Age and Fibromyalgia as Moderators of the Relationships Between Pain and Loneliness: A Longitudinal Study in Patients with Chronic Pain

Chih-Hsun Wu,1,2 Wei-Han Chou,3 Hao-Han Yang,2 Tung Lin,2 Yi-Hsun Long,2,4 Chi-Cheng Yang,1,2 Wei-Zen Sun,3 Chih-Peng Lin3 1Department of Psychology, National Chengchi University, Taipei, Taiwan; 2Clinical Psychology Center, National Taiwan University Hospital, Taipei, Taiwan; 3Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan; 4Cancer Control and Prevention Center, Sijhih Cathay General Hospital, New Taipei City, TaiwanCorrespondence: Chih-Peng Lin, Department of Anesthesiology, National Taiwan University Hospital, 7 Chung Shan S. Road, Taipei, 100225, Taiwan, Tel +88623123456 ext 262158, Email [email protected]: The interwoven relationship between social distress and pain is an emerging topic in pain research. The present study aimed to explore the association between pain intensity and loneliness in patients with chronic pain and to further explore fibromyalgia and age as moderators.Patients and Methods: We recruited adult chronic pain patients from a pain clinic in Taiwan. Pain intensity was evaluated by 0– 10 numerical rating scale, and loneliness was evaluated by 3-item UCLA loneliness scale. The participants were evaluated at baseline (T0) and at a 3-month follow-up (T1). Cross-lagged path analysis was performed to examine the temporal relationship between pain intensity and loneliness. Multigroup analysis was conducted to examine the moderating effect by two pain diagnostic groups (fibromyalgia /non-fibromyalgia), and three age groups (younger /middle /old).Results: A total of 292 patients were included at T0, and 175 completed the T1 evaluation. The mean age of the participants was 60.42 ± 13.73, and 109 were females. The mean pain intensity was 6.00 ± 2.64 and mean duration was 96.73 ± 109.93 months. The results demonstrated that pain intensity (T0) can negatively predict loneliness (T1) (β = − 0.10, p =0.017), and loneliness (T0) can positively predict higher pain intensity (T1) (β = 0.20, p =0.002) and is moderated by fibromyalgia and age groups.Conclusion: The study found the bi-directional relationships between pain and loneliness. However, the direction of prediction from pain to loneliness was negative. This implies that the hypothetical vicious circle of escalating pain and loneliness may warrant further investigation.Keywords: social pain, loneliness, fibromyalgia, age difference