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.
Catastrophizing, the tendency to ruminate about and magnify pain, and depression, a more general mood disorder, are common in patients with chronically painful rheumatic conditions
Catastrophizing and depression are risk factors for a number of adverse long-term pain-related outcomes such as physical disability, increased severity of pain, enhanced pain sensitivity and others
Catastrophizing and depression are complex biopsychosocial constructs that act through a variety of pathways, including behavioral, cognitive, and neurophysiological pathways
Catastrophizing and depression represent important targets of pain treatment, and could be instrumental in helping to tailor pain-management strategies to individual patients
Subscribe to Journal
Get full journal access for 1 year
only $4.92 per issue
All prices are NET prices.
VAT will be added later in the checkout.
Tax calculation will be finalised during checkout.
Rent or Buy article
Get time limited or full article access on ReadCube.
All prices are NET prices.
Fitzcharles, M. A., Lussier, D. & Shir, Y. Management of chronic arthritis pain in the elderly. Drugs Aging 27, 471–490 (2010).
May, S. Self-management of chronic low back pain and osteoarthritis. Nat. Rev. Rheumatol. 6, 199–209 (2010).
Woolf, A. D. & Pfleger, B. Burden of major musculoskeletal conditions. Bull. World Health Organ. 81, 646–656 (2003).
Keefe, F. J. et al. Recent advances and future directions in the biopsychosocial assessment and treatment of arthritis. J. Consult. Clin. Psychol. 70, 640–655 (2002).
Stanos, S. & Houle, T. T. Multidisciplinary and interdisciplinary management of chronic pain. Phys. Med. Rehabil. Clin. N. Am. 17, 435–450, vii (2006).
Gwilym, S. E., Pollard, T. C. & Carr, A. J. Understanding pain in osteoarthritis. J. Bone Joint Surg. Br. 90, 280–287 (2008).
Furukawa, T. A. Assessment of mood: guides for clinicians. J. Psychosom. Res. 68, 581–589 (2010).
Edwards, R. R., Bingham, C. O., III, Bathon, J. & Haythornthwaite, J. A. Catastrophizing and pain in arthritis, fibromyalgia, and other rheumatic diseases. Arthritis Rheum. 55, 325–332 (2006).
Linton, S. J. et al. The role of depression and catastrophizing in musculoskeletal pain. Eur. J. Pain doi:10.1016/j.ejpain.2010.08.009.
Goldenberg, D. L. The interface of pain and mood disturbances in the rheumatic diseases. Semin. Arthritis Rheum. 40, 15–31 (2010).
Keefe, F. J. & Somers, T. J. Psychological approaches to understanding and treating arthritis pain. Nat. Rev. Rheumatol. 6, 210–216 (2010).
El Sayed, A. M. et al. Back and neck pain and psychopathology in rural sub-Saharan Africa: evidence from the Gilgel Gibe Growth and Development Study, Ethiopia. Spine (Phila Pa 1976) doi: 10.1097/BRS.0b013e3181b4926e.
Von Korff, M. et al. Childhood psychosocial stressors and adult onset arthritis: broad spectrum risk factors and allostatic load. Pain 143, 76–83 (2009).
Reme, S. E. & Eriksen, H. R. Is one question enough to screen for depression? Scand. J. Public Health 38, 618–624 (2010).
Picavet, H. S., Vlaeyen, J. W. & Schouten, J. S. Pain catastrophizing and kinesiophobia: predictors of chronic low back pain. Am. J. Epidemiol. 156, 1028–1034 (2002).
Severeijns, R., Vlaeyen, J. W., van den Hout, M. A. & Picavet, H. S. Pain catastrophizing is associated with health indices in musculoskeletal pain: a cross-sectional study in the Dutch community. Health Psychol. 23, 49–57 (2004).
Edwards, R. R. et al. Catastrophizing, pain, and social adjustment in scleroderma: relationships with educational level. Clin. J. Pain 22, 639–646 (2006).
Edwards, R. R. et al. Moderators of the negative effects of catastrophizing in arthritis. Pain Med. 11, 591–599 (2010).
Keefe, F. J., Brown, G. K., Wallston, K. A. & Caldwell, D. S. Coping with rheumatoid arthritis pain: catastrophizing as a maladaptive strategy. Pain 37, 51–56 (1989).
Covic, T., Adamson, B., Spencer, D. & Howe, G. A biopsychosocial model of pain and depression in rheumatoid arthritis: a 12-month longitudinal study. Rheumatology (Oxford) 42, 1287–1294 (2003).
Gauthier, N., Sullivan, M. J., Adams, H., Stanish, W. D. & Thibault, P. Investigating risk factors for chronicity: the importance of distinguishing between return-to-work status and self-report measures of disability. J. Occup. Environ. Med. 48, 312–318 (2006).
Evers, A. W., Kraaimaat, F. W., Geenen, R., Jacobs, J. W. & Bijlsma, J. W. Pain coping and social support as predictors of long-term functional disability and pain in early rheumatoid arthritis. Behav. Res. Ther. 41, 1295–1310 (2003).
Sullivan, M. et al. Psychological determinants of problematic outcomes following total knee arthroplasty. Pain 143, 123–129 (2009).
Rosemann, T., Laux, G., Szecsenyi, J., Wensing, M. & Grol, R. Pain and osteoarthritis in primary care: factors associated with pain perception in a sample of 1,021 patients. Pain Med. 9, 903–910 (2008).
Bousema, E. J., Verbunt, J. A., Seelen, H. A., Vlaeyen, J. W. & Knottnerus, J. A. Disuse and physical deconditioning in the first year after the onset of back pain. Pain 130, 279–286 (2007).
Wolff, B. et al. Pain catastrophizing, physiological indexes, and chronic pain severity: tests of mediation and moderation models. J. Behav. Med. 31, 105–114 (2008).
Edwards, R. R., Haythornthwaite, J. A., Smith, M. T., Klick, B. & Katz, J. N. Catastrophizing and depressive symptoms as prospective predictors of outcomes following total knee replacement. Pain Res. Manag. 14, 307–311 (2009).
Arola, H. M., Nicholls, E., Mallen, C. & Thomas, E. Self-reported pain interference and symptoms of anxiety and depression in community-dwelling older adults: can a temporal relationship be determined? Eur. J. Pain 14, 966–971 (2010).
Chiu, Y. H. et al. Poor sleep and depression are independently associated with a reduced pain threshold. Results of a population based study. Pain 115, 316–321 (2005).
de Souza, J. B., Potvin, S., Goffaux, P., Charest, J. & Marchand, S. The deficit of pain inhibition in fibromyalgia is more pronounced in patients with comorbid depressive symptoms. Clin. J. Pain 25, 123–127 (2009).
Smith, B. W. et al. Habituation and sensitization to heat and cold pain in women with fibromyalgia and healthy controls. Pain 140, 420–428 (2008).
Gracely, R. H., Grant, M. A. & Giesecke, T. Evoked pain measures in fibromyalgia. Best Pract. Res. Clin. Rheumatol. 17, 593–609 (2003).
Lee, Y. C. et al. The relationship between disease activity, sleep, psychiatric distress and pain sensitivity in rheumatoid arthritis: a cross-sectional study. Arthritis Res. Ther. 11, R160 (2009).
Geisser, et al. Perception of noxious and innocuous heat stimulation among healthy women and women with fibromyalgia: association with mood, somatic focus, and catastrophizing. Pain 102, 243–250 (2003).
France, C. R. et al. Laboratory pain perception and clinical pain in post-menopausal women and age-matched men with osteoarthritis: relationship to pain coping and hormonal status. Pain 112, 274–281 (2004).
Campbell, C. M. et al. Situational versus dispositional measurement of catastrophizing: associations with pain responses in multiple samples. J. Pain 11, 443–453 (2010).
Goubert, L., Crombez, G., Eccleston, C. & Devulder, J. Distraction from chronic pain during a pain-inducing activity is associated with greater post-activity pain. Pain 110, 220–227 (2004).
Huijnen, I. P. et al. Do depression and pain intensity interfere with physical activity in daily life in patients with chronic low back pain? Pain 150, 161–166 (2010).
Odegard, S., Finset, A., Kvien, T. K., Mowinckel, P. & Uhlig, T. Work disability in rheumatoid arthritis is predicted by physical and psychological health status: a 7-year study from the Oslo RA register. Scand. J. Rheumatol. 34, 441–447 (2005).
Hawker, G. A. et al. A longitudinal study to explain the pain–depression link in older adults with osteoarthritis. Arthritis Care Res. (Hoboken) doi: 10.1002/acr.20298.
Kendell, K., Saxby, B., Farrow, M. & Naisby, C. Psychological factors associated with short-term recovery from total knee replacement. Br. J. Health Psychol. 6, 41–52 (2001).
Forsythe, M. E., Dunbar, M. J., Hennigar, A. W., Sullivan, M. J. & Gross, M. Prospective relation between catastrophizing and residual pain following knee arthroplasty: two-year follow-up. Pain Res. Manag. 13, 335–341 (2008).
Escobar, A. et al. Effect of patient characteristics on reported outcomes after total knee replacement. Rheumatology (Oxford) 46, 112–119 (2007).
Brander, V., Gondek, S., Martin, E. & Stulberg, S. D. Pain and depression influence outcome 5 years after knee replacement surgery. Clin. Orthop. Relat. Res. 464, 21–26 (2007).
Rolfson, O., Dahlberg, L. E., Nilsson, J. A., Malchau, H. & Garellick, G. Variables determining outcome in total hip replacement surgery. J. Bone Joint Surg. Br. 91, 157–161 (2009).
Singh, J. A. & Lewallen, D. Predictors of pain and use of pain medications following primary total hip arthroplasty (THA): 5,707 THAs at 2-years and 3,289 THAs at 5-years. BMC Musculoskelet. Disord. 11, 90 (2010).
Burns, J. W., Glenn, B., Bruehl, S., Harden, R. N. & Lofland, K. Cognitive factors influence outcome following multidisciplinary chronic pain treatment: a replication and extension of a cross-lagged panel analysis. Behav. Res. Ther. 41, 1163–1182 (2003).
Burns, J. W., Kubilus, A., Bruehl, S., Harden, R. N. & Lofland, K. Do changes in cognitive factors influence outcome following multidisciplinary treatment for chronic pain? A cross-lagged panel analysis. J. Consult. Clin. Psychol. 71, 81–91 (2003).
Quartana, P. J., Campbell, C. M. & Edwards, R. R. Pain catastrophizing: a critical review. Expert Rev. Neurother. 9, 745–758 (2009).
Wasan, A. D., Davar, G. & Jamison, R. The association between negative affect and opioid analgesia in patients with discogenic low back pain. Pain 117, 450–461 (2005).
Campbell, C. M., Edwards, R. R. Mind–body interactions in pain: the neurophysiology of anxious and catastrophic pain-related thoughts. Transl. Res. 153, 97–101 (2009).
Evers, A. W., Kraaimaat, F. W., Geenen, R., Jacobs, J. W. & Bijlsma, J. W. Stress-vulnerability factors as long-term predictors of disease activity in early rheumatoid arthritis. J. Psychosom. Res. 55, 293–302 (2003).
Dessein, P. H., Joffe, B. I. & Stanwix, A. E. High sensitivity C-reactive protein as a disease activity marker in rheumatoid arthritis. J. Rheumatol. 31, 1095–1097 (2004).
Keysor, J., Sokka, T., Krishnan, E., Callahan, L. F. & Pincus, T. Patient questionnaires and formal education level as prospective predictors of mortality over 10 years in 97% of 1416 patients with rheumatoid arthritis from 15 United States private practices. J. Rheumatol. 31, 229–234 (2004).
Edwards, R. R. et al. Association of catastrophizing with interleukin-6 responses to acute pain. Pain 140, 135–144 (2008).
Lam, M., Lehman, A. J., Puterman, E. & DeLongis, A. Spouse depression and disease course among persons with rheumatoid arthritis. Arthritis Rheum. 61, 1011–1017 (2009).
Low, C. A. et al. Association between C-reactive protein and depressive symptoms in women with rheumatoid arthritis. Biol. Psychol. 81, 131–134 (2009).
Kojima, M. et al. Depression, inflammation, and pain in patients with rheumatoid arthritis. Arthritis Rheum. 61, 1018–1024 (2009).
Jorge, L. L., Gerard, C. & Revel, M. Evidences of memory dysfunction and maladaptive coping in chronic low back pain and rheumatoid arthritis patients: challenges for rehabilitation. Eur. J. Phys. Rehabil. Med. 45, 469–477 (2009).
Rosemann, T., Joos, S., Szecsenyi, J., Laux, G. & Wensing, M. Health service utilization patterns of primary care patients with osteoarthritis. BMC Health Serv. Res. 7, 169 (2007).
Ritzwoller, D. P., Crounse, L., Shetterly, S. & Rublee, D. The association of comorbidities, utilization and costs for patients identified with low back pain. BMC Musculoskelet. Disord. 7, 72 (2006).
Bruce, T. O. Comorbid depression in rheumatoid arthritis: pathophysiology and clinical implications. Curr. Psychiatry Rep. 10, 258–264 (2008).
Edwards, R. R., Smith, M. T., Kudel, I. & Haythornthwaite, J. Pain-related catastrophizing as a risk factor for suicidal ideation in chronic pain. Pain 126, 272–279 (2006).
Neame, R. & Hammond, A. Beliefs about medications: a questionnaire survey of people with rheumatoid arthritis. Rheumatology (Oxford) 44, 762–767 (2005).
Castaneda, D. M., Bigatti, S. & Cronan, T. A. Gender and exercise behavior among women and men with osteoarthritis. Women Health 27, 33–53 (1998).
Shih, M., Hootman, J. M., Kruger, J. & Helmick, C. G. Physical activity in men and women with arthritis National Health Interview Survey, 2002. Am. J. Prev. Med. 30, 385–393 (2006).
Sokka, T. & Hakkinen, A. Poor physical fitness and performance as predictors of mortality in normal populations and patients with rheumatic and other diseases. Clin. Exp. Rheumatol. 26 (5 Suppl 51), S14–S20 (2008).
Somers, T. J., Keefe, F. J., Godiwala, N. & Hoyler, G. H. Psychosocial factors and the pain experience of osteoarthritis patients: new findings and new directions. Curr. Opin. Rheumatol. 21, 501–506 (2009).
Verbunt, J. A., Sieben, J., Vlaeyen, J. W., Portegijs, P. & Andre, K. J. A new episode of low back pain: who relies on bed rest? Eur. J. Pain 12, 508–516 (2008).
Abad, V. C., Sarinas, P. S. & Guilleminault, C. Sleep and rheumatologic disorders. Sleep Med. Rev. 12, 211–228 (2008).
Smith, M. T., Quartana, P. J., Okonkwo, R. M. & Nasir, A. Mechanisms by which sleep disturbance contributes to osteoarthritis pain: a conceptual model. Curr. Pain Headache Rep. 13, 447–454 (2009).
Gupta, A. et al. The role of psychosocial factors in predicting the onset of chronic widespread pain: results from a prospective population-based study. Rheumatology (Oxford) 46, 666–671 (2007).
Campbell, C. M. et al. Catastrophizing delays the analgesic effect of distraction. Pain 149, 202–207 (2010).
Covic, T., Tyson, G., Spencer, D. & Howe, G. Depression in rheumatoid arthritis patients: demographic, clinical, and psychological predictors. J. Psychosom. Res. 60, 469–476 (2006).
Conner, T. S. et al. Coping with rheumatoid arthritis pain in daily life: within-person analyses reveal hidden vulnerability for the formerly depressed. Pain 126, 198–209 (2006).
Li, X., Gignac, M. A. & Anis, A. H. Workplace, psychosocial factors, and depressive symptoms among working people with arthritis: a longitudinal study. J. Rheumatol. 33, 1849–1855 (2006).
Lackner, J. M. & Gurtman, M. B. Pain catastrophizing and interpersonal problems: a circumplex analysis of the communal coping model. Pain 110, 597–604 (2004).
McWilliams, L. A. & Asmundson, G. J. The relationship of adult attachment dimensions to pain-related fear, hypervigilance, and catastrophizing. Pain 127, 27–34 (2007).
Holtzman, S. & DeLongis, A. One day at a time: the impact of daily satisfaction with spouse responses on pain, negative affect and catastrophizing among individuals with rheumatoid arthritis. Pain 131, 202–213 (2007).
Barton, J. L. et al. Patient-physician discordance in assessments of global disease severity in rheumatoid arthritis. Arthritis Care Res (Hoboken) 62, 857–864 (2010).
Haugli, L., Strand, E. & Finset, A. How do patients with rheumatic disease experience their relationship with their doctors? A qualitative study of experiences of stress and support in the doctor-patient relationship. Patient Educ. Couns. 52, 169–174 (2004).
Vancleef, L. M. & Peters, M. L. Pain catastrophizing, but not injury/illness sensitivity or anxiety sensitivity, enhances attentional interference by pain. J. Pain 7, 23–30 (2006).
Denton, F. J., Sharpe, L. & Schrieber, L. Cognitive bias in systemic lupus erythematosus. Eur. J. Pain 9, 5–14 (2005).
Sitges, C. et al. Abnormal brain processing of affective and sensory pain descriptors in chronic pain patients. J. Affect Disord. 104, 73–82 (2007).
Gracely, R. H. et al. Pain catastrophizing and neural responses to pain among persons with fibromyalgia. Brain 127, 835–843 (2004).
Schweinhardt, P., Kalk, N., Wartolowska, K., Chessell, I., Wordsworth, P. & Tracey, I. Investigation into the neural correlates of emotional augmentation of clinical pain. Neuroimage 40, 759–766 (2008).
Strigo, I. A., Simmons, A. N., Matthews, S. C., Craig, A. D. & Paulus, M. P. Increased affective bias revealed using experimental graded heat stimuli in young depressed adults: evidence of “emotional allodynia”. Psychosom Med. 70, 338–344 (2008).
Berna, C., Leknes, S., Holmes, E. A., Edwards, R. R., Goodwin, G. M. & Tracey, I. Induction of depressed mood disrupts emotion regulation neurocircuitry and enhances pain unpleasantness. Biol. Psychiatry 67, 1083–1090 (2010).
Buckalew, N., Haut, M. W., Morrow, L. & Weiner, D. Chronic pain is associated with brain volume loss in older adults: preliminary evidence. Pain Med. 9, 240–248 (2008).
Lutz, J. et al. White and gray matter abnormalities in the brain of patients with fibromyalgia: a diffusion-tensor and volumetric imaging study. Arthritis Rheum. 58, 3960–3969 (2008).
Hsu, M. C. et al. No consistent difference in gray matter volume between individuals with fibromyalgia and age-matched healthy subjects when controlling for affective disorder. Pain 143, 262–267 (2009).
Schmidt-Wilcke, T. et al. Affective components and intensity of pain correlate with structural differences in gray matter in chronic back pain patients. Pain 125, 89–97 (2006).
Blankstein, U., Chen, J., Diamant, N. E. & Davis, K. D. Altered brain structure in irritable bowel syndrome: potential contributions of pre-existing and disease-driven factors. Gastroenterology 138, 1783–1789 (2010).
Johansson, A. C. et al. Pain, disability and coping reflected in the diurnal cortisol variability in patients scheduled for lumbar disc surgery. Eur. J. Pain 12, 633–640 (2008).
McBeth, J. et al. Moderation of psychosocial risk factors through dysfunction of the hypothalamic–pituitary–adrenal stress axis in the onset of chronic widespread musculoskeletal pain: findings of a population-based prospective cohort study. Arthritis Rheum. 56, 360–371 (2007).
Riva, R., Mork, P. J., Westgaard, R. H., Ro, M. & Lundberg, U. Fibromyalgia syndrome is associated with hypocortisolism. Int. J. Behav. Med. 17, 223–233 (2010).
Gur, A., Cevik, R., Sarac, A. J., Colpan, L. & Em, S. Hypothalamic-pituitary-gonadal axis and cortisol in young women with primary fibromyalgia: the potential roles of depression, fatigue, and sleep disturbance in the occurrence of hypocortisolism. Ann. Rheum. Dis. 63, 1504–1506 (2004).
Gur, A., Cevik, R., Nas, K., Colpan, L. & Sarac, S. Cortisol and hypothalamic–pituitary–gonadal axis hormones in follicular-phase women with fibromyalgia and chronic fatigue syndrome and effect of depressive symptoms on these hormones. Arthritis Res. Ther. 6, R232–R238 (2004).
Wingenfeld, K., Nutzinger, D., Kauth, J., Hellhammer, D. H. & Lautenbacher, S. Salivary cortisol release and hypothalamic pituitary adrenal axis feedback sensitivity in fibromyalgia is associated with depression but not with pain. J. Pain 11, 1195–1202 (2010).
Geenen, R., van Middendorp, H. & Bijlsma, J. W. The impact of stressors on health status and hypothalamic-pituitary-adrenal axis and autonomic nervous system responsiveness in rheumatoid arthritis. Ann. NY Acad. Sci. 1069, 77–97 (2006).
Cutolo, M. et al. Circadian rhythms: glucocorticoids and arthritis. Ann. NY Acad. Sci. 1069, 289–299 (2006).
MacDermid, J. C. et al. Developing biologically-based assessment tools for physical therapy management of neck pain. J. Orthop. Sports Phys. Ther. 39, 388–399 (2009).
Wolff, B. et al. Pain catastrophizing, physiological indexes, and chronic pain severity: tests of mediation and moderation models. J. Behav. Med. 31, 105–114 (2008).
van der, H. M., Vollenbroek-Hutten, M. M., Schreurs, K. M., Rietman, J. S. & Hermens, H. J. Relationships between coping strategies and lumbar muscle activity in subjects with chronic low back pain. Eur. J. Pain 14, 640–647 (2010).
Cohen, H., Neumann, L., Glazer, Y., Ebstein, R. P. & Buskila, D. The relationship between a common catechol-O-methyltransferase (COMT) polymorphism Val(158)Met and fibromyalgia. Clin. Exp. Rheumatol 27 (5 Suppl 56), S51–S56 (2009).
Fijal, B., Perlis, R. H., Heinloth, A. N. & Houston, J. P. The association of single nucleotide polymorphisms in the catechol-O-methyltransferase gene and pain scores in female patients with major depressive disorder. J. Pain 11, 910–915 (2010).
Diatchenko, L. et al. Genetic basis for individual variations in pain perception and the development of a chronic pain condition. Hum. Mol. Genet. 14, 135–143 (2005).
George, S. Z. et al. Evidence for a biopsychosocial influence on shoulder pain: pain catastrophizing and catechol-O-methyltransferase (COMT) diplotype predict clinical pain ratings. Pain 136, 53–61 (2008).
Henschke, N. et al. Behavioural treatment for chronic low-back pain. Cochrane Database of Systematic Reviews, Issue 7. Art. No.: CD002014. doi: 10.1002/14651858.CD002014.pub3 (2010).
Yohannes, A. M. & Caton, S. Management of depression in older people with osteoarthritis: a systematic review. Aging Ment. Health 14, 637–651 (2010).
Wang, C. et al. Tai chi is effective in treating knee osteoarthritis: a randomized controlled trial. Arthritis Rheum. 61, 1545–1553 (2009).
Zautra, A. J. et al. Comparison of cognitive behavioral and mindfulness meditation interventions on adaptation to rheumatoid arthritis for patients with and without history of recurrent depression. J. Consult Clin. Psychol. 76, 408–421 (2008).
Bailey, K. M., Carleton, R. N., Vlaeyen, J. W. & Asmundson, G. J. Treatments addressing pain-related fear and anxiety in patients with chronic musculoskeletal pain: a preliminary review. Cogn. Behav. Ther. 39, 46–63 (2010).
George, S. Z., Wittmer, V. T., Fillingim, R. B. & Robinson, M. E. Comparison of graded exercise and graded exposure clinical outcomes for patients with chronic low back pain. J. Orthop. Sports Phys. Ther. 40, 694–704 (2010).
Smeets, R. J., Vlaeyen, J. W., Kester, A. D. & Knottnerus, J. A. Reduction of pain catastrophizing mediates the outcome of both physical and cognitive-behavioral treatment in chronic low back pain. J. Pain 7, 261–271 (2006).
George, S. Z. et al. A randomized trial of behavioral physical therapy interventions for acute and sub-acute low back pain (NCT00373867). Pain 140, 145–157 (2008).
Zautra, A. J. & Smith, B. W. Impact of controlled-release oxycodone on efficacy beliefs and coping efforts among osteoarthritis patients with moderate to severe pain. Clin. J. Pain 21, 471–477 (2005).
Glombiewski, J. A. et al. Psychological treatments for fibromyalgia: a meta-analysis. Pain 151, 280–295 (2010).
Evers, A. W., Kraaimaat, F. W., van Riel, P. L. & de Jong, A. J. Tailored cognitive-behavioral therapy in early rheumatoid arthritis for patients at risk: a randomized controlled trial. Pain 100, 141–153 (2002).
Witvrouw, E. et al. Catastrophic thinking about pain as a predictor of length of hospital stay after total knee arthroplasty: a prospective study. Knee Surg. Sports Traumatol. Arthrosc. 17, 1189–1194 (2009).
This work was supported by NIH grants AR 051315 (R. R. Edwards), AT 004641 (M. T. Smith and J. A. Haythornthwaite) and AG 034982 (R. R. Edwards), and by awards from the American College of Rheumatology (R. R. Edwards) and Arthritis Foundation (R. R. Edwards).
The authors declare no competing financial interests.
About this article
Cite this article
Edwards, R., Cahalan, C., Mensing, G. et al. Pain, catastrophizing, and depression in the rheumatic diseases. Nat Rev Rheumatol 7, 216–224 (2011). https://doi.org/10.1038/nrrheum.2011.2
Effect of Preoperative Modifiable Psychological and Behavioural Factors on Early Outcome Following Total Knee Arthroplasty in an Indian Population
Indian Journal of Orthopaedics (2021)
The Association Between Effectiveness of Tinnitus Intervention and Cognitive Function—A Systematic Review
Frontiers in Psychology (2021)
Rheumatology International (2021)
Mind-body approaches targeting the psychological aspects of opioid use problems in patients with chronic pain: evidence and opportunities
Translational Research (2021)
Journal of Oral Rehabilitation (2021)