Pain is a crucial factor in rheumatic disorders, and reducing it is a primary goal of successful treatment. Adaptive pain-coping strategies can enhance this improvement, but maladaptive approaches such as pain catastrophizing may worsen overall patient well-being. This narrative review aims to provide a concise overview of the existing knowledge on pain catastrophizing in the most prevalent specific rheumatic disorders. The objective of this study was to improve understanding of this phenomenon and its implications, as well as to pinpoint potential directions for future research. We conducted searches in the MEDLINE/PubMed, SCOPUS, and DOAJ bibliography databases to identify articles related to pain catastrophizing in rheumatoid arthritis, psoriatic arthritis, axial spondylarthritis, systemic sclerosis, systemic lupus erythematosus, Sjögren’s syndrome, juvenile idiopathic arthritis, and osteoarthritis (non-surgical treatment). Data extraction was performed on November 1, 2023. The investigators screened the identified articles to determine their relevance and whether they met the inclusion criteria. Following a bibliography search, which was further expanded by screening of citations and references, we included 156 records in the current review. The full-text analysis centred on pain catastrophizing, encompassing its prevalence, pathogenesis, and impact. The review established the role of catastrophizing in amplifying pain and diminishing various aspects of general well-being. Also, potential treatment approaches were discussed and summarised across the examined disorders. Pain catastrophizing is as a significant factor in rheumatic disorders. Its impact warrants further exploration through prospective controlled trials to enhance global patient outcomes.

Background: Comorbidities are frequent in psoriatic arthritis (PsA) and may contribute to worse health-related outcomes. Patient-reported outcomes (PROs) are used to evaluate the burden of the assessed disease. The aim of this study is to evaluate the impact of comorbidities on selected PROs in PsA. Methods: Adult patients, diagnosed with PsA, based on CASPAR criteria, were included in this cross-sectional, observational study. Collected data encompassed the comorbidities and PROs (Health Assessment Questionnaire [HAQ], Multi-Dimensional Health Assessment Questionnaire [MDHAQ], 36-Item Short Form Health Survey [SF-36]). Standard statistic methods were performed for data assessment. Results: There were 267 participants included in the study (54.7% females). The most prevalent comorbidities were cardiovascular diseases (CVD) (29.2 %). Multimorbidity was observed in 50.2% cases and was associated with poorer results of SF-36 questionnaire, regarding bodily pain (34.7 [30.1, 39.3] vs. 47.5 [43.1, 52.0]; p<0.01), physical functioning (52.1 [47.3, 56.9] vs. 63.1 [58.9, 67.4]; p<0.01) and role physical (28.5 [21.2, 35.9] vs. 42.8 [35.2, 50.4]; p<0.01). CVD were associated with poorer MDHAQFn score (β=0.17, p<0.01), while mental disorders negatively influenced mental health (β= -0.35, p<0.01), vitality (β= -0.22, p<0.01), general health (β= -0.19, p<0.01), social functioning (β= -0.15, p=0.04) and role emotional (β= -0.30, p<0.01) dimensions of SF-36. Conclusions: Multimorbidity exerts significant impact on physical aspects of quality of life (QoL) in PsA. CVD and mental disorders adversely influence functional capacity as well as mental and social dimensions of QoL, respectively. The impact of comorbidities should be taken into account by clinicians and researchers assessing PROs.

Introduction: Comorbidities are frequently present in patients with axial spondyloarthritis (axSpA) and may contribute to poorer health-related outcomes. Patient-reported outcomes (PROs) serve as tools to assess the patient’s perspective on the burden of the disease. The study aimed to evaluating the impact of comorbidities on selected PROs in axSpA. Method: Adult patients diagnosed with axSpA based on ASAS classification criteria were included in this cross-sectional study. Data collected included comorbidities and PROs [Health Assessment Questionnaire (HAQ), Multi-Dimensional Health Assessment Questionnaire (MDHAQ), 36-Item Short Form Health Survey (SF-36), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and Bath Ankylosing Spondylitis Functional Index (BASFI)]. Results: In total, 323 participants were included in the study (44.0% female). Multimorbidity and extended multimorbidity were observed in 63.8% and 38.7% of patients, respectively. Extended multimorbidity was associated with higher HAQ (0.5 [0.1–1.0] vs. 0.3 [0.0–0.8], p < 0.01) and MDHAQ scores (0.3 [0.0–0.6] vs. 0.1 [0.0–0.5], p = 0.03). The BASDAI score was higher in patients with three or more comorbidities than in patients with no comorbidities (2.8 [1.7–4.3] vs. 1.9 [0.9–3.6], p < 0.01). The number of comorbidities was associated with higher scores in the mental health (β = 0.20, p < 0.01) and vitality (β = 0.16, p = 0.02) domains of the SF-36 questionnaire. Conclusions: Multimorbidity was present in almost two-thirds of cases. Extended multimorbidity was associated with poorer physical functioning, HAQ, MDHAQ, and BASDAI scores, whereas multimorbidity was related to better scores in the mental health and vitality domains. The impact of comorbidities on PROs in axSpA should not be overlooked. Key Points• Multimorbidity is frequent among axial spondyloarthritis’ patients.• Only extended multimorbidity (presence of two or more additional diseases, excluding axial spondyloarthritis) was found to be associated with poorer results of patient-reported outcomes, in particular these regarding physical functioning.• Multimorbidity might influence positively some domains of quality of life such as mental health or vitality.• The findings included in the study support the belief that in patients with spondyloarthritis comorbidities might impact patient-reported outcomes which are important when assessing disease activity and response to treatment and should not be disregarded.