Cited by 596Musculoskeletal pain and rehabilitationPsychosomatic Disorders and Their TreatmentsFibromyalgia and Chronic Fatigue Syndrome Research

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Pain, catastrophizing, and depression in the rheumatic diseases

Edwards, Robert R., Cahalan, Christine, Mensing, George, Smith, Michael, Haythornthwaite, Jennifer A.·2011·Nature Reviews Rheumatology

DOI 10.1038/nrrheum.2011.2

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Abstract

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.

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“Because evidence showed that NPF such as catastrophizing, negative affectivity, and behavioral avoidance may have the potential to aggravate somatic complaints accompanying medical illnesses to an extent that cannot be fully explained by the underlying illness (13,90), future studies should investigate the association…”
Background
The Effects of Combined Respiratory-Gated Auricular Vagal Afferent Nerve Stimulation and Mindfulness Meditation for Chronic Low Back Pain: A Pilot Study
Meints, S. M., Garcia, R. G., Schuman‐Olivier, Z., Datko, M., Desbordes, G., Cornelius, M. C., Edwards, R. R., & Napadow, V. (2022) · Pain Medicine · doi:10.1093/pm/pnac025 · Cited by 20
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Pain patterns in chronic pancreatitis and chronic primary pain
Tuck, N. L., Teo, K., Kuhlmann, L., Olesen, S. S., Johnson, M., Bean, D. J., Rashid, U., MacCormick, A. D., Srikumar, G., Drewes, A. M., et al. (2022) · Pancreatology · doi:10.1016/j.pan.2022.04.016 · Cited by 22
The relationship between emotion regulation and pain catastrophizing in patients with chronic pain
Yuan, Y., Schreiber, K. L., Flowers, K. M., Edwards, R. R., Azizoddin, D. R., Ashcraft, L. E., Newhill, C. E., & Hruschak, V. (2024) · Pain Medicine · doi:10.1093/pm/pnae009 · Cited by 24
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Longitudinal patterns of pain in patients with diffuse and limited systemic sclerosis: integrating medical, psychological, and social characteristics
Merz, E. L., Malcarne, V. L., Roesch, S. C., Nair, D. K., Salazar, G. A., Assassi, S., & Mayes, M. D. (2016) · Quality of Life Research · doi:10.1007/s11136-016-1370-y · Cited by 19
“, rumination, catastrophizing; [43]) were not measured as part of the GENISOS and could not be evaluated.”
Psychosoziale Faktoren bei Schmerz und Schmerzbehandlung
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Benzodiazepine Use and Dependence in Relation to Chronic Pain Intensity and Pain Catastrophizing
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“a set of exaggerated, negative, cognitive-affective response styles or schemas related to pain (e.g., ruminating on pain; Campbell et al., 2015; Edwards et al., 2011; Quartana et al., 2009).”
Self-citation
Exploring the Role of Negative Cognitions in the Relationship Between Ethnicity, Sleep, and Pain in Women With Temporomandibular Joint Disorder
Lerman, S. F., Campbell, C. M., Buenaver, L. F., Medak, M., Phillips, J. L., Polley, M., Smith, M. T., & Haythornthwaite, J. A. (2018) · Journal of Pain · doi:10.1016/j.jpain.2018.05.009 · Cited by 18
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Individuals with chronic pain have the same response to placebo analgesia as healthy controls in terms of magnitude and reproducibility
Power, A., Brown, C. A., Sivan, M., Lenton, A., Rainey, T., El‐Deredy, W., Jones, A. K. P., & Watson, A. (2020) · Pain · doi:10.1097/j.pain.0000000000001966 · Cited by 17
“This is consistent with the known psychological comorbidities often experienced by patients with chronic pain, including anxiety and depression [11], pain catastrophizing [19] and cognitive impairments [7,18].”
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Meulders, A., Vlaeyen, J. W. S., Evers, A. W. M., Köke, A. J. A., Smeets, R., Zundert, J. H. M. V., Verbunt, J., & Ryckeghem, D. M. L. V. (2021) · Pain · doi:10.1097/j.pain.0000000000002428 · Cited by 19
“In this context, catastrophic worry has emerged as one of the best psychosocial predictors of pain, distress, and disability.(27,54,82) Catastrophic worry may exert its detrimental effects through several pathways, such as inducing an aroused, negative”
Background
Arthritis has an impact on the daily lives of Canadians young and old: results from a population-based survey
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“Factors such as pain, fatigue and sleep difficulties may also contribute to other aspects of mental health such as anxiety and depression; conversely, an individuals’ perception of pain and fatigue are closely tied to their mental health [38–40].”
Background
Pharmacotherapeutic outcomes in atypical odontalgia: determinants of pain relief
Tu, T. T. H., Miura, A., Shinohara, Y., Mikuzuki, L., Kawasaki, K., Sugawara, S., Suga, T., Watanabe, T., Aota, Y., Umezaki, Y., et al. (2019) · Journal of Pain Research · doi:10.2147/jpr.s188362 · Cited by 18
“Pain, depression, and catastrophizing Depression and pain-related catastrophizing are common in patients with chronic pain.(29,30) Previous researchers have mentioned catastrophizing as a key factor determining the individual’s experience of pain, especially in the development of pain and increases in its severity.”
Background
What you can do for your fibromyalgia patient
Gota, C. E. (2018) · Cleveland Clinic Journal of Medicine · doi:10.3949/ccjm.85gr.18002 · Cited by 17
Navigating trials of personalized pain treatments: we're going to need a bigger boat
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Chronic Pelvic Pain Patients Demonstrate Higher Catastrophizing in Association with Pelvic Symptoms and Comorbid Pain Diagnoses
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“disturbing by themselves (43), but they also interfere with the severity and treatment of FM, for example by aggravating the affective component of pain, amplifying functional deficits or impairing therapeutic adherence (44).”
Background
Gene expression profiles of fatigued fibromyalgia patients with different categories of pain and catastrophizing: A preliminary report
Lukkahatai, N., Majors, B. L., Reddy, S. Y., Walitt, B. T., & Saligan, L. N. (2013) · Nursing Outlook · doi:10.1016/j.outlook.2013.03.007 · Cited by 16
“Catastrophizing is greatly associated with depression (Edwards et al., 2011).”
Determining pain catastrophizing from daily pain app assessment data: role of computer-based classification
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Psilocybin as a novel treatment for chronic pain
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“Chronic pain patients, in particular, are more likely to experience pain catastrophising, a psychological tendency to ruminate excessively on pain, which can exacerbate and prolong the pain experience (Edwards et al., 2011).”
Wearables-based walking program in addition to usual physiotherapy care for the management of patients with low back pain at medium or high risk of chronicity: A pilot randomized controlled trial
Alzahrani, H. A., Mackey, M., Stamatakis, E., & Shirley, D. (2021) · PLoS ONE · doi:10.1371/journal.pone.0256459 · Cited by 15
The “self” in pain: high levels of schema-enmeshment worsen fibromyalgia impact
Paschali, M., Lazaridou, A., Vilsmark, E. S., Lee, J., Berry, M., Grahl, A., Anzolin, A., Loggia, M. L., Napadow, V., & Edwards, R. R. (2021) · BMC Musculoskeletal Disorders · doi:10.1186/s12891-021-04740-5 · Cited by 16
Self-citation
Intensity of Chronic Low Back Pain and Activity Interference: A Daily Diary Study of the Moderating Role of Cognitive Pain Coping Strategies
Vertsberger, D., Talmon, A., Ziadni, M. S., Kong, J., Darnall, B. D., Manber, R., Mackey, S., & Gross, J. J. (2022) · Pain Medicine · doi:10.1093/pm/pnac151 · Cited by 16
Identification and Treatment Optimization of Comorbid Depression in Rheumatoid Arthritis
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“Yet, such procedures are not routinely implemented in rheumatology practice, highlighting an important service delivery gap in clinical care [68, 74, 75].”
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Understanding the Relationship Between Spiritual Well-Being and Depression in Chronic Pain Patients: The Mediating Role of Pain Catastrophizing
Shaygan, M., & Shayegan, L. (2019) · Pain Management Nursing · doi:10.1016/j.pmn.2018.12.001 · Cited by 16
Pain interference and associated factors in young adults with juvenile idiopathic arthritis
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“032** No medication 25 (26) 7 (12) 6 (15) sDMARD 27 (28) 23 (40) 8 (21) sDMARD + prednisolone 2 (2) 1 (2) 1 (3) bDMARD 14 (14) 9 (16) 3 (8) bDMARD + sDMARD 27 (28) 18 (18) 16 (14) bDMARD + sDMARD + prednisolone 3 (3) 0 (0) 5 (13) NSAID 5 (5) 6 (10) 6 (15) 0.”
Oral health‐related quality of life in different rheumatic diseases
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Patient Perception of Depressive Symptoms in Rheumatic Diseases
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Prediction of Major Depressive Disorder Following Beta-Blocker Therapy in Patients with Cardiovascular Diseases
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Result
Predictors of Pain for Patients With Early Inflammatory Polyarthritis
Dobkin, P. L., Liu, A., Abrahamowicz, M., Carrier, N., de Brum-Fernandes, A. J., Cossette, P., & Boire, G. (2012) · Arthritis Care & Research · doi:10.1002/acr.21923 · Cited by 16
“Emotional coping, much like catastrophizing (10), may negatively influence pain through behavioral (e.”
Background
Chronic Pain in Irish Prison Officers: Profile and Predictors of Pain-Related Disability and Depression
Costello, E., Bogue, J., Sarma, K. M., & McGuire, B. E. (2015) · Pain Medicine · doi:10.1111/pme.12822 · Cited by 16
A prospective randomized controlled study of auricular point acupressure to manage chronic low back pain in older adults: study protocol
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Pilot Investigation of Somatosensory Functioning and Pain Catastrophizing in Pediatric Spinal Fusion Surgery
Sieberg, C. B., Lunde, C. E., Wong, C., Manganella, J. L., Starkweather, A. R., Sethna, N. F., & Perry, M. (2022) · Pain Management Nursing · doi:10.1016/j.pmn.2022.11.001 · Cited by 15
Narrative Review of Dance-based Exercise and Its Specific Impact on Depressive Symptoms in Older Adults
Marks, R. (2016) · AIMS Medical Science · doi:10.3934/medsci.2016.1.61 · Cited by 15
“In addition to feelings of hopelessness, and low self-worth, individuals suffering from depression may experience poor sleep patterns, fatigue, anxiety, depressive mood, apathy, anhedonia, interference with their daily activities, and appetite loss [1].”
Effects of Testosterone Replacement on Pain Catastrophizing and Sleep Quality in Men with Opioid-Induced Androgen Deficiency
Huang, G. T.-W., Travison, T. G., Edwards, R. R., & Basaria, S. S. (2016) · Pain Medicine · doi:10.1093/pm/pnw159 · Cited by 15
Self-citation
Factors Associated With Pain Frequency Among Adults With Chronic Conditions
Robinson, K. T., Bergeron, C. D., Mingo, C. A., Meng, L. M., Ahn, S., Towne, S. D., Ory, M. G., & Smith, M. L. (2017) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2017.07.043 · Cited by 15
Self-citation
Mindfulness as a protective factor against depressive symptoms in people with fibromyalgia
Brooks, J., Muller, V. R., Sánchez, J., Johnson, E. T., Chiu, C.-Y., Cotton, B. P., Lohman, M. C., Catalano, D., Bartels, S. J., & Chan, F. (2017) · Journal of Mental Health · doi:10.1080/09638237.2017.1417555 · Cited by 15
“affect, higher emotional dysregulation, limited use of adaptive pain-coping mechanisms, and higher frequency and intensity of suicidal ideation (Davis et al., 2001; Edwards et al., 2011; Gracely et al., 2012; Zautra et al., 2005).”
Background
Pain referents used to respond to the P ain C atastrophizing S cale
Kapoor, S., Thorn, B. E., Bandy, O., & Clements, K. L. (2014) · European Journal of Pain · doi:10.1002/ejp.561 · Cited by 15
“Findings are consistent across different study populations, including people with chronic pain as well as individuals experiencing acute or experimental pain (Citero et al., 2007; Edwards et al., 2011; de Boer et al., 2012).”
Background
Relationship of 5-HTTLPR Polymorphism with Various Factors of Pain Processing: Subjective Experience, Motor Responsiveness and Catastrophizing
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“Thus, we decided to study pain catastrophizing as one booster factor of pain processing, given its relevance in emotional appraisal processes of pain and given its proven influence on pain processing (also in pain patients) [11].”
Background
Anxiety and depression are associated with lower preoperative quality of life and function but not duration of symptoms in patients with femoroacetabular impingement syndrome
Jochimsen, K. N., Magnuson, J. A., Kocan, K. R., Mattacola, C. G., Noehren, B. W., Duncan, S. T., & Jacobs, C. A. (2019) · Journal of Hip Preservation Surgery · doi:10.1093/jhps/hnz027 · Cited by 15
Support for a non-therapist assisted, internet-based cognitive-behavioral therapy (iCBT) intervention for mental health in rheumatoid arthritis patients
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Authors: Edwards, R. R., Cahalan, C., Mensing, G., Smith, M., & Haythornthwaite, J. A.
Affiliations: Brigham and Women's Hospital (US)
Johns Hopkins University (US)
Corresponding author: Edwards, Robert R.
ORCID: Edwards, Robert R.
Smith, Michael
Haythornthwaite, Jennifer A.
Venue: Nature Reviews Rheumatology
Publisher: Springer Science and Business Media LLC
Published: 2011-02-01
Volume: 7
Issue: 4
Pages: 216-224
ISSN: 1759-4790 (ISSN-L)
1759-4804
DOI: 10.1038/nrrheum.2011.2
OpenAlex: W1986268428
Cited by: 596
References: 123
Citations by year: 2026: 25 · 2025: 29 · 2024: 30 · 2023: 44 · 2022: 48 · 2021: 55 · 2020: 47 · 2019: 54 · 2018: 48 · 2017: 42 · 2016: 30 · 2015: 35 · 2014: 39 · 2013: 31 · 2012: 29
FWCI: 4.33
Type: journal article
Language: en
Update notices: correction (2011-06-03)
Open access: closed
Licence: www.springer.com/tdm (tdm)
www.springer.com/tdm (vor)
Locations: Nature Reviews Rheumatology (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
Keywords: pain catastrophizing, depression, rheumatic diseases, chronic pain, biopsychosocial model of pain, osteoarthritis, rheumatoid arthritis, fibromyalgia, pain sensitivity, disability, treatment outcomes, inflammatory disease activity, mortality, multimodal pain management
MeSH terms: Depression, Disability Evaluation, Helplessness, Learned, Humans, Pain, Rheumatic Diseases, Treatment Failure, Pain Threshold

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Pain, catastrophizing, and depression in the rheumatic diseases

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