Psychological Distress in Out-Patients Assessed for Chronic Pain Compared to Those with Rheumatoid Arthritis

Abstract

Background. Patients diagnosed with chronic pain (CP) and rheumatoid arthritis (RA) represent two samples with overlapping symptoms, such as experiencing significant pain. Objectives. To compare the level of psychological distress among patients diagnosed CP attending a specialist pain clinic with those attending a specialist RA clinic. Measures. A cross-sectional study was conducted at an academic specialist chronic pain and rheumatology clinic. Participants. 330 participants included a CP group (n = 167) and a RA group (n = 163) completed a booklet of questionnaires regarding demographic characteristics, duration, and severity of their pain. Psychological and personality variables were compared between the CP and RA participants using a Multivariate Analysis of Covariance (MANCOVA). Results. Level of psychological distress based on the subscales of the DASS (depression, anxiety, and stress), PASS (escape avoidance, cognitive anxiety, fear of pain, and physiological anxiety), and PCS (rumination, magnification, and helplessness) was significantly higher in the CP group compared to the RA group. Categorization of individuals based on DASS severity resulted in significant differences in rates of depression and anxiety symptoms between groups, with a greater number of CP participants displaying more severe depressive and anxiety symptoms. Discussion and Conclusions. This study found greater levels of psychological distress among CP individuals referred to an academic pain clinic when compared to RA patients referred to an academic rheumatology clinic.

An interesting case of systemic lupus erythematosus in a patient with Moebius syndrome

“…Some studies have described changes in the incidence of oral diseases in MS patients, as is the case of the study by Castro et al. , who found that these patients are more likely to experience more caries compared to nonsyndromic, normoreactive individuals . Moreover, a study by Mussi et al.…”

“…Some studies have sought to relate MS to the autism spectrum disorder, whereas others have raised the possibility that social stigmatization, constant teasing, and bullying perpetrated by people in the same social circle, leading the own patient to become isolated, may work as adjuvants in the development of low selfesteem, behavioral problems, and psychiatric disorders. 15,16 The literature reports that psychological stress, anxiety, and depression are factors contributing to the development and impairment in autoimmune diseases. 16,17 Systemic lupus erythematosus (SLE) is an autoimmune disease with higher prevalence in adult women.…”

“…15,16 The literature reports that psychological stress, anxiety, and depression are factors contributing to the development and impairment in autoimmune diseases. 16,17 Systemic lupus erythematosus (SLE) is an autoimmune disease with higher prevalence in adult women. Its etiology is not fully understood, but it is believed that genetic, epigenetic, and environmental factors may play a role in its development.…”

“…Some studies have sought to relate MS to the autism spectrum disorder, whereas others have raised the possibility that social stigmatization, constant teasing, and bullying perpetrated by people in the same social circle, leading the own patient to become isolated, may work as adjuvants in the development of low self‐esteem, behavioral problems, and psychiatric disorders …”

“…The literature reports that psychological stress, anxiety, and depression are factors contributing to the development and impairment in autoimmune diseases . Systemic lupus erythematosus (SLE) is an autoimmune disease with higher prevalence in adult women.…”