Background & Aims

Chronic pain are a global challenge to public health, affecting millions worldwide. Its persistence results in functional impairment and is also the primary reason for seeking medical assistance. These challenges extend beyond the physical, impacting emotional well-being and mood, leading to episodes of anxiety and/or depression. These exacerbate chronic pain and also complicate its treatment. Studies about resilience, the ability to face adversity, suggest that resilience, as well happiness, play a protective role in mental health during challenges, regardless of chronic pain. Additionally, resilience influences the capacity to manage pain, maintaining a healthy lifestyle, reducing the severity of pain, and mitigating its psychological and social effects, such as depression and isolation. This study explore the link between resilience, catastrophizing, and mood changes in chronic pain patients, aiming to improve management with more targeted and effective therapeutic approaches.

Methods

An exploratory study was conducted with 19 patients experiencing chronic pain of various etiologies who were first attended by the Pain Group at the Institute of Orthopedics and Traumatology of HCFMUSP between November 1st and December 15th, 2023. Participants underwent assessments covering sociodemographic variables, pain-related factors (Visual Analogue Scale – VAS and time living with pain), utilizing the Hospital Anxiety and Depression Scale (HAD), Connor-Davidson Resilience Scale, and Pain Catastrophizing Scale (B-PCS). The correlation between variable groups was examined using the Statistical Package for the Social Sciences (SPSS), employing the Pearson test to assess correlations between variables and the ANOVA test to identify variations in group means. This process allowed for the calculation of frequencies for each response, contributing to a comprehensive analysis of the relationships between the studied variables.

Results

The sample consisted of 19 individuals, with 84.2% females, with an average age of 51.58 years. The VAS average score was 8.42, and participants had been living with pain for an average of 102.06 months. Regarding mood, 21.1% exhibited traits of anxiety, 42.1% of depression, and 47.4% had a mixed mood. The Pearson test shows a moderate perfect negative correlation was observed between anxiety and resilience (p=-0.319), indicating that as anxiety increases, resilience decreases. Additionally, a moderate perfect positive correlation was observed between anxiety and depression (p=0.620) and between anxiety and catastrophizing (p=0.333), signifying that an increase in one of these variables corresponds to an increase in the other. Weak correlations were also noted between depression and resilience (p=-0.268), depression and catastrophizing (p=-0.114), and between resilience and catastrophizing (p=0.073). The ANOVA test did not show statistically significant differences among the means.

Conclusions

The significant global impact of chronic pain demands a comprehensive approach both its causes and effects, operating at both individual and population levels. Preventing and mitigating the impact of chronic pain involves addressing modifiable risk factors, such as lifestyle and behavior, with a focus on active patient participation in their treatment. The study’s results align with the growing body of evidence underscoring the importance of psychological factors in the development and persistence of chronic pain conditions. This contributes to the development of multimodal, personalized, interdisciplinary, and evidence-based treatment approaches for pain management, centered on fostering patients’ resilience. These approaches aim to alleviate the intensity of pain and also to reduce comorbidities related to mood disorders. There is a highlighted need for a simultaneously thorough and comprehensive assessment of the patient, transcending the exclusive analysis of pain.

References

CHNG, Zanna; YEO, Jerry Jay; JOSHI, Ashutosh. Resilience as a protective factor in face of pain symptomatology, disability and psychological outcomes in adult chronic pain populations: a scoping review. Scandinavian Journal of Pain, [s. l.], v. 23, n. 2, p. 228–250, 2023.
HECTOR, Melinda S. et al. Resilience is associated with cortical gray matter of the antinociceptive pathway in people with chronic pain. Biological Psychology, [s. l.], v. 183, n. August, 2023. Disponível em: https://doi.org/10.1016/j.biopsycho.2023.108658
MIRÓ, Jordi et al. The Role of Resilience, Happiness, and Social Support in the Psychological Function during the Late Stages of the Lockdown in Individuals with and without Chronic Pain. International Journal of Environmental Research and Public Health, [s. l.], v. 19, n. 11, 2022. Disponível em: https://doi.org/10.3390/ijerph19116708
SAMPOGNA, Gaia et al. What is the role of resilience and coping strategies on the mental health of the general population during the covid-19 pandemic? Results from the italian multicentric comet study. Brain Sciences, [s. l.], v. 11, n. 9, p. 1–16, 2021. Disponível em: https://doi.org/10.3390/brainsci11091231
VASIC, Verica; SCHMIDT, Mirko H H. Resilience and vulnerability to pain and inflammation in the hippocampus. International Journal of Molecular Sciences, [s. l.], v. 18, n. 4, p. 739, 2017.

Presenting Author

Lin Tchia Yeng

Poster Authors

Barbara Maria Müller

Lead Author

Adrianna Loduca

PHD

FACULTY OF HUMAN SCIENCE AND HEALTH OF THE PONTIFICAL CATHOLIC UNIVERSITY OF SÃO PAULO

Lead Author

Lin Tchia Yeng

PHD

PAIN GROUP OF THE CLINICAL HOSPITAL OF THE UNIVERSITY OF SÃO PAULO

Lead Author

Manoel Jacobsen Teixeira

PHD

PAIN GROUP OF THE CLINICAL HOSPITAL OF THE UNIVERSITY OF SÃO PAULO

Lead Author

Topics

  • Assessment and Diagnosis