Hampel P, Moergel M F
Zentrum für Klinische Psychologie und Rehabilitation, Universität Bremen, Grazer Str. 6, 28359, Bremen, Deutschland.
Schmerz. 2009 Apr;23(2):154-65. doi: 10.1007/s00482-008-0743-8.
Criterion-related validity of the Mainz Pain Staging System (MPSS) was examined.
The effect of staging of pain on pain-related and psychosocial measures was investigated in a cross-sectional design among 478 patients with chronic low back pain in inpatient orthopedic rehabilitation (ICD-10 diagnoses: M45.4/M45.5, M54.4/M54.5). Pain-related measures were selected from the German Pain Questionnaire of the International Association for the Study of Pain (DGSS). The psychosocial measures depression (ADS), anxiety (HADS-D), somatization (SCL-90-R), quality of life (SF-12), functional capacity (FFbH-R), pain sensation (SES) as well as pain experience and strategies of coping with pain (FESV) were assessed. Furthermore, the frequency distribution of scores in the clinical range in pain-related and psychosocial measures depending on the staging of pain was examined. Finally, initial indications of the predictive validity of the MPSS were investigated among 116 inpatients.
Staging of pain had a significant impact both on levels of measures and proportion of clinically referred patients. Patients in stage III, but also those in stage II showed significantly impaired levels. Patients in stage III also showed more scores in the clinical range than expected in the lowest pain intensity, ADS depression, somatization of the SCL, functional capacity, and pain sensation. The MPSS before rehabilitation, together with mental health, seem to be a good predictor of depressive symptoms 6 months after rehabilitation.
The results support criterion validity of the MPSS, however, they also corroborate the concept that identification of medium and high grade pain by the MPSS has to be followed by a psychological diagnostic assessment. By this stepwise diagnostic process, therapy aims and treatment regimens can be designed more adequately.
对美因茨疼痛分期系统（MPSS）的效标关联效度进行了检验。
采用横断面设计，对478例住院骨科康复的慢性下腰痛患者（国际疾病分类第十版诊断：M45.4/M45.5、M54.4/M54.5），研究疼痛分期对疼痛相关及心理社会指标的影响。疼痛相关指标选自国际疼痛研究协会的德国疼痛问卷（DGSS）。评估心理社会指标抑郁（ADS）、焦虑（HADS-D）、躯体化（SCL-90-R）、生活质量（SF-12）、功能能力（FFbH-R）、痛觉（SES）以及疼痛体验和应对疼痛的策略（FESV）。此外，还研究了根据疼痛分期，疼痛相关和心理社会指标临床范围内得分的频率分布。最后，在116例住院患者中研究了MPSS预测效度的初步指征。
疼痛分期对指标水平和临床转诊患者比例均有显著影响。III期患者以及II期患者的指标水平均显著受损。III期患者在最低疼痛强度、ADS抑郁、SCL躯体化、功能能力和痛觉方面，临床范围内的得分也高于预期。康复前的MPSS与心理健康状况似乎是康复后6个月抑郁症状的良好预测指标。
结果支持MPSS的效标效度，然而，它们也证实了这样一个概念，即MPSS识别中度和高度疼痛后，必须进行心理诊断评估。通过这一步骤式诊断过程，可以更充分地设计治疗目标和治疗方案。
