 0.001, Cohen’s d = 0.61), or reported poor to very poor self-rated health (p < 0.001, Cohen’s d = 1.11). Mediational analyses revealed no direct effect of having a chronic illness/physical disability on subjective well-being, but the indirect effects through higher levels of anxiety were significant. Functional impairment related to health conditions was both directly and indirectly (through higher levels of anxiety) associated with lower well-being. The co-occurrence of anxiety and physical disorders may confer a greater level of disability and lower levels of subjective well-being. Clinicians have to screen anxiety, even in a subthreshold level in patients with choric physical illness or with medically unexplained physical symptoms.

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Comorbidity between pain and mental illness – Evidence of a bidirectional relationship

Cited by 78 publications

References 30 publications

The early influence of COVID-19 pandemic-associated restrictions on pain, mood, and everyday life of patients with painful polyneuropathy

The early influence of COVID-19 pandemic-associated restrictions on pain, mood, and everyday life of patients with painful polyneuropathy

Adverse effects of COVID-19-related lockdown on pain, physical activity and psychological well-being in people with chronic pain

Comorbidity of Physical and Anxiety Symptoms in Adolescent: Functional Impairment, Self-Rated Health and Subjective Well-Being

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