Header

UZH-Logo

Maintenance Infos

The influence of catastrophizing on treatment outcome in patients with non-specific low back pain: A systematic review - Zurich Open Repository and Archive


Wertli, Maria M; Burgstaller, Jakob M; Weiser, Sherri; Steurer, Johann; Kofmehl, Reto; Held, Ulrike (2014). The influence of catastrophizing on treatment outcome in patients with non-specific low back pain: A systematic review. Spine, 39(3):263-273.

Abstract

Study Design. Systematic reviewObjective. The aim of the current study was to assess the effect of catastrophizing on treatment efficacy and outcome in patients treated for low back pain.Summary of Background Data. Psychological factors including catastrophizing thoughts are believed to increase the risk for chronic low back pain. The influence of catastrophizing is debated.Methods. In September 2012 the following databases were searched: BIOSIS, CINAHL, Cochrane Library, Embase, OTSeeker, PeDRO, PsycInfo, Medline, Scopus, and Web of Science. For 50 of 706 references full text was assessed. Results based on 11 studies were included in this analysis.Results. In 11 studies, a total of 2,269 patients were included. Seven studies were of good and four of moderate methodological quality. Heterogeneity in study settings, treatments, outcomes, and patient populations impeded meta-analysis. Catastrophizing at baseline was predictive for disability at follow-up in four studies and for pain in two studies. Three studies found no predictive effect of catastrophizing. A mediating effect was found in all studies (n = 5) assessing the impact of a decrease in catastrophizing during treatment. A greater decrease was associated with better outcome. Most studies that investigated the moderating effects on treatment efficacy found no effect (n = 5). However, most studies did not look for a direct interaction between the treatment and catastrophizing thoughts. No study investigated the influence of catastrophizing on work-related outcomes including return to work.Conclusion. Catastrophizing predicted degree of pain and disability and mediated treatment efficacy in most studies. The presence of catastrophizing should be considered in patients with persisting back pain. Limited evidence was found for the moderating effects on treatment efficacy. Future research should aim to clarify the role of catastrophizing as a moderator of outcome and investigate its importance for work-related outcomes.

Abstract

Study Design. Systematic reviewObjective. The aim of the current study was to assess the effect of catastrophizing on treatment efficacy and outcome in patients treated for low back pain.Summary of Background Data. Psychological factors including catastrophizing thoughts are believed to increase the risk for chronic low back pain. The influence of catastrophizing is debated.Methods. In September 2012 the following databases were searched: BIOSIS, CINAHL, Cochrane Library, Embase, OTSeeker, PeDRO, PsycInfo, Medline, Scopus, and Web of Science. For 50 of 706 references full text was assessed. Results based on 11 studies were included in this analysis.Results. In 11 studies, a total of 2,269 patients were included. Seven studies were of good and four of moderate methodological quality. Heterogeneity in study settings, treatments, outcomes, and patient populations impeded meta-analysis. Catastrophizing at baseline was predictive for disability at follow-up in four studies and for pain in two studies. Three studies found no predictive effect of catastrophizing. A mediating effect was found in all studies (n = 5) assessing the impact of a decrease in catastrophizing during treatment. A greater decrease was associated with better outcome. Most studies that investigated the moderating effects on treatment efficacy found no effect (n = 5). However, most studies did not look for a direct interaction between the treatment and catastrophizing thoughts. No study investigated the influence of catastrophizing on work-related outcomes including return to work.Conclusion. Catastrophizing predicted degree of pain and disability and mediated treatment efficacy in most studies. The presence of catastrophizing should be considered in patients with persisting back pain. Limited evidence was found for the moderating effects on treatment efficacy. Future research should aim to clarify the role of catastrophizing as a moderator of outcome and investigate its importance for work-related outcomes.

Citations

32 citations in Web of Science®
42 citations in Scopus®
Google Scholar™

Altmetrics

Downloads

78 downloads since deposited on 28 Jan 2014
32 downloads since 12 months
Detailed statistics

Additional indexing

Item Type:Journal Article, refereed, further contribution
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic and Policlinic for Internal Medicine
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2014
Deposited On:28 Jan 2014 10:09
Last Modified:05 Apr 2016 17:24
Publisher:Lippincott, Williams & Wilkins
ISSN:0362-2436
Additional Information:This is a non-final version of an article published in final form in Wertli, Maria M; Burgstaller, Jakob M; Weiser, Sherri; Steurer, Johann; Kofmehl, Reto; Held, Ulrike (2013). The influence of catastrophizing on treatment outcome in patients with non-specific low back pain: A systematic review. Spine:Epub ahead of print.
Publisher DOI:https://doi.org/10.1097/BRS.0000000000000110
PubMed ID:24253796

Download

Preview Icon on Download
Preview
Content: Accepted Version
Filetype: PDF
Size: 1MB
View at publisher
Preview Icon on Download
Preview
Content: Published Version
Filetype: PDF
Size: 420kB

TrendTerms

TrendTerms displays relevant terms of the abstract of this publication and related documents on a map. The terms and their relations were extracted from ZORA using word statistics. Their timelines are taken from ZORA as well. The bubble size of a term is proportional to the number of documents where the term occurs. Red, orange, yellow and green colors are used for terms that occur in the current document; red indicates high interlinkedness of a term with other terms, orange, yellow and green decreasing interlinkedness. Blue is used for terms that have a relation with the terms in this document, but occur in other documents.
You can navigate and zoom the map. Mouse-hovering a term displays its timeline, clicking it yields the associated documents.

Author Collaborations