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Medical Litigation News |
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Summaries of Recent Medical Research Chronic pain is a complex condition influenced by a variety of factors, including biological, physiological variables, behavioural, environmental, and social variables[1]. If nonpsychiatric specialists are proposing or implying significant psychological factors in pain lasting more than 6 months, psychometric testing can exclude or confirm significant pre-existing psychopathology or dysfunctional personality traits[2]. 3 distinct groups of chronic pain patients can be distinguished[3] by 4 characteristics: Interference with Activity, Emotional Distress, Pain Intensity and perceived Social Support. The authors postulate that Adaptive Copers might have a good outcome irrespective of treatment, Dyfunctional patients might require medical interventions, whereas the Interpersonally Distressed could usefully be directed towards cognitive-behavioural therapy. Beliefs that emotions affect pain, that others should be solicitous when one experiences pain, and (for subjects reporting low and medium pain severity) that one is disabled by pain were associated with psychosocial dysfunction[4]. Beliefs that one is disabled and that activity should be avoided because pain signifies damage were associated with physical disability. Inhibiting the expression of angry feelings strongly predicted Pain Intensity and Pain Behaviour as reported by a group of chronic pain patients[5]. Normal increase in blood flow to exercising trapezius muscles was impaired in whiplash patients with persisting symptoms[6]. Using the medical literature on chronic pain behaviour, the authors[7] have developed a semistructured psychiatric interview for medicolegal reporting purposes. A new study[8], of mainly nonsurgical low back pain, and another[9] analysing past studies, of all types of chronic pain confirm the effectiveness of multidisciplinary nonsurgical treatment programmes in returning patients to stable employment and minimal drug usage. RETURN TO TOP OF PAGE |
