Consequences of Chronic Non-Cancer Pain in adulthood. Scoping Review.

Cáceres-Matos, Rocío; Gil-García, Eugenia; Barrientos-Trigo, Sergio; Porcel-Gálvez, Ana María; Cabrera-León, Andrés

doi:10.11606/s1518-8787.2020054001675

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Review • Rev. Saúde Pública 54 • 2020 • https://doi.org/10.11606/s1518-8787.2020054001675 copy

Consequences of Chronic Non-Cancer Pain in adulthood. Scoping Review.

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

OBJECTIVE

To examine and map the consequences of chronic pain in adulthood.

METHOD

Documents addressing the impact of chronic pain on the psychological and social spheres of people suffering from chronic pain, published in Spanish and English between 2013 and 2018, were included. Those who addressed pharmacological treatments, chronic pain resulting from surgical interventions or who did not have access to the full text were excluded. Finally, 28 documents from the 485 reviewed were included

RESULTS

Studies show that pain is related to high rates of limitation in daily activities, sleep disorders and anxiety-depression spectrum disorders. People in pain have more problems to get the workday done and to maintain social relationships. Chronic pain is also associated with worse family functioning.

CONCLUSIONS

This review shows that limitations in the ability to perform activities of daily living, sleep, psychological health, social and work resources and family functioning are lines of interest in published articles. However, knowledge gaps are detected in areas such as the influence of having suffered pain in childhood or adolescence, the consequences of non-fulfillment of working hours and gender inequalities.

Adult; Adulthood; Chronic Pain; Cost of disease; Daily Activities; Quality of life; Review

Authors, year, country	Objective	Methodology/sample	Intervention	Results	Key points	LE	DR
Altug et al. 2015 Turkey	Compare pain, emotional state and disability level in patients with chronic cervical pain and low back pain.	Cross-sectional study. N=100 patients	Visual Analogue Scale (VAS) Owestry Disability Index (ODI) Neck Disability Index (NDI) Beck Depression Inventory (BDI)	No significant difference was found for the intensity and duration of pain between the low back pain group and the group with neck pain. Pain duration, emotional state and disability level in patients with low back pain were worse than in patients with neck pain.	S, PH	4	C
Akbari et al. 2016 Iran	Examines the role of individual and family variables in understanding chronic pain related to disability.	Cross-sectional study. N=142 people	Visual Analogue Scale (VAS) Tampa Scale of Kinesiophobia (TSK) Pain Catastrophizing Scale (PCS) Roland Morris Disability Questionnaire (RDQ) Anxiety Stress Scales (DASS) Family Assessment Device (FAD)	Family dysfunction can contribute to catastrophic thinking, which in turn contributes to the inability of patients, increasing the fear of movement and depression.	S, PH, SLFC	4	C
Andrews et al. 2014 Australia	Examine the association between daily physical activity and sleep in people with chronic pain.	Prospective observational study. N=50 people	Demographic questionnaire Visual Analogue Scale (VAS)	Individuals who claimed to have a greater number of pain points had longer periods of vigil at night.	ADL	4	C
Bailly et al. 2015 France	Understand the experiences of patients living with low back pain. Monocentric qualitative study.	Monocentric qualitative study. N=25 people (11 men and 14 women)	Semi-structured interview and focus groups	The participants reported negative perception in social interactions, with shame and frustration in relation to their difficulties in performing daily activities. They felt misunderstood and unsupported due to the absence of visible signs of the condition.	PH	5	D
Boggero et al. 2015 USA	Test independent and interactive contributions of the somatosensory component of pain and affective component of pain in emotional, social and daily functioning.	Cross-sectional study N=472 people	The West Haven-Yale Multidimensional Pain Inventory (MPI) Visual Analog Scale (VAS)	Women showed higher overall activity than males. Higher levels of pain resulted in worse results in all areas of functioning.	S, PH	4	C
Cabrera-Perona et al. 2017 Spain	Evaluate the association between social comparison, catabolism and specific health outcomes.	Cross-sectional study. N=131 people		A positive correlation was found between catabolism and functional deficiency, psychological distress, anxiety and depression in fibromyalgia.	S, PH	4	C
Calandre et al. 2015 Spain	Evaluate the prevalence of suicidal ideation among a sample of patients with fibromyalgia.	Cross-sectional study. N=373 people	Fibromyalgia Impact Questionnaire The Beck Depression Inventory (BDI) The Pittsburgh Sleep Quality Index The Brief Pain Inventory (BPI) SF-12 Health Survey	48% of people with chronic pain reported having suicidal thoughts and 31 percent attempted suicide. There were no differences in the age or duration of the disease among patients without suicidal ideation, suicidal thinking and suicidal behavior.	S	4	C
Campbell et al. 2013 UK	Proving that sleep problems in people with chronic pain increase the risk of initiating depression.	Prospective cohort study. N=2,622 people	Jenkins Sleep Questionnaire Hospital Anxiety and Depression Scale (HADS)	Sleep problems can lead to depression three years after it begins. Treatments may include preventing or treating sleep problems, as well as focusing on pain treatment.	ADL, S	1b	A
Campbell et al. 2015 New Zealand	Document the prevalence and correlations of chronic pain and suicide, estimating the contribution of chronic disease to suicide.	Population study. N=8,841 people.	Australian National Mental Health Survey.	The chances of suicide were two to three times higher in people in pain. Sixty-five percent of people who have tried to kill themselves in the last 12 months had a history of chronic pain.	S	3b	B
Castro et al. 2014 Spain	Evaluate sleep quality and the prevalence of severe depressive disorder and generalized anxiety disorder in patients with chronic musculoskeletal pain.	Cross-sectional study. N=39 people	International Neuropsychiatric Interview. Pittsburgh Questionnaire Montgomery-Asberg Depression Scale	69.2% of the sample had severe depressive disorder and/or 65.5% had generalized anxiety disorder. No statistically significant differences in sleep quality were found between groups treated with potent opioids and treated with smaller opioids/anti-inflammatory drugs.	ADL, S	4	C
Danya et al. 2015 France	Explore the relationship between time perspective and psychological difficulties.	Cross-sectional study. N=264 people	Zimbardo Time Perspective Inventory (ZTPI) Pain Beliefs and Perceptions Inventory (PBPI) Hospital Anxiety and Depression Scale (HADS)	Patients with children were more depressed, those at the educational level were more anxious, and those who were unemployed during the disease had higher levels of depression.	S, PH	4	C
De Sola et al. 2017 Spain	Determine prevalence and factors related to medical leave and loss of employment among people suffering from chronic pain.	Cross-sectional study. N=1,543 people	Telephone survey	The prevalence of medical leave due to CP in the Spanish population was 4.21%, being more prevalent in people who need help dressing and caring, taking medications and/or with higher schooling. The prevalence of job loss was 1.8%.	PH, SLFC	4	C
Ditre et al. 2013 USA	Evaluate the importance of pain-related anxiety in relation to tobacco dependence in a sample of smokers with chronic pain.	Cross-sectional study. N=129 people	Pain Anxiety Symptoms Scale (PASS-20) Wisconsin Inventory of Smoking Dependence Motives (WISDM) Chronic Pain Screener Graded Chronic Pain Scale (GCPS) Generalized Anxiety Disorder (GAD-7) Fagerström Test for Nicotine Dependence (FTND)	Pain-related anxiety was strongly associated with tobacco dependence. Smokers may be at risk of maintaining and exacerbating their dependence on tobacco, possibly due to individual differences in pain-related anxiety.	S	4	C
Ferreira-Valente et al. 2014 Portugal	Evaluate coping responses, beliefs, and social support to adapt positively.	Observational study. N=324 people	Numerical Rating Scale (NRS) Portuguese Brief Pain Inventory Interference Scale (P-BPI) Physical Component Summary (MCS) Portuguese Pain Self-Efficacy Questionnaire (P-PSEQ) Social Support Satisfaction Scale (ESSS) Portuguese 2-item per Scale Coping Strategies Questionnaire (CSQ-14)	Coping responses and perceived social support were related to interference in pain and psychological functioning. Coping responses were positively associated with pain interference and negatively to physical and psychological functioning.	ADL, S, PH	4	C
Henne et al. 2015 Australia	Explore the relationship between persistent pain, anguish, and emotional connection.	Cross-sectional study. N=388 women	The McGill Pain Questionnaire (SF-MPQ) Depression, anxiety and stress (DASS-21– short form)	Many women with chronic pain have difficulties in emotional connection that attribute to the experience of persistent pain.	S	4	C
Inoue et al. 2015 Japan	Estimate the prevalence of chronic pain in Japan, analyze the associated factors and evaluate social burden due to chronic pain.	Cross-sectional study N=6,000 people	11-point Numerical Rating Scale (NRS)	Chronic pain worsens with environmental factors. People who exercise had lower rates of pain. Women suffered more pain than men. Elderly, living alone and unemployed were also associated with chronic pain.	PH	4	C
Jensen et al. 2015 Denmark	Describe the associations between demographics and health-related quality of life of patients with chronic non-cancer pain.	Cohort study N=1,176 people	Hospital Anxiety and Depression Scale (HADS) Short-Form 36 Bodily Pain Scale (SF-36).	Patients with chronic pain scored less in all domains, especially in physical activity, pain level and vitality. 75% of patients assess that their physical health affects their work and/or daily activity.	PH	1b	A
Karaman et al. 2014 Turkey	Examine the prevalence and relationship between sleep disorders and chronic pain.	Observational study. N=2,635 people	Visual Analogue Scale (VAS) Pain Sleep Quality Index (PSQI)	33% of patients with chronic pain between 20 and 30 years and 47.8% between 60 and 70 years presented worse sleep quality.	ADL	4	C
Mun et al. 2017 USA	Test the effect of pain expectancy with pain after pain.	Cross-sectional study. N= 451 people	Filling out a pain diary.	Pain management today predicts decreased pain the next day. Negativity and coping are not related to the level of pain the next day.	PH	4	C
Nicholas et al. 2017 USA	Examine the interaction between pain and short-term physical functioning.	Longitudinal study. N=389 people	15-item Brief Pain Inventory 2-item Short-Form 36 Bodily Pain Scale (SF-36)	Therapies to control the consequences of chronic pain in relevant aspects of life and physical activities are necessary for restoration of vital activity.	PH	2b	B
Orhurhu et al. 2015 USA	Determine the prevalence of smoking in patients with chronic pain.	Population study N=5,350 patients		The prevalence of smoking in adults with chronic pain was 23.5%.	S	4	C
Raijmakers et al. 2015 Alemannia	Determine differences in the level of daily activity between people with and without pain.	Clinical trial N=37 people		Patients with chronic pain have a lower overall level of physical activity than the healthy population.	PH	1b	A
Stefane et al. 2013 Brazil	Evaluate perceived pain, disability and quality of life in individuals with chronic low back pain.	Cross-sectional study. N=97 people	Roland Morris Questionnaire (RMQ) WHOQOL-Brief	The perceived score of pain intensity, disability and quality of life were the most affected.	ADL, SP	4	C
Triñanes et al. 2014 Spain	Describe the relationship of suicidal ideation in fibromyalgia.	Cross-sectional study. N=117 women	Beck Depression Inventory (BDI) The Pittsburgh Sleep Quality Index (PSQI) The Fibromyalgia Impact Questionnaire (FIQ) Short-Form 36 Health Survey (SF-36) Visual Analogue Scale (VAS)	Patients with fibromyalgia have a moderate level of depression, sleep dysfunction and severe deterioration in different functional areas and well-being. 32.5% expressed suicidal ideation or suicide attempt.	S	4	C
Walker et al. 2013 USA	Determine whether or not there is a statistically significant relationship between pain severity and life satisfaction in patients with chronic pain.	Cross-sectional study. N=172 people	Pain Severity Scale (PSS) West-Haven-Yale Multidimensional Pain Inventory (WHYMP) Satisfaction with Life Scale (SWL) Coping Responses Inventory-Adult (CRI-A)	A statistically significant negative correlation was observed between pain severity and life satisfaction. The relationship between pain severity and life satisfaction seems to change depending on the level of coping approach exhibited by individuals suffering from chronic pain.	ADL, S, PH	4	C
Wilson et al. 2015 Canada	Describe what adults with chronic pain experience in their role as parents.	Qualitative. In-depth interviews. N=130 people	Brief Pain Inventory (BPI) Numerical Rating Scale (NRS) Pain Catastrophizing Scale-Parent version	Parents with chronic pain are more protective and empathic for children. 81% of parents talk about their experiences of pain with their children, usually when they have to tell them they can’t do anything as a result of pain.	SLFC	5	D
Wing et al. 2016 France	Examine associations between chronic pain and psychiatric morbidity.	Cross-sectional study. N=370 people	7-item Chronic Pain Grade Questionnaire (CPG-7) Numerical Rating Scale (NRS)	Patients with higher pain intensity and interference in social activities were more likely to have depression and anxiety.	S	4	C
Yamada et al. 2016 Japan	Examine the association between psychosocial factors related to work and the prevalence of health-related quality of life.	Cross-sectional study. N=1,764 people	EuroQol-5D (EQ-5D)	The prevalence of pain in workers was higher than in workers. Women had more severe depressive symptoms than men.	SP	4	C

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[1] Correspondence: Eugenia Gil-García Calle Avenzoar 6, 41009, Sevilla, España E-mail: egil@us.es