Premorbid psychosocial factors are associated with poor health-related quality of life in subjects with new onset of chronic widespread pain - results from the EPIFUND study

Pain. 2009 Jan;141(1-2):119-26. doi: 10.1016/j.pain.2008.10.022. Epub 2008 Dec 6.


Chronic widespread pain (CWP) is associated with poor health-related quality of life (HRQoL). It is unclear whether pain itself is the cause of poor HRQoL or other factors play a role. We hypothesised that new onset of CWP was associated with poor physical and mental HRQoL but that psychosocial risk markers for CWP onset would explain this relationship. A prospective population-based survey measured pain and psychosocial status at baseline. Subjects free of CWP at baseline were followed up 15 months later, when pain status, threatening life events and HRQoL (SF-12) were assessed. The risk associated with the new onset of CWP and reporting poor SF12-MCS and SF12-PCS was quantified using multinomial logistic regression (relative risk ratios (RRRs) with 95% confidence intervals (95% CI)), adjusted for age and gender. 3000 subjects (77%) free of CWP at baseline participated at follow-up. 2650 subjects (88%) provided full SF-12 and pain data and formed the cohort for this analysis. 9.4% of subjects (n=248) reported new CWP. New CWP was associated with an increased risk of having the poorest SF12-MCS (RRR=2.3; 95% CI 1.6-3.2) and SF12-PCS (RRR=8.0; 95% CI 5.4-11.8) scores. After adjusting for baseline psychosocial status, the relationship between CWP onset and SF12-MCS was attenuated (RRR=1.2; 95% CI 0.8-1.8), although the association with SF12-PCS remained (RRR=4.8% CI 3.1-7.47). New onset of CWP is associated with poor mental and physical HRQoL. However, the relationship with mental HRQoL is explained by psychosocial risk markers.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Chronic Disease
  • Community Health Planning
  • Factor Analysis, Statistical
  • Female
  • Fibromyalgia / epidemiology
  • Fibromyalgia / psychology*
  • Health Status*
  • Humans
  • Male
  • Middle Aged
  • Musculoskeletal Diseases / epidemiology
  • Musculoskeletal Diseases / psychology*
  • Pain Measurement
  • Pain Threshold
  • Prospective Studies
  • Psychology*
  • Psychometrics
  • Quality of Life / psychology*
  • Sickness Impact Profile
  • Sleep Wake Disorders
  • Somatoform Disorders / complications
  • Somatoform Disorders / psychology
  • Surveys and Questionnaires
  • Young Adult