Relationship between psychiatric disorders, perception and coping with pain in chronic low back pain patients

摘要

Background. Low back pain is the most common specific complaint leading to consultation with primary-care physicians. The outcome of any treatment of low back pain strongly depends on psychiatric cofactors. We investigate the relationship between psychiatric disorders and perception and coping with pain in Chronic Low Back Pain (CLBP) comparing it to another group of chronic pain (CG). Methods. 427 CLBP patients and 629 CG (consisting of patients with different forms of chronic pain) were included in this retrospective study. All patients were assessed with the Mini-International Neuropsychiatric Interview (MINI) for psychiatric disorder, the Italian Pain Questionnaire to assess dimensions and intensity of pain and the Multidimensional Pain Inventory to explore coping with pain. Results. An increase of prevalence of males and older subjects with lower income have been found in the CLBP than CG. More lifetime Major Depressive Episodes (MDEL), increase the prevalence of Dysthymia (DD), Suicidal Risk (SR), Agoraphobia (A) have been found in the CLBP than CG. CLBP subjects showed more Sensorial, Affective, Evaluative dimensions and Intensity of pain with a higher prevalence of Dysfunctional (DYS) pain coping compared to CG. An increased prevalence of agoraphobia with panic disorder in DYS cluster were found in the CLBP group. Conclusions. Both current and historical psychiatric disorders are associated with the modification of perception and ability to cope with pain. Agoraphobia increases the unpleasantness of pain and the disability of CLBP subjects facilitating dysfunctional pain related coping..