HIGH risk of chronic pain in women with LOW education, LOW socio-economic status, and LOW mood
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Harald Breivik
In this issue of the Scandinavian Journal of Pain Thomtén et al. publish an interesting study on chronic pain in women indicating that depressive symptoms may have a mediating role in the high risk of developing chronic pain in women with low socio-economic status [1]. Their study confirms what Eriksen et al. have reported in their publications from the ongoing health surveys in Denmark for almost two decades [2]: low education and depression in middle aged women are significantly associated with persistent pain conditions. We do not know what is the egg and what is the hen: does low mental mood and depression cause chronic pain [3,4]? Or does a persistent pain condition and the accompanying stress on mental energy, working abilities, social interactions and financial strain cause depression [3,4]? Or is the explanation that some unfortunate persons have a shared vulnerability to both chronic pain and mental diseases such as depression, possibly through a dysfunctional brain dopamine system as suggested by Taiminen et al. [5]. It is not possible to successfully treat chronic pain without treating the accompanying depression as suggested by Linton and Bergbom [3] and strongly supported by Nicholas [4]. It is also not possible to help a complex chronic pain patient with amassive burden of socio-economic problems in addition to the pain condition without helping the patient with her (most often women) economic and social problems as emphasized by Hagelberg [6] and Aho et al. [7,8]. The study by Thomtén et al. [1] in this issue of the Scandinavian Journal of Pain is therefore a valuable reminder that chronic pain is strongly associated with the socio-economic status of the patient and that those who try to help these unfortunate women face a complex challenge where a truly multidisciplinary team approach is necessary [9]. The social worker, the psychologist and psychiatrist [3,4,10], the physiotherapist [11], as well as specialists in women’s diseases [11] are more important than the “pain specialist” using pharmacology and interventional techniques.
All of these aspects of chronic pain among women have been reviewed and discussed in-depth during the three first years of our publishing the Scandinavian Journal of Pain [1,3,4,5,6,78,9,10,11]. As founding Editor-in-Chief, I amgrateful for all the enthusiastic contributors to our scientific journal from the large group of health care providers and researchers in the Nordic countries who are interested in the many aspects of the conundrum chronic of pain and pain management. The Scandinavian Association for the Study of Pain (SASP) was founded in 1976 by Professor Ulf Lindblom and reinvigorated as newSASP in 2009 by Professor Torsten Gordh, launching the scientific journal of newSASP already in May 2009. The success of the journal so far witnesses to the need for this venue of scientific pain publications in the Nordic countries.
DOI of refers to article: 10.1016/j.sjpain.2011.12.003.
References
[1] Thomtén J, Soares JJF, Sundin Ö. Pain among women: association with socioeconomic factors over time and the mediating role of depressive symptoms. Scand J Pain 2012;3:62–7.Search in Google Scholar
[2] Eriksen J, Jensen MK, Sjøgren P, Ekholm O, Rasmussen NK. Epidemiology of chronic nonmalignant pain in Denmark. Pain 2003;106:221–8.Search in Google Scholar
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[6] Hagelberg NM. Social work in a pain clinic. Scand J Pain 2010;1:74–5.Search in Google Scholar
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[8] Aho H, Kauppila T, Haanpää M. Patients referred from a multidisciplinary pain clinic to the social worker, their general health, pain condition, treatment, and outcome. Scand J Pain 2010;1:220–6.Search in Google Scholar
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© 2012 Scandinavian Association for the Study of Pain
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Articles in the same Issue
- Editorial comment
- HIGH risk of chronic pain in women with LOW education, LOW socio-economic status, and LOW mood
- Observational studies
- Pain among women: Associations with socio-economic factors over time and the mediating role of depressive symptoms
- Editorial comment
- Systematic reviews—Great gains and significant pitfalls
- Review
- Does evidence support physiotherapy management of adult female chronic pelvic pain? A systematic review
- Editorial comment
- Effective treatment of osteoarthritic pain, tackling the challenge with pets
- Review
- Translational animal models using veterinary patients – An example of canine osteoarthritis (OA)
- Editorial comment
- Pre-procedure anxiety aggravates pain—A problem also in adult patients
- Clinical pain research
- Anxiety and pain during bone marrow aspiration and biopsy
- Editorial comment
- What is required from studies evaluating multidisciplinary treatment in pain clinics?
- Clinical pain research
- Long-term outcome of multidisciplinary intervention of chronic non-cancer pain patients in a private setting
- Editorial comment
- Optimal thoracic epidural analgesia–Again
- Clinical pain research
- Epidural pain management after open lateral thoracotomy: Female patients have better pain relief and need smaller amounts of analgesics than males
