02199nas a2200217   4500000000100000008004100001260001600042100001700058700001600075700001400091700001500105700001500120700001600135700001300151245007100164250001500235300001100250490000700261520166700268020004601935       2011                            d  c780679369181 aRefshauge K.1 aNicholas M.1 aLinton S.1 aBoersma K.1 aBergbom S.1 aMcDonald S.1 aMaher C.00aThe role of depression and catastrophizing in musculoskeletal pain  a2010/10/05  a416-220 v153 a<p>
Many patients with musculoskeletal pain also suffer from a depressed mood. Catastrophizing is one process that may link depression and pain since it is a key concept in models of both problems. Earlier research has suggested that catastrophizing measures something above and beyond depression. This study tests the idea that if depressed mood and catastrophizing are separate entities then when one is absent the other should still contribute to poor outcome, and, when both are present there should be an additional adverse effect. To this end, a prospective design, with a built-in replication from two clinical samples of patients with sub-acute pain (one from Sweden, N=373; one from Australasia, N=259), was employed. Participants were classified as to having high/low scores on measures of depression and catastrophizing. Subsequently, these classifications were studied in relation to outcome variables cross-sectionally and at follow-up. Results showed a small to moderate correlation between catastrophizing and depression and that there are individuals with one, but not the other problem. Further, having one or the other of the entities was associated with current pain problems and outcome, while having both increased the associations substantially. The replication showed very similar results Our data demonstrate that pain catastrophizing and heightened depressed mood have an additive and adverse effect on the impact of pain, relative to either alone. It suggests that each should be assessed in the clinic and that future research should focus on treatments specifically designed to tackle both depressed mood and catastrophizing.
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