Philipps-University of Marburg, Section for Clinical Psychology and Psychotherapy, Gutenbergstr., Marburg, Germany.
Clin J Pain. 2010 Sep;26(7):593-601. doi: 10.1097/AJP.0b013e3181e37611.
The aim of this study was to identify pretreatment factors associated with dropout from outpatient individualized cognitive-behavioral treatment for chronic back pain. Despite the importance of this issue, little is known about determinants of dropout from cognitive-behavioral treatment for chronic pain. The presented study is a subanalysis of a larger study on cognitive-behavioral treatment for chronic back pain.
The study included 128 patients, who began a 25 session treatment. Three pretreatment domains (demographic variables, psychologic and pain-related symptom severity, and attitude toward treatment) and satisfaction with treatment within the first 3 sessions were considered as potential predictors of attrition.
Twenty-three patients (18%) were classified as dropouts. Low psychologic distress, low medication intake, and low treatment satisfaction were significantly associated with dropout. Other demographic variables, pain-related variables, attributions, and attitude toward treatment were not associated with treatment attrition. The associations were only valid for early dropouts.
It is concluded that cognitive-behavioral treatment of chronic pain should be adapted for less psychologically distressed patients to avoid treatment dropout.
本研究旨在确定与慢性腰痛门诊个体化认知行为治疗脱落相关的治疗前因素。尽管这一问题很重要，但人们对认知行为治疗慢性疼痛脱落的决定因素知之甚少。本研究是对慢性腰痛认知行为治疗的一项更大研究的子分析。
该研究纳入了 128 名开始接受 25 次治疗的患者。在治疗前的三个方面（人口统计学变量、心理和疼痛相关症状严重程度以及对治疗的态度）以及前 3 次治疗中对治疗的满意度被认为是脱落的潜在预测因素。
23 名患者（18%）被归类为脱落者。低心理困扰、低药物摄入和低治疗满意度与脱落显著相关。其他人口统计学变量、疼痛相关变量、归因和对治疗的态度与治疗脱落无关。这些关联仅对早期脱落者有效。
结论是，慢性疼痛的认知行为治疗应该针对心理困扰较小的患者进行调整，以避免治疗脱落。
