Catastrophizing, defined as an overly negative evaluation of one's situation, is associated with worse disease outcomes in patients with chronic pain but remains unexplored in pruritus medicine. In this cross-sectional study, we included patients with chronic prurigo (CPG, n=50), chronic pruritus on nonlesional skin (CPNL, n=50) and chronic spontaneous urticaria (CSU, n=50) to investigate catastrophizing and determine possible associations with demographic and clinical factors. Patients completed validated questionnaires assessing catastrophizing (Itch-Cognition-Questionnaire), itch intensity, disease control, quality of life, anxiety, depression, stress and attention to itch. We recorded median interquartile range catastrophizing scores of 19.0 11.0; 29.0 for CPG, 17.0 11.8; 24.3 for CPNL and 10.0 5.0; 18.3 for CSU patients. Catastrophizing correlated positively with itch intensity (r=0.382-0.678, p<0.001-0.006), quality of life impairment (r=0.554-0.716, p<0.001) and vigilance and awareness to itch (r=0.407-0.591, p<0.001-0.003) across patient groups. Linear regression analysis revealed a lower likelihood of catastrophizing in CSU patients (CSU: β=-5.905, p<0.001; CPG: reference), a positive association of catastrophizing with average itch intensity (β=1.119, p=0.008) and attention to itch (β=0.150, p<0.001), and a negative association with age (β=-0.095, p=0.004) and short disease duration (β=-5.797, p=0.049). Catastrophizing represents a pivotal cognitive process, which is associated with worse clinical outcomes in chronic itch patients.
Niemeyer et al. (Mon,) studied this question.