Psychosocial experiences among female and male primary care patients with and without pain

• Objective: The study examined the psychosocial characteristics and experiences of female and male primary care patients with and without pain with particular interest in gender differences and whether females were more vulnerable to pain than males.Patients and methods: A total of 1122 primary care patients from 20 randomly selected primary care centres in Stockholm were assessed cross-sectionally on various variables during 15 consecutive days. The data were examined with chi-square tests, ANOVAs, Dunn?Bonferroni tests and multivariate logistic/linear regression analyses.Results: Pain patients compared to pain-free patients reported more depression, burn-out, job demands, less job control, more job strain, and financial problems, with no gender differences in general. These constructs were associated with pain in the regressions and some of them were inter-related. Factors such as sick-leave were also important. Female pain patients had a more severe clinical profile (e.g. pain intensity) than male patients. Female gender was a 'risk' factor for pain and for pain intensity/complexity, but other factors (e.g. sick-leave) were also important. In other areas (e.g. diagnoses), there were no gender differences. Missing data from the non-participant control group may have resulted in cases and controls that were not well matched. This may have weakened the strength of the comparisons between patient groups. Nevertheless, the results derive from a large clinical sample and are noteworthy.Conclusions: Pain patients did less well psychosocially and had received many traditional treatments for their pain without good effects. Interventions should be attentive to this and approaches such as cognitive-behaviour therapy used more often. Variables such as sick-leave and financial difficulties were associated with psychological and pain problems, and female gender was a 'risk' factor for pain and for pain intensity and complexity (multiple types of pain). Interventions should consider psychosocial factors and problems experienced particularly by women. The results confirmed previous findings from other studies and may have provided new insights into the experiences of female and male primary care patients with and without pain.

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