Frettlöh J, Maier C, Gockel H, Hüppe M
Berufsgenossenschaftliche Kliniken Bergmannsheil, Abteilung für Schmerztherapie, Bochum.
Schmerz. 2003 Aug;17(4):240-51. doi: 10.1007/s00482-003-0227-9.
Our study was carried out to clarify whether differences in pain intensity,pain-related disability,depression and quality of life change with respect to the stage of chronicity of the Mainz Pain Staging Study (MPSS) in different pain syndromes. Keywords.
All patients with an initial pain clinic consultation from July 2000 to July 2001 and suffering from four major pain syndromes ("headache", "neuropathic pain", "back pain" or "muscle and joint pain") were included. Indicators of validity were several self-rating scales from the German pain questionnaire of the German Chapter of the International Association for the Study of Pain (DGSS). Patient data were collected using QUAST, a database environment specifically developed for documentation and quality assurance in pain therapy. An assessment was made for each of the four major diagnoses to determine whether patients in the three chronicity stages differed in their psychometric test results. In addition,the four diagnosis groups were tested for differences from one another.
A total of 862 patient charts with documented pain syndromes and MPSS were extracted and analyzed. The extent of the subjective psychosocial stress and disability increased in all diagnosis groups and was correlated with the chronicity stage. The proportion of patients with an indication of clinically relevant depression (ADS score >23) increased with chronicity regardless of the pain diagnosis. The four main diagnosis groups differed with respect to the chronicity stage according to MPSS (P<0.001), with headache patients being classified predominantly as stage I. Patients with an additional pain diagnosis had a higher chronicity stage (P<0.001).
Our results underline the validity of the MPSS for the four diagnosis groups examined; however, pain diagnosis must be controlled in all studies using chronicity stage as an independent variable, e.g., therapy studies. For optimal results physicians must closely follow the test instructions of the MPSS.
开展本研究以阐明在不同疼痛综合征中，疼痛强度、疼痛相关功能障碍、抑郁及生活质量的差异是否随美因茨疼痛分期研究（MPSS）的慢性化阶段而变化。关键词。
纳入2000年7月至2001年7月首次到疼痛门诊就诊且患有四种主要疼痛综合征（“头痛”、“神经性疼痛”、“背痛”或“肌肉与关节疼痛”）的所有患者。效度指标为国际疼痛研究协会德国分会疼痛问卷（DGSS）中的多个自评量表。使用QUAST收集患者数据，QUAST是专门为疼痛治疗中的记录和质量保证而开发的数据库环境。对四种主要诊断中的每一种进行评估，以确定处于三个慢性化阶段的患者在心理测量测试结果上是否存在差异。此外，对四个诊断组相互之间的差异进行了测试。
共提取并分析了862份记录有疼痛综合征和MPSS的患者病历。所有诊断组中主观心理社会压力和功能障碍的程度均增加，且与慢性化阶段相关。无论疼痛诊断如何，有临床相关抑郁迹象（ADS评分>23）的患者比例随慢性化而增加。根据MPSS，四个主要诊断组在慢性化阶段存在差异（P<0.001），头痛患者主要归类为I期。有额外疼痛诊断的患者慢性化阶段更高（P<0.001）。
我们的结果强调了MPSS对所研究的四个诊断组的有效性；然而，在所有将慢性化阶段作为自变量的研究（如治疗研究）中，必须控制疼痛诊断。为获得最佳结果，医生必须严格遵循MPSS的测试说明。
