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人格障碍与多学科疼痛治疗后的结果。

Personality disorders and outcome after multidisciplinary pain therapy.

机构信息

Department of Anesthesiology, Ludwig-Maximilians-University, Munich, Germany.

Interdisciplinary Pain Centre, Klinikum Landsberg am Lech, Germany.

出版信息

Chronic Illn. 2023 Sep;19(3):635-645. doi: 10.1177/17423953221110150. Epub 2022 Jul 5.

Abstract

OBJECTIVES

Interdisciplinary treatment programmes are the gold standard for patients suffering from chronic pain. However, several patient-related factors seem to influence the patients' outcome. The aim of our study was to inquire whether patients with personality disorders (PD) might benefit less from an interdisciplinary treatment programme compared to patients without PD.

METHODS

A prospective, observational study with chronic pain patients attending a 5-week interdisciplinary treatment programme was performed. Main outcome parameters were psychological stabilization and pain intensity before and after the programme.

RESULTS

Out of the 104 included patients, 71 (68.3%) showed personality accentuations and 16 (15.4%) were diagnosed with PDs. PDs were mostly classified as histrionic, followed by borderline and narcistic personality. Patients diagnosed with histrionic accentuation showed a significantly better treatment response in terms of pain. Reduction in ADS (Allgemeine Depressionsskala - depression scale) was 3.4 in patients with PD and 11.1 in those without PD. Borderline patients showed a significant increase of ADS (by 2.0;  < 0.05) after programme completion.

DISCUSSION

Patients with chronic pain and personality accentuations or disorder only showed a slightly different outcome after interdisciplinary treatment programme and should therefore not be excluded from these programmes. Registered at German Clinical Trials Register (DRKS-ID: DRKS00015141).

摘要

目的

跨学科治疗方案是慢性疼痛患者的金标准。然而,一些与患者相关的因素似乎会影响患者的治疗效果。我们的研究目的是探究是否患有人格障碍(PD)的患者从跨学科治疗方案中获益可能不如没有 PD 的患者。

方法

对参加为期 5 周的跨学科治疗方案的慢性疼痛患者进行前瞻性、观察性研究。主要的疗效参数是治疗前后的心理稳定和疼痛强度。

结果

在纳入的 104 名患者中,71 名(68.3%)表现出人格特质,16 名(15.4%)被诊断为 PD。PD 主要分为表演型、边缘型和自恋型。被诊断为表演型人格特质的患者在疼痛方面的治疗反应明显更好。PD 患者的 ADS(Allgemeine Depressionsskala - depression scale)减少了 3.4,而无 PD 的患者减少了 11.1。在完成方案后,边缘型患者的 ADS 显著增加(增加了 2.0;<0.05)。

讨论

患有慢性疼痛和人格特质或障碍的患者在接受跨学科治疗方案后仅显示出略有不同的结果,因此不应将其排除在这些方案之外。在德国临床试验注册处(DRKS-ID:DRKS00015141)注册。

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