Pain-mood relationships in patients with rheumatoid arthritis

Pain-mood relationships were investigated in 23 patients with long-standing rheumatoid arthritis over a two-week period. Patients completed form B of the Eysenck personality inventory on entry to the study and visual analogue scales for pain, anxiety and sadness daily throughout the study period. Two pain-mood relationships were identified: a synchronous relationship in which pain and mood scores were positively correlated and an asynchronous relationship in which pain and mood scores were uncorrelated. Furthermore, in all patients reporting high pain and showing synchronous relationships, the pain and mood scores were similar in magnitude, while in all patients reporting high pain and showing asynchronous relationships, the pain and mood scores were dissimilar in magnitude. The latter patients remained calm and happy despite severe pain. All patients reporting low pain showed synchronous and close relationships between pain and mood. Extraversion, neuroticism, age, duration and severity of disease were unrelated to pain severity and the pain-mood relationships recorded. The asynchronous pain-mood relationship was attributed to a coping response to severe pain. Patient education combined with physical, psychological and pharmacological treatments might induce such a response in patients unable to cope with chronic pain.