Perception of pain in men and women with rheumatoid arthritis

Czech version

Authors: I. Nagyová ¹; K. Thorstensen ¹; J. Benka ²; Ž. Macejová ³
Authors‘ workplace: Ústav sociálnej a behaviorálnej medicíny, Lekárska fakulta, Univerzita P. J. Šafárika, Košice ¹; Katedra pedagogickej psychológie a psychológie zdravia, Filozofická fakulta, Univerzita P. J. Šafárika, Košice ²; I. interná klinika, Lekárska fakulta, Univerzita P. J. Šafárika a Univerzitná nemocnica L. Pasteura, Košice ³
Published in: Čes. Revmatol., 27, 2019, No. 3, p. 106-114.
Category: Original article

Overview

Objective: Epidemiologic, clinical, and experimental evidence points to gender differences in musculoskeletal pain. However, less is known about the factors that play a role in these differences. The aim of our study was to analyse the relative proportion of sociodemographic, clinical, and psychological characteristics explaining differences in perception of pain in men and women with rheumatoid arthritis (RA).

Sample and methods: The sample consisted of 297 patients with RA (240 women and 57 men) with mean age of 56.0 ± 11.6 years and mean disease duration of 10.3 ± 6.9 years. Pain was assessed using two standardized scales – the Ritche Articular Index (RAI) and the pain subscale of the Short Form-36 Health Survey (SF36-BP). The disease activity was measured by examining the CRP levels, FW values, and DAS28-CRP4. Disability was assessed by the Health Assessment Questionnaire (HAQ-DI), anxiety and depression using the General Health Questionnaire (GHQ-28), and adjustment to disease by a single-item scale ADJ.

Results: Multiple regression analyses showed that men and women differ in perception of pain. In males, significant factors associated with pain were clinical parameters explaining 40% and 22% of the total variance in pain (RAI: Fsmc = 7.189, p < 0.001; SF36-BP: Fsmc = 5.187, p < 0.001). In females, also psychological characteristics played a significant role in subjective perception of pain, adding up to 9% to the total explained variance (SF36-BP: Fsmc = 8.107, p < 0.001), after controlling for relevant sociodemographic and clinical characteristics.

Conclusions: The results of this study suggest that psychological distress and especially pain-related anxiety is part of the reason why men and women might perceive pain differently. A better understanding of the mechanisms that lead to persistent chronic pain and accounting for gender differences may increase the overall effectiveness of treatment in RA patients.

Keywords:

rheumatoid arthritis – Pain – gender differences – anxiety – depression – disease activity

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Odborné události

Article was published in

Czech Rheumatology

2019 Issue 3