Design: Retrospective cross-sectional study

Setting: Academic tertiary care center

Patients or Participants: Patients presenting to chronic pelvic pain referral clinic

Interventions: New patient intake questionnaire which included pertinent medical/surgical history, multiple validated self-report measures of pain characteristics, and functional and quality of life factors. Low emotional support was defined as <50% percentile on PROMIS Emotional Support 4a.

Measurements and Main Results: Of 2,182 patients who completed the intake questionnaire, 762 (34.9%) had low emotional support (LES) and 1420 (65.1%) had high emotional support (HES).

Patients with LES reported a higher number of chronic pain diagnoses (2.6 ±1.62) compared to those with HES (2.2 ±1.37, p<.001). Prior clinical or surgical diagnosis of endometriosis did not differ between the groups.

BPI pain severity and number of days with bothersome pain per month did not differ significantly between the groups, but patients with LES did have higher BPI pain interference compared to patients with HES (35.1 ±19.91 vs 32.0 ±20.88 respectively, p<.001). Patients with LES also had worse physical function, fatigue, sleep disturbance, satisfaction with participation in social roles, meaning and purpose, anxiety, and depression compared to patients with HES (all PROMIS measures, all p<.001).

Multivariable linear regression was performed to evaluate the independent relationship between emotional support and pain interference. After adjusting for pain severity, higher emotional support was independently associated with lower pain interference (β 0.17, SE 0.035, p<.001).

Conclusion: Patients with lower emotional support experience worse pain interference, functional and quality of life outcomes compared to those with higher emotional support. Interventions focusing on bolstering emotional support, such as cognitive behavioral therapy, narrative medicine, or peer support groups, may help improve function and quality of life for patients with chronic pelvic pain.