Factors associated with disability in women with chronic pelvic pain: A cross-sectional study

Objective: We aimed to explore the factors associated with disability in women with chronic pelvic pain (CPP). Methods: This is a cross-sectional study conducted in Brazil with women with CPP, between 18 and 45 years old. Disability was measured using the World Health Organisation Disability Assessment Scale (WHODAS 2.0). Socioeconomic and clinical data were collected, and instruments to assess pain intensity and catastrophising, sexual function, kinesiophobia, depression, physical activity and the sit-to-stand test were applied. Correlations of Spearman, Student's t-test and multiple linear regression were used for data analysis (α = 0.05). Results: 168 women with a median age of 36 (IQR 29 - 40) years were evaluated. Those with greater pain intensity and catastrophising, sexual dysfunction, kinesiophobia, depression, who do not practice regular physical activity and with worse performance in the sit-to-stand test had greater disability on correlation analysis. However, only pain catastrophising (β = 6.40; 95%CI 0.44 - 12.36) and depression (β = 12.03; 95%CI 6.61 - 17.45) were predictors of disability (p < 0.05) in the adjusted linear regression model. Conclusion: Our results indicate that psychosocial factors (pain catastrophising and depression) have a stronger relationship with disability than pain intensity or physical factors (sit to stand and physical activity). Therefore, all clinicians involved in the care of women with CPP could systematically assess and address pain catastrophising and depression as part of comprehensive management to prevent disability.