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Catastrophizing, pain self-efficacy and acceptance in patients with Burning Mouth Syndrome

Burning mouth syndrome (BMS) can negatively impact health-related quality of life (HRQoL) and is linked to anxiety and depressive disorders. Less is known about pain-related cognitions in BMS and how they affect mood and health.

Objectives: To describe pain catastrophising, pain self-efficacy and chronic pain acceptance in BMS patients and explore associations with affective function and HRQoL.

Methods: A cross-sectional study of 36 BMS patients (31 female) referred to an Orofacial Pain Clinic completed the Pain Catastrophizing Scale, the Pain Self-Efficacy Questionnaire and the Chronic Pain Acceptance Questionnaire-8 in addition to standardised self-reported questionnaires measuring mood and oral and generic HRQoL.

Results: Pain catastrophising levels were markedly higher than (nonclinical) population norms, with 32.0% of patients reporting clinically relevant levels. Pain self-efficacy and chronic pain acceptance varied widely; 24.0% evidenced low confidence to cope with pain and 53.8% reported low activity engagement and/or low pain willingness. Catastrophising showed moderate-to-strong associations with measures of anxiety (r=0.63), depression (r=0.80), and oral (r=0.61) and generic HRQoL (rho=-0.84). Self-efficacy and acceptance were also closely related to levels of depression (r/rho=-0.83 to -0.73) and generic HRQoL (r/rho=0.74 to 0.75). These associations were stronger than those between pain severity and affective function/HRQoL and persisted after controlling for pain severity.

Conclusions: A significant number of BMS patients evidence maladaptive pain-related cognitive responses, which is closely related to affective disorders and impaired HRQoL. As such, treatment approaches targeting catastrophising, pain self-efficacy and acceptance may prove beneficial in improving mood and quality of life in BMS patients.


Pavneet Chana

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