Chaput Geneviève, Lajoie Susanne P, Naismith Laura M, Lavigne Gilles
Department of Cancer Support and Palliative Medicine, McGill University Health Centre, Montreal, QC, Canada H4A 3J1.
Department of Educational and Counselling Psychology, McGill University, Montreal, QC, Canada H3A 1Y2.
Pain Res Manag. 2016;2016:2825856. doi: 10.1155/2016/2825856. Epub 2016 Mar 2.
Background. Identifying which patients are most likely to be at risk of chronic pain and other postconcussion symptoms following mild traumatic brain injury (MTBI) is a difficult clinical challenge. Objectives. To examine the relationship between pain catastrophizing, defined as the exaggerated negative appraisal of a pain experience, and early MTBI outcome. Methods. This cross-sectional design included 58 patients diagnosed with a MTBI. In addition to medical chart review, postconcussion symptoms were assessed by self-report at 1 month (Time 1) and 8 weeks (Time 2) after MTBI. Pain severity, psychological distress, level of functionality, and pain catastrophizing were measured by self-report at Time 2. Results. The pain catastrophizing subscales of rumination, magnification, and helplessness were significantly correlated with pain severity (r = .31 to .44), number of postconcussion symptoms reported (r = .35 to .45), psychological distress (r = .57 to .67), and level of functionality (r = -.43 to -.29). Pain catastrophizing scores were significantly higher for patients deemed to be at high risk of postconcussion syndrome (6 or more symptoms reported at both Time 1 and Time 2). Conclusions. Higher levels of pain catastrophizing were related to adverse early MTBI outcomes. The early detection of pain catastrophizing may facilitate goal-oriented interventions to prevent or minimize the development of chronic pain and other postconcussion symptoms.
背景。确定哪些患者在轻度创伤性脑损伤(MTBI)后最有可能面临慢性疼痛和其他脑震荡后症状的风险是一项艰巨的临床挑战。目的。研究疼痛灾难化(定义为对疼痛体验的夸大负面评价)与早期MTBI结局之间的关系。方法。这项横断面设计纳入了58例被诊断为MTBI的患者。除了查阅病历外,在MTBI后1个月(时间1)和8周(时间2)通过自我报告评估脑震荡后症状。在时间2通过自我报告测量疼痛严重程度、心理困扰、功能水平和疼痛灾难化程度。结果。沉思、放大和无助的疼痛灾难化子量表与疼痛严重程度(r = 0.31至0.44)、报告的脑震荡后症状数量(r = 0.35至0.45)、心理困扰(r = 0.57至0.67)和功能水平(r = -0.43至-0.29)显著相关。对于被认为有高脑震荡后综合征风险的患者(在时间1和时间2均报告6种或更多症状),疼痛灾难化得分显著更高。结论。较高水平的疼痛灾难化与早期MTBI不良结局相关。早期检测疼痛灾难化可能有助于采取以目标为导向的干预措施,以预防或尽量减少慢性疼痛和其他脑震荡后症状的发展。