Pain locus of control predicts return to work among Spanish fibromyalgia patients after completion of a multidisciplinary pain program

Gen Hosp Psychiatry. 2009 Mar-Apr;31(2):137-45. doi: 10.1016/j.genhosppsych.2008.12.001. Epub 2009 Jan 24.

Abstract

Objective: To assess the influence of the pain locus of control on return to work in fibromyalgia patients.

Methods: Ninety-eight fibromyalgia patients on sick leave were enrolled in a multidisciplinary treatment program and were followed up for 12 months post-discharge. Treatment was considered successful at discharge in the case of patients who returned to work and unsuccessful in patients who remained sick listed. Treatment was considered successful during follow-up in patients who remained at work for at least the last 6 months of follow-up. Patients who took sick leave again and those lost to follow-up were considered failures. Logistic regression methods were used to define the best predictive models of treatment failure.

Results: Fifty-eight patients were considered treatment successes at discharge and 50 at 12-month follow-up. The subscale Fate from the Multidimensional Health Locus of Control-Pain Scale and the Health Assessment Questionnaire predicted treatment failure at discharge (-2lnR=57.79; chi-square=74.74; df=2; P<.001). The predictive model of treatment failure at 12-month follow-up was unspecific.

Conclusion: Fibromyalgia patients undergoing a multidisciplinary treatment who were least likely to return to work at discharge were those with a pain locus of control characterized by more negative expectations about pain progression and a high perceived functional disability.

MeSH terms

  • Adult
  • Employment / statistics & numerical data*
  • Female
  • Fibromyalgia / diagnosis
  • Fibromyalgia / epidemiology*
  • Follow-Up Studies
  • Humans
  • Interdisciplinary Communication*
  • Internal-External Control*
  • Male
  • Pain / diagnosis*
  • Patient Care Team*
  • Predictive Value of Tests
  • Program Development*
  • Prospective Studies
  • Spain / epidemiology
  • Surveys and Questionnaires