Study on pain catastrophizing and pain improvement rate in patients with rheumatoid arthritis

2020 Fiscal Year Final Research Report

• Project/Area Number: 19K21429
• Project/Area Number (Other): 18H06346 (2018)
• Research Category: Grant-in-Aid for Research Activity Start-up
• Allocation Type: Multi-year Fund (2019); Single-year Grants (2018)
• Review Section: 0908:Society medicine, nursing, and related fields
• Research Institution: Kyoto Prefectural University of Medicine
• Principal Investigator: Yoshida Tamami 京都府立医科大学, 医学部, 客員講師 (30826087)
• Project Period (FY): 2018-08-24 – 2021-03-31
• Keywords: 関節リウマチ / 心理・認知行動療法 / 破局的思考 / 疼痛 / 臨床的寛解

Outline of Final Research Achievements

This cross-sectional study in patients with rheumatoid arthritis (RA) has two aim; To evaluate the relationship between pain catastrophizing, the state of systemic inflammation, and achievement of remission, to evaluate the relationship between residual pain after improved inflammation and pain catastrophizing.
We showed that pain catastrophizing is a major obstacle to achieving remission. The overestimation of RA disease activity due to elevated patient global assessment, which is one of the index of clinical remission, was more likely in the presence of pain catastrophizing, which was especially observed in patients without systemic inflammation. Moreover, pain catastrophizing was associated with pain VAS scores in patients who achieve remission except patient's oriented report.
These results showed that the presence of high-risk group in which it is difficult to achieve remission due to psychogenic factors and the image of patients suffering from psychogenic pain have become clear.

Free Research Field

臨床看護

Academic Significance and Societal Importance of the Research Achievements

本研究で明らかになった「CRPレベルが正常な非寛解患者の約34％の疾患活動性は、破局的思考（心因的要因）に起因した患者主観的評価の上昇により過大評価されている可能性がある」、「腫脹関節・圧痛関節・CRPレベルが正常化したにもかかわらず残存する疼痛強度と破局的思考には正相関があった」、この2点の結果は、痛みの改善に対する心理・認知行動療法が有効である可能性が高い患者像を明確にしたと言える。寛解率のさらなる向上とともに、残存痛への対応というアンメットニーズに貢献すると考える。