Psychological Factors Affect Skeletal Trauma Recovery

Catastrophic thinking in particular linked to follow-up pain intensity, disability

FRIDAY, Feb. 21, 2014 (HealthDay News) -- For patients recovering from musculoskeletal trauma, psychological factors, especially catastrophic thinking, are associated with pain intensity and disability, according to a study published in the Feb. 5 issue of The Journal of Bone & Joint Surgery.

Ana-Maria Vranceanu, Ph.D., from Massachusetts General Hospital in Boston, and colleagues estimated the prevalence of clinical depression and posttraumatic stress disorder (PTSD) at one to two months (Time 1; 152 patients) and five to eight months (Time 2; 136 patients) after musculoskeletal trauma.

The researchers found that the screening criteria for an estimated diagnosis of clinical depression were met by 35 and 29 patients at Times 1 and 2, respectively; and those for PTSD were met by 43 and 25 patients, respectively. At Time 1, 24 and 29 percent of the variance in pain and disability was explained by models that included multiple injuries, Abbreviated Injury Scale score, and self-reported opioid use. Incorporation of psychological variables into the models accounted for between 49 percent and 55 percent of the variance. The sole significant predictor of pain at rest, pain during activity, and disability at Time 2 was catastrophic thinking at Time 1.

"We found that psychological factors that are responsive to cognitive behavioral therapy -- catastrophic thinking, in particular -- are strongly associated with pain intensity and disability in patients recovering from musculoskeletal trauma," the authors write.

One or more authors disclosed financial ties to an entity in the biomedical arena.

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