Keywords: Pain, headache, 4DSQ, mental health

Background:

This study was designed to enhance our understanding of the mediating role of sociodemographic factors in the relationship between mental health and pain .

Research questions:

1.Is there a correlation between mental health status and pain perception?
2.Which sociodemographic factors influence or are influenced by pain symptom?
3. Is there a difference between type of pain and related mental health symptoms?

Method:

Four-dimensional symptom questionnaire (4DSQ) was used to determine the mental health status of 158 participants who were separated into four groups as follows: 1: Control group (CG), 2:Headache group (HG), 3: Physical pain group (PPG), 4: Mixt pain group (MPG). A demographic data form, and a pain questionnaire were also applied. The Chi-square test or Fisher’s exact test was used to compare the categorical variables. The Independent samples t-test or Mann-Whitney U test was used to compare continuous variables between two independent samples, and the one-way ANOVA test or Kruskall-Wallis test was used to compare continuous variables between more than two independent samples.

Results:

Female gender was significantly more expressed in mixt pain group. Mixt pain group had higher VAS scores (p=0.002) and higher BMI scores (p=0.025) than headache group. The group with headache was significantly younger than the group with physical pain (p<0.001). Headache and mixt pain groups reported lower income compared with controls and physical pain group (p<0.001). Unemployment rate was higher in mixt pain group than physical pain and control groups (p<0.001). Psychiatric diagnoses were more common in the mixt pain group than the other groups (p=0.047). Among all participants expressing pain, 88.9% of them felt that their quality of life (QoL) either partially or completely was affected.

Conclusions:

Socioeconomic and individual factors influence the relationship between headache, physical pain and mental health. It is crucial in primary care to understand the multifaceted etiology of chronic pain.

Points for discussion:

emphasizing the need of a biopsychosocial approach when assessing chronic pain

Differentiating social and individual stress from other organic and psychiatric causes in chronic pain syndromes

Initiating an individualized, person-centered approach