Associations of Psychologic Factors with Multiple Chronic Overlapping Pain Conditions

J Oral Facial Pain Headache. 2020;34(Suppl):s85-s100. doi: 10.11607/ofph.2584.


Aims: To characterize psychologic functioning across five chronic overlapping pain conditions (COPCs)-temporomandibular disorders, fibromyalgia, low back pain, headache, and irritable bowel syndrome-and their overlaps.

Methods: Participants were 655 adults in the OPPERA study. Psychologic variables were standardized in separate logistic regression models to compare their relative strength of association with each COPC. Random forest regression was used to explore the association of all psychologic measures with COPCs simultaneously. Linear regression analyses examined whether the count of COPCs was associated with psychologic measures.

Results: In univariate and multivariable analyses, measures of somatic symptom burden showed the strongest associations with individual COPCs and with the number of COPCs. Additional psychologic variables that showed significant associations with individual COPCs and their overlap included negative mood, perceived stress, and pain catastrophizing.

Conclusion: These findings highlight the importance of psychologic functioning in the assessment and management of these overlapping pain conditions.

MeSH terms

  • Adult
  • Chronic Disease
  • Chronic Pain*
  • Humans
  • Pain Measurement
  • Somatoform Disorders
  • Temporomandibular Joint Disorders*