Maladaptive stress coping: An additional psychological factor in the process of chronification of pain or pruritus

Abstract

• Increased dysfunctional stress coping in patients with chronic pruritus or back pain • Married use positive coping strategies more often than single persons • Women use negative coping strategies more often than men. • Recommendation of early psychological interventions may reduce maladaptive stress coping Inflammatory skin diseases with chronic pruritus and chronic back pain are very common symptoms in the general population and are associated with a reduced quality of life (QOL). In addition to biological factors, psychosocial reasons are also considered to be responsible for their development. So far, it is not known whether chronic pruritus and chronic back pain are related to maladaptive stress coping. In our matched pilot case-control study with a total of 259 analyzed subjects, we compared outpatient groups, one suffering from chronic skin diseases with pruritus, the other with chronic back pain, to a healthy control group in terms of their stress coping approach. For analysis, the stress coping questionnaire (“Stressverarbeitungsfragebogen SVF78”) was employed, which records the habitual individual tendency for different types of stress coping. Both investigated patient groups showed a higher expression in the negative strategies compared to the control group. Both, the mean values of the pain group (12.28; p < 0.01) and the mean values of the pruritus group (10.59; p < 0.05) differed significantly from the mean values of the control group (8.69). In comparison, the manifestation of positive strategies did not vary significantly between the groups. Furthermore, gender and marital status were identified as impact factors for stress coping mechanism. Additionally, the duration of pruritus turned out to be a predictor for negative stress coping in the pruritus group. A limitation of our study is the lack of validated data, since there was no study available comparing chronic back pain and chronic pruritus patients assessing stress coping mechanism via SVF78. Furthermore, the missing screening for anxiety and depression could be seen critically in retrospect. It could be shown that patients with chronic pruritus and patients with chronic back pain have a more negative and thereby more dysfunctional stress coping compared to healthy study participants. Psychological interventions to reduce maladaptive stress coping strategies for pain and pruritus patients are recommended.