Pain catastrophizing and mental health phenotypes in adults with refractory chronic pain: A latent class analysis

Deepika E. Slawek, Madiha Syed, Chinazo O. Cunningham, Chenshu Zhang, Jonathan Ross, Merrill Herman, Nancy Sohler, Haruka Minami, Frances R. Levin, Julia H. Arnsten, Joanna L. Starrels

Research output: Contribution to journalReview articlepeer-review

1 Scopus citations

Abstract

Chronic pain, pain catastrophizing, and mental health disorders such as anxiety or depression frequently occur together and are challenging to treat. To help understand the relationship between these conditions, we sought to identify distinct phenotypes associated with worse pain and function. In a cohort of people with chronic pain on opioids seeking medical cannabis in New York, we conducted latent class analysis to identify clusters of participants based on pain catastrophizing and mental health symptoms of depression, anxiety, post-traumatic stress disorder (PTSD) and attention deficit/hyperactivity disorder (ADHD). We then compared clusters with respect to sociodemographic and clinical characteristics using descriptive statistics. Among 185 participants, we identified four discrete groups: low pain catastrophizing and low mental health symptoms (49% of participants), low pain catastrophizing and ADHD-predominant mental health symptoms (11%), high pain catastrophizing and anxiety-predominant mental health symptoms (11%), and high pain catastrophizing and high mental health symptoms (30%). The group with high pain catastrophizing and high mental health symptoms had the worst pain intensity and interference, disability, insomnia, and quality of life, compared to the two groups with lower pain catastrophizing, though not all differences were statistically significant. Our findings highlight the importance of identifying and addressing pain catastrophizing in patients with comorbid chronic pain and mental health symptoms.

Original languageEnglish (US)
Pages (from-to)102-110
Number of pages9
JournalJournal of Psychiatric Research
Volume145
DOIs
StatePublished - Jan 2022
Externally publishedYes

Keywords

  • Latent class analysis
  • Maximum 6): chronic pain
  • Pain catastrophizing
  • Refractory pain

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry

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