Background & Aims

The pathological conditions of chronic pain often involve not only actual or potential tissue damage but also psychosocial factors (Raja 2020). Therefore, it is important to conduct a comprehensive assessment of pain that includes not only pain intensity but also psychological status in order to understand the symptoms of patients with chronic pain. However, it is not easy for evaluators to interpret many different assessment items. This study aimed to classify the characteristics of patients with chronic pain and to derive components related to chronic pain using multiple pain-related questionnaires.

Methods

118 patients with chronic pain treated at the neurosurgical department of Osak University Hospital were included. All patients were assessed using a tablet device for the following pain-related assessments: a numerical rating scale (NRS) and the short-form McGill pain questionnaire 2 (SF-MPQ2) for pain intensity, the brief pain inventory (BPI) for the severity of pain and its impact on functioning. The pain catastrophizing scale (PCS) and the hospital anxiety and depression scale for psychological evaluation, the EQ-5D-5L for quality of life (QOL), and the pain self-efficacy questionnaire (PSEQ) for self-efficacy were assessed. Patients were classified into neuropathic pain (NP) and chronic pain other than NP (No-NP) according to the pain specialist’s diagnosis (Finnerup 2016), and their assessment items were compared. Hierarchical cluster analysis with Ward’s method and the principal component analysis (PCA) were also conducted using the above assessment items.

Results

In comparison between NP and No-NP, No-NP was significantly higher on the NRS, SF-MPQ2 subscale (affective descriptors), BPI, and PCS (total score, helplessness, and magnification), and significantly lower on the PSEQ (p<0.05). Cluster analysis was classified into three categories according to severity of symptoms. As the results of the PCA, the first principal component reflected pain intensity, or pain severity, while the second principal component reflected self-efficacy, catastrophic thinking, depression/anxiety, QOL, and pain-related interference.

Conclusions

This study aimed to classify the characteristics of patients with chronic pain using multiple pain-related questionnaires such as psychological and pain-related interference as well as pain intensity. The PCA can yield two new components, pain severity, and psychological and other factors, from pain-related questionnaires. This study suggest that it may be possible to classify the characteristics of chronic pain patients and derive some pain-related components by using multiple pain-related questionnaires.

References

1)Raja SN et al. The revised International Association for the Study of Pain definition of pain: concepts, challenges, and compromises. Pain. 2020
2)Finnerup NB et al. Neuropathic pain: an updated grading system for research and clinical practice. Pain. 2016

Presenting Author

Nobuhiko Mori

Poster Authors

Nobuhiko Mori

Osaka University Graduate School of Medicine

Lead Author

Koichi Hosomi

Osaka University

Lead Author

Akihiro Yamamoto MD

Department of Neurosurgery, Osaka University Graduate School of Medicine

Lead Author

Naoki Tani MD

PhD

Department of Neurosurgery, Osaka University Graduate School of Medicine

Lead Author

Satoru Oshino MD

PhD

Department of Neurosurgery, Osaka University Graduate School of Medicine

Lead Author

Youichi Saitoh MD

PhD

Tokuyukai Rehabilitation Clinic, Osaka University Graduate School of Engineering Science

Lead Author

Haruhiko Kishima MD

PhD

Department of Neurosurgery, Osaka University Graduate School of Medicine

Lead Author

Topics

  • Assessment and Diagnosis