Developing a better biopsychosocial understanding of pain in inflammatory bowel disease, 2019, Moss-Morris et al

[Andy]

Objective
Pain is frequently reported by patients with inflammatory bowel disease (IBD). Pain in IBD is not fully explained by disease activity or other clinical findings, and a recent systematic review suggested that psychosocial factors have an important role in IBD-pain. The aim of this study was to investigate psychosocial factors associated with pain in IBD.

Methods
297 adults (>16 years) with IBD were recruited from outpatient clinics (n = 114) and online (n = 183). Participants completed validated questionnaires assessing pain and potential emotional, cognitive and behavioural correlates. Socio-demographic and clinical factors including disease activity were also recorded.

Results
243 (81.8%) of participants reported pain. Of these 243, mean age was 36 years; 153 (63%) had Crohn’s disease, 90 (37%) had ulcerative colitis, and 165 (67.9%) were female. 62.6% reported mild, 31.6% moderate and 5.8% severe pain. 40.3% of participants with pain met established criteria for chronic pain and 18.5% reported opioid use. Female gender, smoking, surgery and steroid use were associated with greater pain severity. Psychosocial factors associated with pain-related interference included depression, catastrophising, fear avoidance, lower self-efficacy and worse mental well-being. Regression models explained 45.6% of the variance in pain severity and 49.7% of pain interference. Psychosocial factors explained 9.5% and 24% of this variance respectively when controlling for demographic and clinical variables.

Conclusions
Pain in IBD is significantly associated with cognitive and behavioural factors as well as low mood. This study contributes to a biopsychosocial understanding of pain in IBD and identifies important targets for future interventions.

Paywall, https://journals.lww.com/eurojgh/Ab...tter_biopsychosocial_understanding.97659.aspx
Unavailable via Sci hub at time of posting.

 

[Hoopoe]

I wish they'd just get on with it and embrace the lightning process. I'm sure it's superior to anything else in unblinded clinical trials that rely on self reported outcomes. If you discard the skeptical participants first as they usually do.

 

[Cheshire]

Psychological taylorism. You have a single and simple model that you apply to every illnesses you happen to work on. You have adapted tools that measure only positive results.

Spares time and intellectual activity.
You can copy and paste lots of stuff.

MM and her mates are geniuses, truly.

 

[ladycatlover]

Dear lord, when will these idiots ever stop? They're trying to take over the whole of medicine! Moss-Morris, that explains a lot.

 

[James Morris-Lent]

So it's news to these people that pain is psychologically distressing? That's literally part of the definition...

 

[shak8]

I think there needs to be an IQ test and higher threshold for prospective PhD psychology students.

 

[rvallee]

Could this be any more vague?

Pain in IBD is significantly associated with cognitive and behavioural factors as well as low mood

This thing is associated with... other... things. And sick people feel sick but that makes no sense to some people apparently. People who have been trained in the science of sickness, but they can't wrap their heads around what those words mean.

Regression models explained 45.6% of the variance in pain severity and 49.7% of pain interference. Psychosocial factors explained 9.5% and 24% of this variance respectively when controlling for demographic and clinical variables.

There is literally more value in throwing random numbers down some stairs than this nonsense. Does anyone even actually read this stuff and think it makes any sense? Entirely meaningless statistical drivel. Throwing manufactured numbers around does not in itself make something significant. It's literally arguing that the consequence of should be thought of as a contributing factor, that it is the choking of those breathing the smoke that creates the fire. As is tradition.

This study did not, in fact, contribute any understanding of anything. Building an entire discipline around "those random correlations are in fact causation", unsurprisingly not useful at all.

 

[Trish]

I think there needs to be an IQ test and higher threshold for prospective PhD psychology students.

And for their professors!

Seriously though, I think skills required include far broader than the narrow range tested in an IQ test. Ability to see when they are being misled by supervisors with a fixed mindset. Ability to distinguish correlation from causation, ability to understand the severe limitations of questionnaires... Lateral thinking, curiosity, genuine interest in understanding patients...

 

[Jonathan Edwards]

All you need is to be an occupational therapist and have poor skills in the English language:

I have had an unusual trajectory into science. My early career was as a clinical occupational therapist (OT) and at that time I had no intention of becoming a scientist. I loved clinical work and my aim was to try and make a difference to the lives of people dealing with illnesses. OT provided a good foundation for the work I do now as it included training in both mental and physical health. My work with patients made me increasingly aware that too often these aspects are separated in our current health system with detrimental results. When an opportunity arose to return to post graduate study I decided to investigate this further by focusing on patient groups who really loose out in the current system, those considered to have medically unexplained physical symptoms. Overtime I realised the issues for those with physical illnesses were not too different to those with medically unexplained illnesses and my work expanded to look at adaptation to long term conditions and managing difficult and unpleasant symptoms.

I was particularly interested in the sentence:
Overtime I realised the issues for those with physical illnesses were not too different to those with medically unexplained illnesses...

So maybe they are unexplained physical illnesses. After all they have unexplained physical symptoms. But wait, no, that cannot be right, can it? How can unexplained physical things be physical? Can someone explain?

No, what was meant was that medically unexplained illnesses are not physical, not even biopsychosociophysical. Just psychological. Good we have got that straight.