THU0482 PAIN CATASTROPHIZING AND DISEASE PERCEPTION DIFFERS BETWEEN NORWEGIAN AND FINNISH OUTPATIENT CLINIC PSORIATIC ARTHRITIS PATIENTS DESPITE COMPARABLE OUTCOMES ON OBJECTIVE MEASURES OF DISEASE
Authors: G. Haugeberg, I. J. Widding Hansen, H. Berner Hammer, A. Kavanaugh, B. Michelsen, K. Paalanen, T. Sokka-Isler
Journal: Annals of the Rheumatic Diseases (2020)

Background: Pain catastrophizing (the tendency to describe a pain experience in more exaggerated terms than the average person, to ruminate on it more, or to feel more helpless about it), has been associated with reduced likelihood of achieving remission in rheumatoid arthritis patients (1). Cultural and societal differences between countries may have an impact on outcome such as patients’ perceptions of disease. Objectives: To compare patient pain catastrophizing, patient perception of disease, objective measures of disease and treatment in psoriatic arthritis (PsA) patients between a Norwegian and a Finnish outpatient clinic. Further, to explore for associations with pain catastrophizing. Methods: All PsA patients followed at the outpatient clinics are routinely monitored using a structured medical support system (GoTreatIT® Rheuma). Data collection, done in 2018-19 is listed in the table. Patients reported their pain catastrophizing answering the two questions, “When I feel pain it is terrible and I feel it is never going to get any better. When I feel pain, I can’t stand it anymore.” Each question is scored 0-6 and mean value of both is calculated. Pain catastrophizing was defined if mean score ≥4. Categorical variables were presented as numbers (%) and continuous variables as mean (SD) and associates explored using univariate and multivariate analysis. Results: A total of 302 Finnish and 363 Norwegian PsA patients were examined. Pain catastrophizing was reported significantly less commonly among the Finnish as compared to the Norwegian PsA clinic patients, both expressed as mean (SD) values (1.48 (1.42) vs 2.05 (1.42), p&lt;0.001) and proportions of patients having a score ≥4 (7.6% (n=23) vs 12.5% (n=45), p=0.043, respectively). As shown in the table the Finnish patients had significantly more years of education, shorter disease duration and less pain and fatigue than the Norwegian patients. For the other features, no significant differences between the two cohorts were found. Finland (n=302) Norway (n=363) P Age, years 54.0 (13.3) 54.7 (12.5) 0.49 Females 153 (50.7%) 181 (49.9%) 0.84 BMI. Kg/m2 28.8 (5.6) 28.1(5.1) 0.06 Current smoking 44 (14.6%) 51 (14.1%) 0.86 Education, years 13.6 (3.5) 12.7 (3.8) 0.001 Disease duration, years 4.7 (4.3) 9.9 (8.9) &lt;0.001 CRP, mg/L 4.3 (6.8) 4.0 (8.8) 0.69 MDglobal assessment, VAS 0-100 mm 6.84 (1.29) 5.71 (8.50) 0.19 28 swollen joint count 0.48 (1.35) 0.31 (1.16) 0.14 28 tender joint count 1.01 (2.83) 1.37 (2.80) 0.14 DAPSA 9.66 (8.95) 11.33 (9.60) 0.06 Pain, VAS 0-100 mm 30.73 (25.92) 35.55 (25.76) 0.023 Fatigue, VAS 0-100 mm 29.96 (29.24) 42.56 (31.94) &lt;0.001 MHAQ, 0-3 0.39 (0.44) 0.43 (0.41) 0.24 Body surface area for psoriasis 2.45 (8.15) 2.66 (6.15) 0.17 Current b-tsDMARDs 121 (40.1%) 139 (38.3%) 0.64 In univariate analyses female gender, higher BMI, less years of education, Dr. global, tender joint count, DAPSA, pain, fatigue, MHAQ and psoriasis body surface area were found to be associated with more pain catastrophizing. In multivariate analysis (mandatory adjusting for age, gender, BMI, years of education and disease duration) fewer years of education, higher scores for pain, fatigue and MHAQ and being patient at the Norwegian center were independently associated with more pain catastrophizing. Conclusion: Our data indicate that cultural differences across countries may have a significant impact on outcomes that reflecting patients’ perceptions of disease. This may have an implication when merging heterogeneous databases across countries. References: [1]Hammer HB et al. Arthritis Care Res 2018;70:703-12. Disclosure of Interests: : Glenn Haugeberg: None declared, Inger Johanne Widding Hansen: None declared, Hilde Berner Hammer: None declared, Arthur Kavanaugh Grant/research support from: Abbott, Amgen, AstraZeneca, BMS, Celgene Corporation, Centocor-Janssen, Pfizer, Roche, UCB – grant/research support, Brigitte Michelsen: None declared, Kirsi Paalanen: None declared, Tuulikki Sokka-Isler: None declared