A study examined 392 patients with chronic low back pain treated in hospital between 2018–2023 and found that pain catastrophizing – a maladaptive psychological response to pain – was strongly associated with patients' functional disability[1]. Pain catastrophizing was strongly correlated with disability scores (ρ = 0.68) and remained an independent predictor of disability even after controlling for pain intensity, depression, anxiety, and demographics (β = 0.62)[ 1 ]. Patients with a higher level of catastrophizing showed progressively worse functional results[1]. Depressive symptoms partially explained the relationship between catastrophizing and disability[1]. The authors recommend routine psychological screening and targeted cognitive-behavioral interventions to improve functional outcomes and quality of life in this group of patients[1]. Due to the retrospective design of the study, the findings should be interpreted as associations rather than direct evidence of causation[1].