Top

Published in:

01-06-2012 | Original Article

Role of psychological aspects in both chronic pain and in daily functioning in chronic fatigue syndrome: a prospective longitudinal study

Authors: Mira Meeus, Jo Nijs, Evelyne Van Mol, Steven Truijen, Kenny De Meirleir

Published in: Clinical Rheumatology | Issue 6/2012

Abstract

In addition to fatigue, many patients with chronic fatigue syndrome (CFS) experience chronic musculoskeletal pain. We aimed at examining the role of catastrophizing, coping, kinesiophobia, and depression in the chronic pain complaints and in the daily functioning of CFS patients. A consecutive sample of 103 CFS patients experiencing chronic widespread musculoskeletal pain completed a battery of questionnaires evaluating pain, daily functioning, and psychological characteristics (depression, kinesiophobia, pain coping, and catastrophizing). Thirty-nine patients participated in the 6–12-month follow-up, consisting of questionnaires evaluating pain and pressure pain algometry. Correlation and linear regression analyses were performed to identify predictors. The strongest correlations with pain intensity were found for catastrophizing (r = −.462, p < .001) and depression (r = −.439, p < .001). The stepwise multiple regression analysis revealed that catastrophizing was both the immediate main predictor for pain (20.2%) and the main predictor on the longer term (20.1%). The degree of depression was responsible for 10% in the observed variance of the VAS pain after 6–12 months. No significant correlation with pain thresholds could be revealed. The strongest correlations with daily functioning at baseline were found for catastrophizing (r = .435, p < .001) and depression (r = .481, p < .001). Depression was the main predictor for restrictions in daily functioning (23.1%) at baseline. Pain catastrophizing and depression were immediate and long-term main predictors for pain in patients with CFS having chronic widespread musculoskeletal pain. They were also correlated to daily functioning, with depression as the main predictor for restrictions in daily functioning at baseline.

Fukuda K, Straus SE, Hickie I et al (1994) The chronic fatigue syndrome: a comprehensive approach to its definition and study. International Chronic Fatigue Syndrome Study Group. Ann Intern Med 121:953–959PubMed

Jason LA, Torres-Harding SR, Carrico AW et al (2002) Symptom occurrence in persons with chronic fatigue syndrome. Biol Psychol 59:15–27PubMedCrossRef

Nijs J, Aerts A, De Meirleir K (2006) Generalized joint hypermobility is more common in chronic fatigue syndrome than in healthy control subjects. J Manipulative Physiol Ther 29:32–39PubMedCrossRef

Nijs J, Van de Velde B, De Meirleir K (2005) Pain in patients with chronic fatigue syndrome: does nitric oxide trigger central sensitisation? Med Hypotheses 64:558–562PubMedCrossRef

Meeus M, Nijs J, Meirleir KD (2007) Chronic musculoskeletal pain in patients with the chronic fatigue syndrome: a systematic review. Eur J Pain 11:377–386PubMedCrossRef

Hassett AL, Cone JD, Patella SJ et al (2000) The role of catastrophizing in the pain and depression of women with fibromyalgia syndrome. Arthritis Rheum 43:2493–2500PubMedCrossRef

Vlaeyen JW, Linton SJ (2000) Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art. Pain 85:317–332PubMedCrossRef

Sullivan MJL, Bishop SR, Pivik J (1995) The pain catastrophizing scale: development and validation. Psychol Asses 7:524–532CrossRef

Bradley LA, McKendree-Smith NL, Alarcon GS (2000) Pain complaints in patients with fibromyalgia versus chronic fatigue syndrome. Curr Rev Pain 4:148–157PubMed

10.

Kraaimaat FW, Bakker A, Evers AWM (1997) Pijncoping-strategieën bij chronische pijnpatiënten: de ontwikkeling van de Pijn Coping Inventarisatielijst (PCI). Gedragstherapie 30:185–201

11.

Kraaimaat FW, Evers AW (2003) Pain-coping strategies in chronic pain patients: psychometric characteristics of the pain-coping inventory (PCI). Int J Behav Med 10:343–363PubMedCrossRef

12.

Ray C, Jefferies S, Weir WR (1995) Coping with chronic fatigue syndrome: illness responses and their relationship with fatigue, functional impairment and emotional status. Psychol Med 25:937–945PubMedCrossRef

13.

Heijmans MJ (1998) Coping and adaptive outcome in chronic fatigue syndrome: importance of illness cognitions. J Psychosom Res 45:39–51PubMedCrossRef

14.

Ray C, Jefferies S, Weir WR (1997) Coping and other predictors of outcome in chronic fatigue syndrome: a 1-year follow-up. J Psychosom Res 43:405–415PubMedCrossRef

15.

Kori SH, Miller RP, Todd DD (1990) Kinesiophobia: a new view of chronic pain behavior. Pain Management 35–43

16.

Nijs J, De Meirleir K, Duquet W (2004) Kinesiophobia in chronic fatigue syndrome: assessment and associations with disability. Arch Phys Med Rehabil 85:1586–1592PubMedCrossRef

17.

Silver A, Haeney M, Vijayadurai P et al (2002) The role of fear of physical movement and activity in chronic fatigue syndrome. J Psychosom Res 52:485–493PubMedCrossRef

18.

Morriss RK, Ahmed M, Wearden AJ et al (1999) The role of depression in pain, psychophysiological syndromes and medically unexplained symptoms associated with chronic fatigue syndrome. J Affect Disord 55:143–148PubMedCrossRef

19.

Smeets RJ, Maher CG, Nicholas MK et al (2009) Do psychological characteristics predict response to exercise and advice for subacute low back pain? Arthritis Rheum 61:1202–1209PubMedCrossRef

20.

Kraemer HC, Wilson GT, Fairburn CG et al (2002) Mediators and moderators of treatment effects in randomized clinical trials. Arch Gen Psychiatry 59:877–883PubMedCrossRef

21.

Wolfe F, Smythe HA, Yunus MB et al (1990) The American College of Rheumatology 1990 Criteria for the Classification of Fibromyalgia. Report of the Multicenter Criteria Committee. Arthritis Rheum 33:160–172PubMedCrossRef

22.

Bishop SR, Edgley K, Fisher R et al (1993) Screening for depression in chronic low back pain with the Beck Depression Inventory. Can J Rehab 7:143–148

23.

Van Damme S, Crombez G, Bijttebier P et al (2002) A confirmatory factor analysis of the Pain Catastrophizing Scale: invariant factor structure across clinical and non-clinical populations. Pain 96:319–324PubMedCrossRef

24.

Vlaeyen JW, Kole-Snijders AM, Boeren RG et al (1995) Fear of movement/(re)injury in chronic low back pain and its relation to behavioral performance. Pain 62:363–372PubMedCrossRef

25.

De Becker P, McGregor N, De Meirleir K (2001) A definition-based analysis of symptoms in a large cohort of patients with chronic fatigue syndrome. J Intern Med 250:234–240PubMedCrossRef

26.

Nijs J, Thielemans A (2008) Kinesiophobia and symptomatology in chronic fatigue syndrome: a psychometric study of two questionnaires. Psychol Psychother 81:273–283PubMedCrossRef

27.

Ware JE Jr, Snow KK, Kosinki M et al (1993) SF-36 Health Survey manual and interpretation guide. The Health Institute, Boston

28.

McHorney CA, Ware JE Jr, Raczek AE (1993) The MOS 36-Item Short-Form Health Survey (SF-36): II. Psychometric and clinical tests of validity in measuring physical and mental health constructs. Med Care 31:247–263PubMedCrossRef

29.

Nijs J, Vaes P, Van Hoof E et al (2002) Activity limitations and participation restrictions in patients with chronic fatigue syndrome—construction of a disease specific questionnaire. J Chronic Fatigue Syndr 10:3–23CrossRef

30.

Nijs J, Vaes P, McGregor N et al (2003) Psychometric properties of the Dutch Chronic Fatigue Syndrome–Activities and Participation Questionnaire (CFS-APQ). Phys Ther 83:444–454PubMed

31.

Whiteside A, Hansen S, Chaudhuri A (2004) Exercise lowers pain threshold in chronic fatigue syndrome. Pain 109:497–499PubMedCrossRef

32.

Farasyn A, Meeusen R (2003) Pressure pain thresholds in healthy subjects: influence of physical activity, history of lower back pain factors and the use of endermology as a placebo-like treatment. J Bodywork Mov Ther 7:53–61CrossRef

33.

Vanderweeen L, Oostendorp RA, Vaes P et al (1996) Pressure algometry in manual therapy. Man Ther 1:258–265PubMedCrossRef

34.

Fischer A (1998) Muscle pain syndromes and fibromyalgia. Pressure algometry for quantation of diagnosis and treatment outcome. J Musculoskelet Pain 6:1–32CrossRef

35.

Sullivan MJ, Thorn B, Haythornthwaite JA et al (2001) Theoretical perspectives on the relation between catastrophizing and pain. Clin J Pain 17:52–64PubMedCrossRef

36.

Nijs J, Van de Putte K, Louckx F et al (2008) Exercise performance and chronic pain in chronic fatigue syndrome: the role of pain catastrophizing. Pain Med. doi:10.1111/j.1526-4637.2007.00368.x

37.

Petrie K, Moss-Morris R, Weinman J (1995) The impact of catastrophic beliefs on functioning in chronic fatigue syndrome. J Psychosom Res 39:31–37PubMedCrossRef

38.

Gracely RH, Geisser ME, Giesecke T et al (2004) Pain catastrophizing and neural responses to pain among persons with fibromyalgia. Brain 127:835–843PubMedCrossRef

39.

Verbunt JA, Seelen HA, Vlaeyen JW et al (2003) Fear of injury and physical deconditioning in patients with chronic low back pain. Arch Phys Med Rehabil 84:1227–1232PubMedCrossRef

40.

Wilson A, Hickie I, Lloyd A et al (1994) Longitudinal study of outcome of chronic fatigue syndrome. BMJ 308:756–759PubMedCrossRef

41.

Morriss RK, Wearden AJ (1998) Screening instruments for psychiatric morbidity in chronic fatigue syndrome. J R Soc Med 91:365–368PubMed

42.

Mannion AF, Helbling D, Pulkovski N et al (2009) Spinal segmental stabilisation exercises for chronic low back pain: programme adherence and its influence on clinical outcome. Eur Spine 18:1881–91JCrossRef

43.

van Wilgen CP, van Ittersum MW, Kaptein AA et al (2008) Illness perceptions in patients with fibromyalgia and their relationship to quality of life and catastrophizing. Arthritis Rheum 58:3618–3626PubMedCrossRef

44.

Jackson T, Pope L, Nagasaka T et al (2005) The impact of threatening information about pain on coping and pain tolerance. Br J Health Psychol 10:441–451PubMedCrossRef

45.

Meeus M, Nijs J, Van Oosterwijck J et al (2010) Pain physiology education improves pain beliefs in patients with chronic fatigue syndrome compared with pacing and self-management education: a double-blind randomized controlled trial. Arch Phys Med Rehabil 91:1153–1159PubMedCrossRef

46.

Leeuw M, Goossens ME, van Breukelen GJ et al (2008) Exposure in vivo versus operant graded activity in chronic low back pain patients: results of a randomized controlled trial. Pain 138:192–207PubMedCrossRef

47.

Knoop H, Stulemeijer M, Prins JB et al (2007) Is cognitive behaviour therapy for chronic fatigue syndrome also effective for pain symptoms? Behav Res Ther 45:2034–2043PubMedCrossRef

48.

Alda M, Luciano-Devis JV, Andres E et al (2011) Effectiveness of cognitive behaviour therapy for the treatment of catastrophisation in patients with fibromyalgia: a randomised controlled trial. Arthritis Res Ther 13:R173PubMedCrossRef

Title: Role of psychological aspects in both chronic pain and in daily functioning in chronic fatigue syndrome: a prospective longitudinal study
Authors: Mira Meeus
Jo Nijs
Evelyne Van Mol
Steven Truijen
Kenny De Meirleir
Publication date: 01-06-2012
Publisher: Springer-Verlag
Published in: Clinical Rheumatology / Issue 6/2012
Print ISSN: 0770-3198
Electronic ISSN: 1434-9949
DOI: https://doi.org/10.1007/s10067-012-1946-z

Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin

Prof. Florian Limbourg

Prof. Anoop Chauhan

Developed by: Springer Medicine

Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 6/2012

Entheseal ultrasound abnormalities in patients with SAPHO syndrome

Translation, adaptation and validation of the Moroccan version of the Quebec Back Pain Disability Scale

Supernatants from culture of type I collagen-stimulated PBMC from patients with cutaneous systemic sclerosis versus localized scleroderma demonstrate suppression of MMP-1 by fibroblasts

Life-threatening spontaneous splenic rupture with systemic lupus erythematosus: case report and literature review

Access to the next wave of biologic therapies (Abatacept and Tocilizumab) for the treatment of rheumatoid arthritis in England and Wales

The relationship between latent trigger points and depression levels in healthy subjects

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

At a glance: The STEP trials