Adaptation to chronic pain in systemic lupus erythematosus: applicability of the multidimensional pain inventory.

Abstract

1) Investigate psychosocial adaptation to chronic pain in patients with systemic lupus erythematosus; 2) Compare pain adaptation of lupus, chronic low back pain, and temporomandibular disorders patients; and 3) Evaluate the validity of Multidimensional Pain Inventory-based profiles of lupus patients. Two hundred forty females with pain related to systemic lupus erythematosus (N =80), chronic low back pain (N=80), or pain related to temporomandibular disorders (N=80) completed the Multidimensional Pain Inventory, a 60-item psychosocial assessment instrument. All patients were classified into empirically derived profiles based on Multidimensional Pain Inventory responses. Systemic lupus erythematosus profile groups were compared on conceptually related variables external to the classification, including indices of lupus disease activity, pain, distress, and physical function. The scores of lupus patients resembled those of temporomandibular disorder patients, while chronic low back pain patients had higher pain and activity interference. 87.5% of lupus patients could be classified into one of three profiles: Dysfunctional (14%), interpersonally distressed (27.5%), or adaptive coper (46%). The Multidimensional Pain Inventory profiles for lupus patients demonstrated validity, based on external measures. Although many systemic lupus erythematosus patients cope well with their chronic pain, a substantial proportion exhibit pain-related distress, activity interference, or interpersonal difficulties.