The role of psychosocial factors in predicting the onset of chronic widespread pain: results from a prospective population-based study

Rheumatology (Oxford). 2007 Apr;46(4):666-71. doi: 10.1093/rheumatology/kel363. Epub 2006 Nov 4.


Objective: Chronic widespread pain (CWP) is strongly associated with psychosocial distress both in a clinical setting and in the community. The aim of this study was to determine the contribution of measures of psychosocial distress, health-seeking behaviour, sleep problems and traumatic life events to the development of new cases of CWP in the community.

Methods: In a population-based prospective study, 3171 adults aged 25-65 yrs free of CWP were followed-up 15 months later to identify those with new CWP. Baseline data were available on their scores from a number of psychological scales including Illness Attitude Scales (IAS), Somatic Symptom Checklist (SSC), Hospital Anxiety & Depression Scale, Sleep Problems Scale, and Life Events Inventory.

Results: 324 subjects [10%, 95% confidence interval (CI) 9.2, 11.3] developed new CWP at follow-up. After adjustment for age and sex, three factors independently predicted the development of CWP: scoring three or more on the SSC [odds ratio (OR) 1.8, 95% CI 1.1, 3.1], scoring eight or more on the Illness Behaviour subscale of the IAS (OR 3.3, 95% CI 2.3, 4.8), and nine or more on the Sleep Problem Scale (OR 2.7, 95% CI 1.6, 3.2). Subjects exposed to all three factors were at 12 times the odds of new CWP than those with low scores on all scales.

Conclusion: Subjects are at substantial increased odds of developing CWP if they display features of somatization, health-seeking behaviour and poor sleep. Psychosocial distress has a strong aetiological influence on CWP.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Distribution
  • Aged
  • Chronic Disease
  • Epidemiologic Methods
  • Female
  • Fibromyalgia / etiology
  • Fibromyalgia / psychology*
  • Humans
  • Life Change Events
  • Male
  • Middle Aged
  • Pain Measurement / methods
  • Patient Acceptance of Health Care
  • Psychiatric Status Rating Scales
  • Psychometrics
  • Psychophysiologic Disorders / psychology*
  • Sleep Wake Disorders / psychology