COVID-19’s Lasting Effects in People With and Without Persistent Pain: A UK-Based Survey of Symptoms, Psychological Flexibility, and Mental Health, 2021

Persisting symptoms following COVID-19 may adversely impacts general mental health of people with chronic pain, and psychological flexibility may buffer these impacts. However, it remains unclear whether such lasting implications of COVID-19 would differ between people with and without chronic pain.

This study investigates the relationships between persistent symptoms post COVID-19, psychological flexibility general mental health among people with and without persistent pain, during the COVID-19 pandemic in the UK.

204 adults living in the UK were recruited via social media, and completed an online survey including measures of persistent symptoms, depression (Patient Health Questionnaire-9), anxiety (General Anxiety Disorder-7) and insomnia (Insomnia Severity Index), and psychological flexibility (Multidimensional Psychological Flexibility Inventory), and were included in the analyses.

Participants with persistent pain (n = 70) experienced more persistent symptoms, poorer general mental health, and higher level of psychological inflexibility, compared with participants without persistent pain (n = 133). Overall, the relationships between persistent physical symptoms, general mental health, and psychological (in)flexibility showed similar patterns in the two groups. Participants with more persistent physical symptoms experienced significantly poorer general mental health. Furthermore, people with higher levels of psychological inflexibility reported worse general mental health. There was little evidence that psychological (in)flexibility could “buffer” the association between persistent physical symptoms and general mental health. Conclusions: People with chronic pain appear more vulnerable to persistent symptoms and reduced general mental health, compared with people without pain. Treatments that reduce psychological inflexibility, such as ACT, may improve outcomes for people with persistent symptoms post COVID-19.