Navigating the biopsychosocial landscape: A systematic review on the association between social support and chronic...

The biopsychosocial model is widely used to explain chronic pain conditions. Yet, the role of social aspects including social support is not clear. Literature on social support and chronic pain is still sparse and results inconsistent. The aim of this review is to evaluate the association between social support and different aspects of chronic pain such as pain intensity, pain interference, quality of life, depression and anxiety. We performed a search on Pubmed, Embase, PsycINFO, Cochrane Library, Scopus and CINAHL database entries between January 1, 1980 and May 7, 2024. Two independent investigators selected all longitudinal (prospective or retrospective) and cross-sectional studies in adult populations investigating the effect of perceived social support, social support satisfaction or spousal responses on different aspects of chronic pain (persistent or recurrent pain lasting longer than 3 months). Out of 11,908 queried results, 67 studies met our inclusion criteria. After assessing for risk of bias (adapted version of the "JBI Critical Appraisal Checklist for Analytical Cross-Sectional Studies") and quality of evidence (adapted version of the quality assessment tool of Hawker and al.), 35 studies were included in the final analysis. We found that perceived social support was positively associated with quality of life and negatively associated with depression. Social support satisfaction was negatively associated with depression. Spousal responses were positively associated with pain intensity, pain interference and depression. This review found that, in patients with chronic pain, social support is mainly associated with psychological variables. However, most studies were cross-sectional, and most analyses were correlations. There is a need for higher quality longitudinal studies. The type of social support studied should be clearly defined in every study.