The role of catastrophizing in the prediction of postoperative pain

Pain Med. 2009 Nov;10(8):1452-9. doi: 10.1111/j.1526-4637.2009.00730.x. Epub 2009 Oct 26.


Objective: Catastrophizing has been broadly conceived as an exaggerated negative "mental set" brought to bear during actual or anticipated pain experience and has risen to the status of one of the most important psychological predictors of pain. The present study aimed at investigating the relationship between catastrophizing and postoperative pain outcomes (pain intensity and analgesia use) in patients undergoing elective instrumented lumbar fusion surgery.

Design: On the day before surgery, 61 patients completed the Greek versions of the Pain Catastrophizing Scale and the Hospital Anxiety and Depression Scale. On postoperative days 1 and 2, pain intensity (at rest and during activity) on the Verbal Rating Scale as well as intravenous patient-controlled analgesia fentanyl use were assessed.

Results: Catastrophizing and gender predicted postoperative pain intensity at rest, whereas catastrophizing emerged as the unique predictor of postoperative pain intensity during activity. Catastrophizing and anxiety predicted analgesic use.

Conclusions: The present study findings suggest that it is possible to preoperatively identify patients at risk for experiencing more severe pain in the postoperative recovery period. In such cases, consideration might be given to utilizing a variety of resources to ameliorate or prevent pain.

MeSH terms

  • Adult
  • Aged
  • Analgesics / therapeutic use
  • Anxiety / diagnosis*
  • Anxiety / epidemiology
  • Attitude to Health
  • Comorbidity
  • Depression / diagnosis*
  • Depression / epidemiology
  • Female
  • Greece
  • Humans
  • Illness Behavior*
  • Male
  • Mass Screening
  • Middle Aged
  • Neuropsychological Tests
  • Pain Measurement
  • Pain Threshold / psychology*
  • Pain, Postoperative / diagnosis*
  • Pain, Postoperative / epidemiology
  • Pain, Postoperative / psychology*
  • Predictive Value of Tests
  • Preoperative Care
  • Sex Distribution
  • Spinal Fusion / psychology
  • Spondylosis / surgery
  • Stress, Psychological / diagnosis
  • Stress, Psychological / epidemiology
  • Stress, Psychological / psychology
  • Young Adult


  • Analgesics