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Scandinavian Journal of Pain

Official Journal of the Scandinavian Association for the Study of Pain

Editor-in-Chief: Breivik, Harald

CiteScore 2017: 0.84

SCImago Journal Rank (SJR) 2017: 0.401
Source Normalized Impact per Paper (SNIP) 2017: 0.452

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Volume 18, Issue 3


The role of pain in chronic pain patients’ perception of health-related quality of life: a cross-sectional SQRP study of 40,000 patients

Peter Molander
  • Pain and Rehabilitation Centre, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
  • Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Huan-Ji Dong
  • Pain and Rehabilitation Centre, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
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/ Björn Äng
  • Department of Neurobiology, Care Science and Society, Karolinska Institute, Stockholm, Sweden
  • School of Education, Health and Social Studies, Dalarna University, Falun, Sweden
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/ Paul Enthoven
  • Department of Medical and Health Sciences, Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden
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/ Björn Gerdle
  • Corresponding author
  • Pain and Rehabilitation Centre, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
  • Email
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Published Online: 2018-05-18 | DOI: https://doi.org/10.1515/sjpain-2018-0003


Background and aims

Health-related quality of life (Hr-QoL) reflects the burden of a condition on an overarching level. Pain intensity, disability and other factors influence how patients with chronic pain perceive their condition, e.g. Hr-QoL. However, the relative importance of these factors is unclear and there is an ongoing debate as to what importance pain measures have in this group. We investigated the importance of current pain level and mood on aspects of Hr-QoL in patients with chronic pain and investigated whether such relationships are influenced by demographics.


Data was obtained from the Swedish Quality Registry for Pain Rehabilitation (SQRP), between 2008 and 2016 on patients ≥18 years old who suffered from chronic pain and were referred to participating specialist clinics. Dependent variables were general Hr-QoL [using two scales from European Quality of Life instrument: EQ5D Index and the European Quality of Life instrument health scale (EQ thermometer)] and specific Hr-QoL [from the Short Form Health Survey (SF36) the physical component summary (SF36-PCS) and the mental (psychological) component summary (SF36-MCS)]. Independent variables were sociodemographic variables, pain variables, psychological distress and pain attitudes. Principal component analysis (PCA) was used for multivariate correlation analyses of all investigated variables and Orthogonal Partial Least Square Regression (OPLS) for multivariate regressions on health aspects.


There was 40,518 patients (72% women). Pain intensity and interference showed the strongest multivariate correlations with EQ5D Index, EQ thermometer and SF36-PCS. Psychological distress variables displayed the strongest multivariate correlations with SF36-MCS. Demographic properties did not significantly influence variations in the investigated Hr-QoL variables.


Pain, mood and pain attitudes were significantly correlated with Hr-QoL variables, but these variables cannot explain most of variations in Hr-QoL variables. The results pinpoint that broad assessments (including pain intensity aspects) are needed to capture the clinical presentation of patients with complex chronic pain conditions.

This article offers supplementary material which is provided at the end of the article.

Keywords: mood; pain; quality of life; acceptance; health


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About the article

Corresponding author: Björn Gerdle, Professor, MD, PhD, Pain and Rehabilitation Centre, Department of Medical and Health Sciences, Linköping University, SE-581 85 Linköping, Sweden, Tel.: +46763927191

Received: 2018-01-06

Revised: 2018-04-05

Accepted: 2018-04-24

Published Online: 2018-05-18

Published in Print: 2018-07-26

Authors’ statements

Research funding: This study was supported by grants from the Swedish Research Council, County Council of Östergötland (forsknings-ALF), and AFA insurance. The sponsors of the study had no role in study design, data collection, data analysis, data interpretation, writing of the report, or the decision to submit for publication. The authors had full access to all the data in the study and had final responsibility for the decision to submit for publication.

Conflict of interest: The authors declare no financial conflicts of interest and no competing interests.

Informed consent: All participants received written information about the study and gave their written consent.

Ethical approval: The study was conducted in accordance with the Helsinki Declaration and Good Clinical Practice and approved by the Ethical Review Board in Linköping (Dnr: 2015/108-31).

Availability of data and material

The datasets generated and/or analysed by this study are not publicly available as the Ethical Review Board has not approved the public availability of these data.

Authors’ contributions

All authors contributed to the conception of the study. BG extracted the data from SQRP and analysed the data. BG, PM, PE, BA and H-JD drafted the manuscript. All authors contributed to the writing and have approved the final version of the manuscript.

Citation Information: Scandinavian Journal of Pain, Volume 18, Issue 3, Pages 417–429, ISSN (Online) 1877-8879, ISSN (Print) 1877-8860, DOI: https://doi.org/10.1515/sjpain-2018-0003.

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