NEW YORK (Reuters Health) - Chronic pain patients who are satisfied with their level of social support are less depressed and more likely to take active steps to cope with their pain, Spanish researchers report.

Social support can be a double-edged sword for people with chronic pain, Dr. Alicia E. Lopez-Martinez and colleagues from the University of Malaga note; high levels have been linked to less pain and distress, but attention from spouses as well as "solicitousness regarding patient pain behavior" may actually intensify pain.

To understand how social support might influence the severity of pain, the researchers looked at the relationship among social support, intensity of pain, depressed mood, coping strategies and disability in 117 chronic pain patients.

Along with lower levels of depressed mood, people who reported more satisfaction with their social support network also had less intense pain. While social support didn't directly influence how well patients were able to function, the reduced pain intensity associated with more social support was tied to better functional status.

People who had more satisfactory levels of social support were also more likely to choose active coping strategies for dealing with their pain, such as trying to distract themselves by doing something pleasant, rather than passive strategies like complaining about their pain to others.

Active coping strategies were also linked to lower levels of depressed mood and better functioning, while patients who coped with their pain passively tended to be more depressed and to have more severe pain.

The findings demonstrate that social support directly influences depressed mood, Lopez-Martinez and her team conclude, while coping strategies in themselves can affect both mood and pain intensity.

Psychosocial factors thus appear to have independent effects on mood and pain in chronic pain patients, "pointing to the potential benefit of interventions that seek to alter environmental factors on long-term adjustment to chronic pain," they add.

SOURCE: The Journal of Pain, April 2008.

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