Ann Rehabil Med.  2014 Feb;38(1):77-83. 10.5535/arm.2014.38.1.77.

The Relationships Between Determination of Treatment Success and Emotional Factors in Patients With Chronic Musculoskeletal Pain

• Yi TI
• Kim BK
• Ha SA
• Lim JY

• KMID: 2266544
• DOI: http://doi.org/10.5535/arm.2014.38.1.77

Abstract

OBJECTIVE
To investigate the relationship of the patient's criteria of successful treatment to emotional factors in patients with chronic musculoskeletal pain.
METHODS
Patients who visited our outpatient hospital due to chronic musculoskeletal pain were evaluated using a questionnaire survey. Patients were evaluated with the Patient-Centered Outcomes Questionnaire (PCOQ) to investigate their expectation and criteria for success regarding treatment of chronic musculoskeletal pain. Beck Depression Inventory and State-Trait Anxiety Inventory were used to check for psychological variables. Correlations among each of the variables were evaluated statistically.
RESULTS
Patients with higher levels of depression and anxiety needed larger improvements to consider the treatment as a success in the pain domain (depression, r=0.398, p=0.04; anxiety, r=0.447, p=0.02) and emotional distress domain (depression, r=0.617, p=0.001; anxiety, r=0.415, p=0.03), but had lower level of expectation of the treatment in the pain domain (depression, r=-0.427, p=0.01; anxiety, r=-0.441, p=0.004), emotional distress domain (depression, r=-0.454, p=0.01; anxiety, r=-0.395, p=0.04), and interference of daily activities domain (depression, r=-0.474, p=0.01; anxiety, r=-0.396, p=0.04). Patients were classified into 3 clusters based on the importance rating of each domain via a hierarchical analysis. The cluster of the patients with the higher rating of importance across all domains (importance of pain domain, 9.54; fatigue domain, 9.08; emotional distress domain, 9.23; interference of daily activities domain, 9.23) had the highest level of depression and anxiety.
CONCLUSION
Consideration of psychological factors, especially in patients who require larger improvements in all treatment domains, may be helpful for the successful treatment of chronic musculoskeletal pain.

Keyword

Chronic pain; Questionnaire; Depression; Anxiety

MeSH Terms

Anxiety
Chronic Pain
Depression
Fatigue
Humans
Musculoskeletal Pain*
Outpatients
Psychology
Surveys and Questionnaires

Figure

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  Fig. 1 Patients were classified into the 3 clusters based on the importance rating of each domain by hierarchical analysis. Cluster 1, patients with the high importance across all domains; Cluster 2, patients with moderately high importance in domains except pain domain; Cluster 3, patients with low importance in domains except pain domain.

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  Fig. 2 Comparison of the Beck Depression Inventory (BDI, A) and state anxiety of State-Trait Anxiety Inventory (STAI-S, B) between the patient clusters classified by rating the importance across each domain. Cluster 1, patients with the higher importance across all domains, had significantly higher levels of depression and anxiety relative to other clusters. Bars represent standard deviation. *p<0.05.

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