Sex differences in psychosocial resources among people with chronic pain and with pain more seldom

Abstract

Abstract Background Despite the importance of psychosocial resources such as self-efficacy and social support for pain coping, sex differences in populations with and without chronic pain, and the impact of psychosocial resources on pain prospectively is sparsely examined. Methods Data from the Health Assets Project, a longitudinal cohort study with two data collections (2008 and 2009) in Sweden was used. We analyzed self-efficacy, emotional and instrumental social support among 1155 people with chronic pain and 2855 people with pain more seldom, including sex differences and the interaction between pain and sex. Among people with chronic pain we examined prospective associations between self-efficacy and social support in 2008 and pain in 2009. All regression models were analyzed unadjusted and adjusted for age, education and place of birth. Results People with chronic pain had lower psychosocial resources than people with pain more seldom (p<.001). People with pain more seldom showed sex differences for all psychosocial resources (p<.001), people with chronic pain did not show sex differences for instrumental social support. In addition, the interaction between sex and pain was significant for instrumental social support (p=.006, p=.005). Men with pain more seldom had the highest prevalence of low instrumental social support. High compared to low instrumental social support in 2008 was associated with lower odds of chronic pain in 2009, especially for women (OR = 2.2, 95%CI=1.19-4.28). The association between pain 2009 and the interaction between sex and high emotional social support was significant (p=.040). Women with high compared to low emotional support 2008 had 55% higher chance to have pain more seldom 2009, men had a 28% lower chance. Conclusions People with chronic pain showed less sex differences in psychosocial resources, compared to people with pain more seldom. In addition, for women, social support was associated with lower pain frequency during one-year follow-up. Key messages Men and women with chronic pain reported more alike on psychosocial resources than men and women with pain more seldom. For women only, both high instrumental and high emotional social support were associated with lower pain frequency during one-year follow-up.