Predictors of pain intensity and pain functioning in patients with the hepatitis C virus

Abstract

OBJECTIVE-To examine the relationships among biological and psychological variables with pain intensity and pain functioning in patients with the hepatitis C virus (HCV). METHODS-Participantswere 49 patients with HCV who completed well-validated assessments of pain intensity and pain functioning. Participants also completed measures of psychological functioning and medical records were reviewed.RESULTS-Thirty-three of 49 participants (67.3%) had a current diagnosis for a pain-related condition. Regression analyses were conducted to examine variables associated with pain intensity and pain functioning. The psychosocial variables, particularly depression severity, accounted for an additional 21% of the variance in average pain intensity (p = 0.002) and 33% of the variance in pain functioning (p < 0.001). These results remained significant even after controlling for demographic characteristics, opioid prescription status, and disease-related variables. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. CONCLUSION-These NIH Public Access Author ManuscriptGen Hosp Psychiatry. Author manuscript; available in PMC 2011 July 1. understanding of the factors associated with pain in HCV patients will help to inform future interventions for chronic pain in this patient population.

Biopsychosocial factors associated with pain in veterans with the hepatitis C virus

“…Results from this study extend findings from a preliminary study examining biopsychosocial factors associated with pain in patients with HCV (Morasco et al, 2010). We found that general and pain-specific psychosocial factors were most strongly associated with pain severity and pain interference in patients with HCV.…”

“…HCV genotype (Mohammad et al, 2012) and liver disease severity (Morasco et al, 2010) have been associated with pain-related outcomes in prior research. In the current study, liver disease severity was not independently associated with pain severity or pain interference, after controlling for the effects of covariates.…”

“…Immune mechanisms have been hypothesized to play a role in the development of chronic pain among patients with HCV (Cacoub et al, 1999; Thompson & Barkhuizen, 2003); however, the results are inconsistent and a recent empirical study did not confirm this association (Tsui et al, 2012). A preliminary cross-sectional study indicated biopsychosocial factors, particularly depressive symptoms, were associated with pain intensity and pain-related function; these results remained significant after controlling for the effects of demographic and disease-related variables (Morasco et al, 2010). This prior study, however, was limited by a small sample size and restricted assessment of pain-specific psychosocial variables.…”

Correlates of prescription opioid therapy in Veterans with chronic pain and history of substance use disorder

“…Participants consisted of a sample from a larger study at a single VA medical center in the Pacific Northwest that examined the relationship between chronic pain, hepatitis C virus infection, and substance abuse [23]. Participants were recruited by posted advertisements in the medical center, letters sent to patients with scheduled primary care appointments, announcements in mental health classes, and referral by clinicians in the medical center's Hepatology Clinic.…”

Pain-related anxiety mediates the relationship between depressive symptoms and pain interference in veterans with hepatitis C

“…Moreover, patients with HCV and chronic pain utilize more medical services than patients with HCV alone, including primary care visits, overall hospital services, and pain specialty services [15]. Research indicates that psychological factors are significantly associated with chronic pain in patients with HCV; notably, pain catastrophizing, perceived self-efficacy for managing pain, and depressive symptoms have been shown to be predictive of pain severity and declines in physical function [16,17]. …”