Catastrophizing Worsens Osteoarthritis Disability

By McNamara, Damian | Clinical Psychiatry News, May 2008 | Go to article overview

Catastrophizing Worsens Osteoarthritis Disability


McNamara, Damian, Clinical Psychiatry News


FORT LAUDERDALE, FLA. -- Pain catastrophizing and pain-related fear are associated with increased disability and worse physical functioning among overweight patients with osteoarthritis, according to a study presented at the World Congress on Osteoarthritis.

"In the cognitive-behavioral area, what people are thinking about pain while they are having it can have a significant effect," said Francis J. Keefe, Ph.D. "We need to be thinking about pain-related cognitions. These can increase the patient perception of pain."

Researchers assessed pain among 106 patients with knee osteoarthritis. They also evaluated psychological disability physical impairment, and walking velocity while controlling for pain levels. They measured walking velocity, stride length, and knee range of motion. Mean body mass index was 35kg/[m.sup.2], mean age was 58 years, and 77% were women. The mean Kellgren-Lawrence Scale score was 2.79.

Dr. Keefe and his associates sought to assess how pain catastrophizing and pain-related fear might affect psychological and physical functioning in this patient population. It already is well accepted that increased body weight can increase severity of knee osteoarthritis, he said.

People who catastrophize focus on their pain and magnify it. They can misinterpret pain as more threatening than it is and underestimate their ability to manage it. "Pain catastrophizing tends to increase the pain experience and disability. The reason people do this is it tends to pull other people into their situation," said Dr. Keefe, who is with the medical psychology division, psychiatry and behavioral sciences de- partment, Duke University, Durham, N.C.

Pain-related fear includes excessive fear of experiencing pain during movement, or kinesiophobia. …

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