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Pain Med ; 2022 May 19.
Article in English | MEDLINE | ID: covidwho-1853156

ABSTRACT

OBJECTIVE: Individuals experience chronic pain differently, not only based on different clinical diagnosis, but also on differing degrees of influence by biopsychosocial pain modulators. We aimed to cluster chronic pain patients into distinct subgroups based on psychosocial characteristics and pain intensity, and subsequently examined group differences in pain-related interference approximately one year later. METHODS: In this observational, longitudinal study, patients with chronic pain (N = 94) completed validated assessments of psychosocial characteristics and pain intensity at the beginning of COVID-related social distancing (April-June, 2020). One year later (May-June, 2021), patients completed a follow-up survey with assessments of pain interference, loneliness, social support, mindfulness, and optimism. RESULTS: A cluster analysis, using psychosocial factors and pain intensity, empirically produced three patient groups: 1) PsychoSocial Predominant (PSP), characterized by high psychosocial distress and average pain intensity; 2) Pain Intensity Predominant (PIP), characterized by average psychosocial distress and high pain intensity; and 3) Less Elevated Symptoms (LES), characterized by low psychosocial distress and low pain intensity. At the 1-year follow-up, patients in the PSP and PIP clusters suffered greater pain interference compared to the LES cluster, while the PSP cluster also reported greater loneliness, and lower mindfulness and optimism. CONCLUSIONS: An empiric psychosocial-based clustering of patients identified three distinct groups, which differed in pain interference. Patients with high psychosocial modulation of pain at the onset of social distancing (PSP cluster) suffered not only greater pain interference, but also greater loneliness and lower levels of mindfulness and optimism, suggesting some potential behavioral targets for this group in the future.

2.
Pain ; 162(2): 619-629, 2021 02 01.
Article in English | MEDLINE | ID: covidwho-940829

ABSTRACT

ABSTRACT: The COVID-19 pandemic has had a tremendous impact, including on individuals with chronic pain. The social distancing policies necessary to slow the spread of SARS-CoV-2 have involved increased levels of social isolation. This cross-sectional survey study examined pain severity and interference among individuals with chronic pain during an early phase of social distancing mandates and identified characteristics of individuals who were most impacted. Approximately 4 to 8 weeks after social distancing mandates commenced in the state of Massachusetts, 150 patients with fibromyalgia, chronic spine, and postsurgical pain completed demographic, pain, social distancing, and validated psychosocial questionnaires. Patients self-reported an overall significant increase in pain severity and pain interference, compared with before social distancing, although both pain severity and interference were quite variable among individuals under conditions of social distancing. Several demographic, socioeconomic, and psychosocial factors were associated with greater pain severity and interference during social distancing. Multivariable linear regression demonstrated that female sex, nonwhite race, lower education, disability, fibromyalgia, and higher pain catastrophizing were independently associated with greater pain severity, while female sex and pain catastrophizing were independently associated greater pain interference. The findings suggest that individual differences among patients with chronic pain should be considered in the planning, development, and prioritization of interventions to improve pain care and to prevent worsening of symptoms during the continuing COVID-19 pandemic.


Subject(s)
Activities of Daily Living , Back Pain/physiopathology , COVID-19 , Catastrophization/physiopathology , Chronic Pain/physiopathology , Fibromyalgia/physiopathology , Pain, Postoperative/physiopathology , Physical Distancing , Adult , African Americans , Back Pain/psychology , Catastrophization/psychology , Chronic Pain/psychology , Cross-Sectional Studies , Disabled Persons , Educational Status , Female , Fibromyalgia/psychology , Humans , Linear Models , Male , Massachusetts , Middle Aged , Multivariate Analysis , Pain Measurement , Pain, Postoperative/psychology , Public Policy , SARS-CoV-2 , Self Report , Sex Factors , Social Isolation/psychology , Stress Disorders, Post-Traumatic/psychology , Surveys and Questionnaires , Young Adult
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