Psychosocial predictors and correlates for chronic post-surgical pain (CPSP)—a systematic review.

Hinrichs‐Rocker, Anke; Schulz, Kerstin; Järvinen, Imke; Lefering, Rolf; Simanski, Christian; Neugebauer, Edmund A.M.

doi:10.1016/j.ejpain.2008.07.015

Cited by 461Anesthesia and Pain ManagementPain Management and TreatmentMusculoskeletal pain and rehabilitation

Psychosocial predictors and correlates for chronic post-surgical pain (CPSP)—a systematic review.

Hinrichs‐Rocker, Anke, Schulz, Kerstin, Järvinen, Imke, Lefering, Rolf, Simanski, Christian, Neugebauer, Edmund A.M.·2009·European Journal of Pain

DOI 10.1016/j.ejpain.2008.07.015

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Abstract

Chronic post-surgical pain (CPSP) is a serious problem. Incidence as high as 50% has been reported, depending on type of surgery undergone. Because the etiology of chronic pain is grounded in the bio-psychosocial model, physical, psychological, and social factors are implicated in the development of CPSP. Biomedical factors such as pre-operative pain, severe acute post-operative pain, modes of anesthesia, and surgical approaches have been extensively examined, therefore this systematic review focuses on psychosocial elements. A systematic search was performed using the PubMed, PsychINFO, Embase, and Cochrane Databases. Fifty relevant publications were selected from this search, in which psychosocial predictors for and correlates to CPSP were identified. The level of evidence was assessed for each study, and corresponding score points were awarded for ease of comparison. The grade of association with CPSP for each predictor/correlate was then determined. Depression, psychological vulnerability, stress, and late return to work showed likely correlation with CPSP (grade of association=1). Other factors were determined to have either unlikely (grade of association=3) or inconclusive (grade of association=2) correlations. In addition, results were examined in light of the type of surgery undergone. This review is intended as a first step to develop an instrument for identifying patients at high risk for CPSP, to optimize clinical pain management.

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Psychological factors are modifiable, robust, and potent predictors of CPSP and fatigue.
“However, a preventive intervention could target psychological factors, which are both modifiable, robust, and potent predictors of CPSP and fatigue [20,24].”
From Pre- and post-operative psychological interventions to prevent pain and fatigue after breast cancer surgery (PREVENT): Protocol for a randomized controlled trial (2022) · cites this paper as [20]
CPSP is grounded in the bio-psycho-social model, where psychological and social factors contribute to biological factors in the development of chronic pain.
“CPSP is now grounded in the bio-psycho-social model, where psychological and social factors contribute to biological factors in the development of chronic pain [20,21].”
From Pre- and post-operative psychological interventions to prevent pain and fatigue after breast cancer surgery (PREVENT): Protocol for a randomized controlled trial (2022) · cites this paper as [20]
Other significant predictors of CPSP and fatigue involve depression, stress, and optimism.
“Other significant predictors involve depression, stress, and optimism [12,20,27].”
From Pre- and post-operative psychological interventions to prevent pain and fatigue after breast cancer surgery (PREVENT): Protocol for a randomized controlled trial (2022) · cites this paper as [20]
Most patients are provided little more than pharmacotherapy for pain after surgery and are generally offered no intervention targeting the psychological vulnerability factors associated with a greater probability of pain chronicity, including pain catastrophizing, sensitivity to pain traumatization, anxiety and depressive symptoms.
“Most patients are provided little more than pharmacotherapy for pain after surgery and are generally offered no intervention targeting the psychological vulnerability factors that are associated with a greater probability of pain chronicity, including pain catastrophizing,8 sensitivity to pain traumatization,9 anxiety and depressive symptoms.10”
From Acceptance and Commitment Therapy to manage pain and opioid use after major surgery: Preliminary outcomes from the Toronto General Hospital Transitional Pain Service (2017) · cites this paper as [10]
Hinrichs-Rocker's systematic review on psychological predictors and correlates for CPSP found that depression, psychological vulnerability, stress and late return to work showed a probable correlation with CPSP.
“Hinrichs-Rocker did a systematic review on the psychological predictors and correlates for CPSP, and found that depression, psychological vulnerability, stress and late return to work showed a probable correlation with CPSP [47].”
From Chronic postsurgical pain: current evidence for prevention and management (2018) · cites this paper as [47]

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“factors that are associated with a greater probability of pain chronicity, including pain catastrophizing,(8) sensitivity to pain traumatization,(9) anxiety and depressive symptoms.(10) In addition, although behavioral interventions have been shown to reduce the impact of persistent pain in terms of reducing pain inte…”
Background
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PREDICTING THE TRAJECTORIES OF POST-SURGICAL PAIN: THE ROLE OF BIOPSYCHOSOCIAL FACTORS
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Authors: Hinrichs‐Rocker, A., Schulz, K., Järvinen, I., Lefering, R., Simanski, C., & Neugebauer, E. A. M.
Affiliations: Witten/Herdecke University (DE)
Corresponding author: Neugebauer, Edmund A.M.
ORCID: Lefering, Rolf
Venue: European Journal of Pain
Publisher: Wiley
Published: 2009-08
Volume: 13
Issue: 7
Pages: 719-730
ISSN: 1090-3801 (ISSN-L)
1532-2149
DOI: 10.1016/j.ejpain.2008.07.015
OpenAlex: W2112752919
Cited by: 461
References: 82
Citations by year: 2026: 23 · 2025: 33 · 2024: 17 · 2023: 26 · 2022: 28 · 2021: 37 · 2020: 27 · 2019: 25 · 2018: 48 · 2017: 30 · 2016: 39 · 2015: 23 · 2014: 25 · 2013: 25 · 2012: 21
FWCI: 1.88
Type: journal article
Language: en
Open access: closed
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor, 891 d)
Locations: European Journal of Pain (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Surgery › Anesthesia and Pain Management
Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
Keywords: chronic postoperative pain, psychosocial factors, depression, psychological vulnerability, stress, biopsychosocial model, risk prediction, pain management
MeSH terms: Chronic Disease, Depression, Humans, Postoperative Pain, Predictive Value of Tests, Risk Factors, Socioeconomic Factors, Stress, Psychological, Surgical Procedures, Operative, Work, Databases, Factual

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Psychosocial predictors and correlates for chronic post-surgical pain (CPSP)—a systematic review.

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