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Article

The Predictive Role of Executive Functions and Psychological Factors on Chronic Pain after Orthopaedic Surgery: A Longitudinal Cohort Study

1
Department of Psychology, Catholic University of Milan, 20123 Milan, Italy
2
Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Ospedale San Giuseppe, 28921 Verbania, Italy
3
Faculty of Psychology, eCampus University, 22060 Novedrate, Italy
4
Casa di Cura San Pio X, 20159 Milan, Italy
5
Humanitas San Pio X Clinic, 20159 Milan, Italy
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Neurology Service, and Pain Center, Humanitas San Pio X Clinic, 20159 Milan, Italy
*
Author to whom correspondence should be addressed.
Brain Sci. 2020, 10(10), 685; https://doi.org/10.3390/brainsci10100685
Received: 22 August 2020 / Revised: 16 September 2020 / Accepted: 23 September 2020 / Published: 28 September 2020
(This article belongs to the Special Issue Emerging Treatment Approaches for Chronic Pain Syndromes)
Prevention and treatment of chronic post-surgical pain should be based on the early identification of patients at risk. The presence of a deficit in executive functions, along with the presence of psychological risk factors, could impair the use of appropriate pain coping strategies and might facilitate the transition to chronic post-surgical pain. A longitudinal cohort study was implemented. Patients listed for orthopaedic surgery were enrolled. Variables measured before surgery were pain intensity, the sensory, affective, cognitive and mixed components of pain, state and trait variables associated with the psychological status of the patient, fear of movement, pain catastrophizing, visual attention and cognitive flexibility. Pain intensity and the components of pain were re-evaluated after surgery and after three months. A linear mixed model was used to assess the predictors of pain intensity, and a multivariate linear mixed model was used to assess the predictors of the pain components. 167 patients were enrolled. Controlling for sex, age, pain duration and surgical procedure, catastrophizing and visual attention were predictors of pain intensity at follow-up. The sensory component of pain was predicted by state anxiety, healthcare-related fears, pain catastrophizing and visual attention. Anxiety and catastrophizing were predictors of the affective and evaluative components of pain. The mixed component of pain was predicted by state anxiety, healthcare-related fears and pain catastrophizing. Executive functions, along with psychological risk factors, shape the course of post-surgical pain. The efficacy of preventive and rehabilitation treatment could be possibly enhanced if these factors are treated. View Full-Text
Keywords: chronic post-surgical pain; psychology; catastrophizing; depression; anxiety; predictors; executive functions; rehabilitation chronic post-surgical pain; psychology; catastrophizing; depression; anxiety; predictors; executive functions; rehabilitation
MDPI and ACS Style

Giusti, E.M.; Manna, C.; Varallo, G.; Cattivelli, R.; Manzoni, G.M.; Gabrielli, S.; D’Amario, F.; Lacerenza, M.; Castelnuovo, G. The Predictive Role of Executive Functions and Psychological Factors on Chronic Pain after Orthopaedic Surgery: A Longitudinal Cohort Study. Brain Sci. 2020, 10, 685. https://doi.org/10.3390/brainsci10100685

AMA Style

Giusti EM, Manna C, Varallo G, Cattivelli R, Manzoni GM, Gabrielli S, D’Amario F, Lacerenza M, Castelnuovo G. The Predictive Role of Executive Functions and Psychological Factors on Chronic Pain after Orthopaedic Surgery: A Longitudinal Cohort Study. Brain Sciences. 2020; 10(10):685. https://doi.org/10.3390/brainsci10100685

Chicago/Turabian Style

Giusti, Emanuele M., Chiara Manna, Giorgia Varallo, Roberto Cattivelli, Gian M. Manzoni, Samantha Gabrielli, Federico D’Amario, Marco Lacerenza, and Gianluca Castelnuovo. 2020. "The Predictive Role of Executive Functions and Psychological Factors on Chronic Pain after Orthopaedic Surgery: A Longitudinal Cohort Study" Brain Sciences 10, no. 10: 685. https://doi.org/10.3390/brainsci10100685

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