Simple pain measures reveal psycho-social pathology in patients with Crohn's disease

Shmuel Odes, Michael Friger, Ruslan Sergienko, Doron Schwartz, Orly Sarid, Vered Slonim-Nevo, Terri Singer, Elena Chernin, Hillel Vardi, Dan Greenberg

Research output: Contribution to journalArticlepeer-review

12 Scopus citations

Abstract

AIM To determine whether pain has psycho-social associations in adult Crohn's disease (CD) patients. METHODS Patients completed demographics, disease status, Patient Harvey-Bradshaw Index (P-HBI), Short Form Health Survey (SF-36), Short Inflammatory Bowel Disease Questionnaire (SIBDQ), and five sociopsychological questionnaires: Brief Symptom Inventory, Brief COPE Inventory, Family Assessment Device, Satisfaction with Life Scale, and Work Productivity and Activity Impairment Questionnaire. Pain sub-scales in P-HBI, SF-36 and SIBDQ measures were recoded into 4 identical scores for univariate and multinomial logistic regression analysis of associations with psycho-social variables. RESULTS The cohort comprised 594 patients, mean age 38.6 ± 14.8 years, women 52.5%, P-HBI 5.76 ± 5.15. P-HBI, SF-36 and SIBDQ broadly agreed in their assessment of pain intensity. More severe pain was significantly associated with female gender, low socioeconomic status, unemployment, Israeli birth and smoking. Higher pain scores correlated positively with psychological stress, dysfunctional coping strategies, poor family relationships, absenteeism, presenteeism, productivity loss and activity impairment and all WPAI sub-scores. Patients exhibiting greater satisfaction with life had less pain. The regression showed increasing odds ratios for psychological stress (lowest 2.26, highest 12.17) and female gender (highest 3.19) with increasing pain. Internet-recruited patients were sicker and differed from hardcopy questionnaire patients in their associations with pain. CONCLUSION Pain measures in P-HBI, SF-36 and SIBDQ correlate with psycho-social pathology in CD. Physicians should be aware also of these relationships in approaching CD patients with pain.

Original languageEnglish
Pages (from-to)1076-1089
Number of pages14
JournalWorld Journal of Gastroenterology
Volume23
Issue number6
DOIs
StatePublished - 1 Jan 2017

Keywords

  • Crohn's disease
  • Pain
  • Psycho-social pathology

ASJC Scopus subject areas

  • Gastroenterology

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