The role of emotions reported in the emergency department in four-month chronic pain development: Effects of sadness and anger

Abstract

Objective: This study aims to assess whether the emotions experienced during an urgent health problem represent risk factors for developing chronic pain.

Method: A pain study was carried out as part of a randomized multicentre study on the prevention of post-concussion syndrome and post-traumatic stress syndrome (SOFTER) following emergency hospitalisation. Nine hundred and fourteen patients not suffering from chronic pain at admission provided information on the presence and intensity of eight emotions (anger, fear, regret, sadness, relief, contentment, joy, and interest) during their stay at the emergency department. Four months later, they were called to assess if chronic pain had developed. The predisposition to experience these emotions prior to the emergency room was questioned at this occasion.

Results: Four months after their admission to the emergency department (ED), 30 % of the patients described experiencing chronic pain. Adjusted for patient's perception of own health, intensity of acute pain, reason for visit and level of education at the time of admission, sadness (OR = 1.5 95 % CI = [1.1-2.2]) and anger (OR = 1.6 95 % CI = [1.1-2.5]) declared in the ED were predictive of pain status at four months. By taking into account patient pre-disposition to feel each of these two emotions, we observed a significantly higher risk of chronic pain at four months among patients pre-disposed to anger who declared a relatively strong anger during their time spent in the ED (OR = 2.90, IC = 1.12-7.52).

Conclusion: This study shows that the emotional state of patients admitted to the ED must be taken into consideration in order to detect people likely to experience chronic pain and therefore offer personalised preventive treatment. Further studies will be necessary to better comprehend the role played by emotions in the development of chronic pain.

Keywords: Anger; Biopsychosocial model; Chronic pain; Emergency department; Emotions; Sadness.