Predictors of outcome in a cohort of women with chronic pelvic pain - a follow-up study.

BACKGROUND Chronic pelvic pain (CPP) in women is a long-lasting condition. AIMS To explore changes in pain intensity, adjustment to pain, pain appraisal and coping strategies as well as to evaluate whether baseline pain appraisals and coping strategies and their changes were associated with outcome in the long term. METHODS A follow-up study was conducted on all consecutive women who had visited a CPP-team of a university hospital. After an average period of 3.2 years 64% of them (N=84) completed questionnaires at baseline and follow-up. RESULTS A reduction in pain intensity (p<.001, d=.6), improvement in adjustment to pain (SF-36 Physical Component Summary (p<.001, d=.4) and depressive symptoms (p<.01, d=.2)), as well as a reduction in catastrophizing pain (p<.01, d=.4) and an increase in perceived pain control (p<.01, d=.3) were observed. Neither biographic nor clinical variables were related with these changes. Pain appraisal and coping strategies at baseline did not predict changes from baseline in pain intensity. However, baseline levels of perceived pain control correlated with a change in depressive symptoms (r=-.27, p<.05), also after adjustment for pain intensity at baseline (r=-.28, p<.05). Changes from baseline in levels of catastrophizing pain were associated with changes in pain intensity (r=.44, p<.01), SF-36 Physical Component Summary (r=-.34, p<.01) and depressive symptoms (r=.71, p<.01). CONCLUSION At a 3 year follow-up, improvement in pain intensity in women with CPP was not associated with baseline pain appraisals and coping strategies. A reduction in catastrophizing was related to better outcome in the long term.