The relationship of gender to pain, pain behavior, and disability in osteoarthritis patients: the role of catastrophizing

TLDR

The study enrolled 168 knee osteoarthritis patients (72 men, 96 women) who completed the Arthritis Impact Measurement Scales, a 10‑minute pain‑behavior observation, and self‑report measures of catastrophizing and depression. Women with OA reported higher pain, disability, and pain behavior than men, but these gender differences were fully mediated by catastrophizing, which remained significant even after adjusting for depression.

Abstract

One hundred and sixty-eight patients with osteoarthritis (OA) of the knees participated in this study. Of the participants, 72 were men and 96 were women. All participants completed the Arthritis Impact Measurement Scales (AIMS), underwent a 10 min standardized observation session to assess their pain behavior, and completed the Catastrophizing Scale of the Coping Strategies Questionnaire (CSQ) and the Depression Scale of the Symptom Checklist 90 Revised (SCL-90R). The study found that there were significant differences in pain, pain behavior, and physical disability in men and women having OA. Women had significantly higher levels of pain and physical disability, and exhibited more pain behavior during an observation session than men. Further analyses revealed that catastrophizing mediated the relationship between gender and pain-related outcomes. Once catastrophizing was entered into the analyses, the previously significant effects of gender were no longer found. Interestingly, catastrophizing still mediated the gender–pain relationship even after controlling for depression. These findings underscore the importance of both gender and catastrophizing in understanding the OA pain experience and may have important implications for pain assessment and treatment.