Pain catastrophising is associated with greater disease impact in women with endometriosis: a cross-sectional study

Objective: Analyse the relationship between the dimensions of pain catastrophising, chronic pain magnitude and quality of life. Design : Cross-sectional observational study. Setting: Online survey through associations of patients with endometriosis in Spain. Sample : 111 women diagnosed with endometriosis. Methods: Primary analyses used Spearman’s ρ with 95% CIs and Benjamini-Hochberg FDR; group comparisons by PCS≥30; multivariable linear and logistic models; ROC analysis. Main outcome measures : Pain Catastrophising, pain magnitude and quality of life. Results : Higher catastrophising correlated with worse QoL (Core-EHP-30 vs PCS total ρ = 0.695, 95% CI 0.581 to 0.783) and greater pain burden (GCPS magnitude vs PCS total r = 0.594, 95% CI 0.454 to 0.705). EQ VAS correlated negatively with PCS total (ρ = -0.383, 95% CI -0.536 to -0.205). In multivariable models, Core-EHP-30 and GCPS magnitude were independently associated with PCS total and helplessness (adjusted R 2 = 0.48 and R 2 = 0.51 respectively) while the subscales of rumination (adjusted R 2 = 0.29) and magnification (adjusted R 2 = 0.35) showed an association only with Core-EHP-30. Logistic regression identified CORE-EHP-30 (OR 1.056, 95% CI 1.017 to 1.097) and GCPS magnitude (OR 1.053, 95% CI 1.006 to 1.103) as predictor of PCS≥30; AUC = 0.854 (CI 0.783 to 0.925). Conclusion : In endometriosis, pain catastrophising, (especially helplessness) shows robust associations with pain magnitude and poorer quality of life. These findings support routine pain catastrophising screening (PCS≥30) and targeted non-invasive interventions (for example, pain neuroscience education and graded therapeutic exercise, with reassessment. Longitudinal and interventional studies are warranted.