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Psychological distress mediates the effect of pain on function
Stephen T Wegener1, Renan C Castillo, Jennifer Haythornthwaite
1Department of Physical Medicine and Rehabilitation, The Johns Hopkins School of Medicine, Phipps Rm 174, 600 N Wolfe St., Baltimore, MD 21287, USA Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA Department of Orthopaedic Surgery, Carolinas Medical Center, Charlotte, NC, USA.
Pain
|March 15, 2011
Summary
Psychological distress significantly impacts physical function after lower extremity trauma. As recovery progresses, distress plays a greater role than pain in mediating functional outcomes.
Area of Science:
- Orthopedics
- Trauma Surgery
- Rehabilitation Medicine
- Psychology
Background:
- Major lower extremity trauma presents complex recovery challenges.
- Understanding factors influencing physical function is crucial for patient outcomes.
- Psychological distress and pain are common sequelae of severe traumatic injuries.
Purpose of the Study:
- To analyze the longitudinal relationship between pain, psychological distress, and physical function after major lower extremity trauma.
- To determine the mediating role of psychological distress and pain on physical function over time.
- To identify key factors influencing recovery trajectories in trauma patients.
Main Methods:
- Prospective 2-year observational study of 327 patients with major lower extremity trauma.
- Data collected at 3, 6, 12, and 24 months post-injury.
- Structural equation modeling used to analyze relationships between pain, psychological distress (depressive and anxious), and physical function.
Main Results:
- Higher preceding psychological distress correlated with lower physical function at 6, 12, and 24 months.
- Higher preceding pain correlated with lower physical function at 6 and 12 months, but not 24 months.
- Psychological distress increasingly mediated the impact of pain on function over the 2-year recovery period.
Conclusions:
- Psychological distress is a significant predictor of long-term physical function after lower extremity trauma.
- The influence of psychological distress on physical function increases over time, becoming more prominent than pain.
- Interventions addressing psychological distress are vital for optimizing recovery and physical function in trauma survivors.
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