Pain, catastrophizing, and depression in the rheumatic diseases

Robert R. Edwards, Christine Calahan, George Mensing, Michael T Smith, Jennifer Haythornthwaite

Research output: Contribution to journalArticle

Abstract

Persistent and disabling pain is the hallmark of osteoarthritis, rheumatoid arthritis, fibromyalgia, and various other rheumatologic conditions. However, disease severity (as measured by 'objective' indices such as those that employ radiography or serology) is only marginally related to patients' reports of pain severity, and pain-related presentation can differ widely between individuals with ostensibly similar conditions (for example, grade 4 osteoarthritis of the knee). Increasing evidence in support of the biopsychosocial model of pain suggests that cognitive and emotional processes are crucial contributors to inter-individual differences in the perception and impact of pain. This Review describes the growing body of literature relating depression and catastrophizing to the experience of pain and pain-related sequelae across a number of rheumatic diseases. Depression and catastrophizing are consistently associated with the reported severity of pain, sensitivity to pain, physical disability, poor treatment outcomes, and inflammatory disease activity, and potentially with early mortality. A variety of pathways, from cognitive to behavioral to neurophysiological, seem to mediate these deleterious effects. Collectively, depression and catastrophizing are critically important variables in understanding the experience of pain in patients with rheumatologic disorders. Pain, depression, and catastrophizing might all be uniquely important therapeutic targets in the multimodal management of a range of such conditions.

Original languageEnglish (US)
Pages (from-to)216-224
Number of pages9
JournalNature Reviews Rheumatology
Volume7
Issue number4
DOIs
StatePublished - Apr 2011

Fingerprint

Catastrophization
Rheumatic Diseases
Depression
Pain
Pain Perception
Fibromyalgia
Knee Osteoarthritis
Serology
Individuality
Radiography
Osteoarthritis
Rheumatoid Arthritis

ASJC Scopus subject areas

  • Rheumatology

Cite this

Pain, catastrophizing, and depression in the rheumatic diseases. / Edwards, Robert R.; Calahan, Christine; Mensing, George; Smith, Michael T; Haythornthwaite, Jennifer.

In: Nature Reviews Rheumatology, Vol. 7, No. 4, 04.2011, p. 216-224.

Research output: Contribution to journalArticle

Edwards, Robert R. ; Calahan, Christine ; Mensing, George ; Smith, Michael T ; Haythornthwaite, Jennifer. / Pain, catastrophizing, and depression in the rheumatic diseases. In: Nature Reviews Rheumatology. 2011 ; Vol. 7, No. 4. pp. 216-224.
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