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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Wolff, B. et al. Pain catastrophizing, physiological indexes, and chronic pain severity: tests of mediation and moderation models. J. Behav. Med. 31, 105–114 (2008). · DOI

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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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