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Ann Gen Psychiatry. 2019 May 31;18:8. doi: 10.1186/s12991-019-0231-9. eCollection 2019.

Positive psychological well-being predicts lower severe pain in the general population: a 2-year follow-up study of the SwePain cohort.

Author information

1Pain and Rehabilitation Centre, and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
2Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden.
3Clinical Studies Sweden, Forum South, Skåne University Hospital Lund, Lund, Sweden.
Contributed equally



Positive psychology indicators like well-being and life satisfaction may play a pivotal role in pain-related outcomes. In this study, we aimed to examine the prospective associations of positive well-being and life satisfaction with pain severity.

Methods and Subjects:

This longitudinal study, with a follow-up of 2 years, included 9361 participants (4266 males, 5095 females; mean age: 52.5 years; SD: 17.5) without and with chronic pain (CP) at baseline. All analyses were stratified by the two sub-cohorts-participants without CP (sub-cohort 1) and participants with CP (sub-cohort 2) at baseline. The predictive associations, assessed using ordinal regression in a Generalized Linear Model, were adjusted for baseline potential confounders and reported as odds ratios (ORs) with corresponding 95% confidence intervals (CIs).


After adjustments, in sub-cohort 1 positive well-being at baseline was associated with lower severe pain at follow-up compared to participants with severe distress (OR: 0.64; 95% CI 0.49-0.84; p < 0.001). In sub-cohort 2, both positive well-being and life satisfaction at baseline were associated with lower severe pain at follow-up compared to participants with severe distress and not satisfied with life (OR: 0.80; 95% CI 0.65-0.98; p = 0.031 and OR: 0.82; 95% CI 0.69-0.96; p = 0.014, respectively).


Positive well-being is predictive of lower pain severity both among participants without and with CP at baseline, whereas life satisfaction was found predictive of lower pain severity only for subjects with CP. Future research should emphasize implementing treatments associated with promoting and maintaining positive well-being and life satisfaction in patients who suffer from chronic pain and in risk populations.


Chronic pain; Cohort; Multimorbidity; Pain severity; Positive outcomes; Positive well-being

Conflict of interest statement

Competing interestsThe authors declare that they have no competing interests.

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