Patients with Chronic Pain: Are Mindfulness Traits Protective Against Distress, Anxiety and Depression?

Abstract

Objective: To investigate mindfulness traits/attitudes as protective factors against chronic pain related distress, depression and anxiety.

Method: Fifty patients (25 with chronic non-oncologic pain-NOP; 25 with chronic oncologic pain-COP) were administered with the following scales: Visual Analogue Scale (VAS), Pain Disability Index (PDI), Italian Questionnaire for Pain (QUID), Perceived Stress Scale (PSS), State and Trait Anxiety Scale (STAY-y1 module), Beck Depression Inventory II (BDI-II), Pittsburgh Sleep Quality Index (PSQI), Psychological General Well Being Index (PGWBI), Mindful Attention Awareness Scale (MAAS).

Results: MAAS value ≥ 4.38 was adopted as cut-off to compare 'high level of mindfulness' (HM) vs. 'normal level of mindfulness' (NM) attitudes. Twenty-six patients (52%) scored ≥4.38, with no different distribution between NOP and COP. HM patients scored significantly lower than NM patients on PDI 'family/home responsibilities' domain (4.5±3.2 vs. 6.4±2.8; p<.037), and on PSS (17.8±2.6 vs. 20.9±2.5; p<.0001), STAY-y1 (9.4±1.8 vs. 10.3±2.1; p<.0001), BDI-II (7.8±5.0 vs. 17.6±8.6; p<.0001) total scores. HM scored significantly higher than NM patients in all PGWBI domains. A multiple regression analysis was carried out to analyze the predictor variables of PGWB. The most complete model considered the variables MAAS, STAIy and VAS (F=42.21; p<.0001), that accounted for the 71.6% of PGWB variance. MAAS score was the only variable positively predicting for PGWB; STAIy and VAS scores predicted negatively.

Conclusions: Chronic pain patients with high levels of mindfulness attitudes experienced less distress, anxiety, depressive symptoms, and more physical and general wellbeing than patients with low levels of mindfulness attitudes.

Keywords: anxiety; chronic pain; depression; mindfulness; oncologic.