Article

OBJECTIVE: To evaluate the contribution of improvement in negative emotional
cognitions, active cognitive coping, and control and chronicity beliefs to the
outcome of multidisciplinary treatment in patients with chronic widespread pain.
DESIGN: Prospective cohort study. PATIENTS: A total of 120 subjects diagnosed
with chronic widespread pain, who completed a multidisciplinary pain programme.
METHODS: Data from baseline, 6 months and 18 months follow-up measurements were
analysed. Longitudinal relationships were analysed between changes in cognitions
and outcome, using generalized estimated equations. Outcome domains included:
pain, interference of pain in daily life, depression, and global perceived
effect. Cognitive domains included: negative emotional cognitions, active
cognitive coping and control and chronicity beliefs.
RESULTS: Improvements in
negative emotional cognitions were associated with improvements in all outcome
domains, in particular with improvement in interference of pain with daily life
and depression (between baseline and 6 months, and 6 and 18 months). Improvements
in active cognitive coping were associated with improvements in interference of
pain in daily life (between baseline and 6 months). Improvements in control and
chronicity beliefs were associated with improvements in pain and depression
(between 6 and 18 months). CONCLUSION: Improvement in negative emotional
cognitions seems to be a key mechanism of change in multidisciplinary treatment
of chronic widespread pain. Improvement in active cognitive coping and
improvement in control and chronic timeline beliefs may also constitute
mechanisms of change, although the evidence is less strong.

Langue : ANGLAIS