Methodology

The research team selected a group of variables hypothesized to impact pain coping or catastrophizing in patients with SLE. These variables included sociodemographic characteristics, disease-related outcomes, physical activity, physical and mental functioning, social participation, lupus medications, and 18 different comorbidities.  Detection of coping and catastrophizing was accomplished with the Pain-Related Self Statements Scale, which assesses situation-specific aspects of patients’ cognitive coping with pain.1,4 Data were collected in conjunction with the Lupus Erythematosus Long-term Study (LuLa Study), a prospective study begun in 2001 to investigate the long-term management, course of disease, and quality of life in a large group of German patients with SLE.

Results

Results from 447 patients showed that catastrophizing scores were significantly worse in patients with lupus than in healthy controls.  Catastrophizing was significantly associated with number of SLE-specific drugs; depression and anxiety as assessed by the Mental Component Summary of the Short-Form 12 Health Survey, disease activity as indicated by the Systemic Lupus Activity Questionnaire; and pain within the last 7 days.  Catastrophizing was also associated with specific comorbidities: diabetes, chronic respiratory disease, chronic liver damage, chronic gastrointestinal disorders, mental illness, arthrosis, scarring changes of the skin, fibromyalgia, and stroke. Coping was positively associated with social participation, a measure which was inferred by participation in dancing or bowling. The authors note that while the factors they identified appear to impact catastrophizing or pain coping, cross-sectional studies do not provide definite information about the causal relationship between predictors and outcomes.


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“Further studies are necessary to determine which patients benefit most from psychoeducation and to identify the impact of revised modifiable parameters on coping strategies,” concluded the researchers.

References

  1. Fischin J, Chehab G, Richter JG, et al. Factors associated with pain coping and catastrophising in patients with systemic lupus erythematosus: a cross-sectional study of the LuLa cohort. Lupus Sci Med. 2015;2(1):e000113. doi:10.1136/lupus-2015-000113.
  2. D’Cruz D, Houssiau FA. Editorial: advances in SLE–an innovative era for patients and clinicians. Best Pract Res Clin Rheumatol. 2013;27(3):307-308. doi:10.1016/j.berh.2013.08.001.
  3. Dua AB, Touma Z, Toloza S, Jolly M. Top 10 recent developments in health-related quality of life in patients with systemic lupus erythematosus. Curr Rheumatol Rep. 2013;15(12). doi:10.1007/s11926-013-0380-9.
  4. Flor H, Behle DJ, Birbaumer N. Assessment of pain-related cognitions in chronic pain patients. Behav Res Ther. 1993;31(1):63-73.