Frettlöh J, Maier C, Gockel H, Zenz M, Hüppe M
Abteilung für Schmerztherapie, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil GmbH, Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Deutschland.
Schmerz. 2009 Dec;23(6):576-91. doi: 10.1007/s00482-009-0836-z.
In 1998 the board of the DGSS introduced a computerized documentation system named QUAST (quality assurance in pain therapy) building the foundation for a large, anonymous database that served as a data source for the statistical characterization of clinically relevant profiles of patients in German pain clinics.
A total of 10,054 data files collected between 1998 and 2004, including socio-demographic as well as psychometric and pain parameters were analyzed.
The main pain diagnoses found in the database sample were back pain (37%), neuropathic pain (21.4%), soft tissue or arthralgia pain (19.5%) and headache (10.6%). The average duration of illness upon presentation at pain clinics was 7 years, nearly 20% contacted it within the first year. Of the sample, 43.8% of the patients were in the second chronicity stage and 39.0% in the third stage of the Mainz Pain Staging System (MPSS). Psychological measurements concerning despression, pain disability and quality of life indicated a great amount of psychological distress. Pronounced differences between main diagnostic groups were observed not only for psychological factors but also for direct pain parameters.
The documented data differ from other population-based data collections. In contrast to common belief there are a considerable number of patients who find access to specialized pain therapy institutions at an early stage of their illness. The hitherto regular use of generic, syndrome-overlapping diagnosis and treatment tools should be reconsidered taking into account the differences found between the main pain diagnosis groups. Lastly, this analysis provides current data on the psychological state of chronic pain patients showing a high degree of psychological distress and underlying the need of psychotherapeutic interventions in the treatment of chronic pain patients.
1998年，德国疼痛学会董事会引入了一个名为QUAST（疼痛治疗质量保证）的计算机化文档系统，为一个大型匿名数据库奠定了基础，该数据库作为德国疼痛诊所患者临床相关特征统计表征的数据源。
分析了1998年至2004年间收集的总共10054个数据文件，包括社会人口统计学以及心理测量和疼痛参数。
数据库样本中发现的主要疼痛诊断为背痛（37%）、神经性疼痛（21.4%）、软组织或关节痛（19.5%）和头痛（10.6%）。患者到疼痛诊所就诊时的平均病程为7年，近20%的患者在第一年就出现了疼痛。在样本中，43.8%的患者处于美因茨疼痛分期系统（MPSS）的第二慢性阶段，39.0%处于第三阶段。关于抑郁、疼痛残疾和生活质量的心理测量表明存在大量心理困扰。不仅在心理因素方面，而且在直接疼痛参数方面，主要诊断组之间都观察到了明显差异。
记录的数据与其他基于人群的数据收集不同。与普遍看法相反，有相当数量的患者在疾病早期就能获得专门的疼痛治疗机构的治疗。考虑到主要疼痛诊断组之间的差异，应重新考虑迄今常规使用的通用、综合征重叠的诊断和治疗工具。最后，该分析提供了关于慢性疼痛患者心理状态的当前数据，显示出高度的心理困扰，并强调了在慢性疼痛患者治疗中进行心理治疗干预的必要性。
