Pelz Margaret, Merskey H
Department of Psychiatry, University of Western Ontario, and Department of Education and Research, London Psychiatric Hospital, 850 Highbury Avenue P.O. Box 2532, Terminal "A", London, Ont. N6A 4H1 Canada.
Pain. 1982 Nov;14(3):293-301. doi: 10.1016/0304-3959(82)90136-1.
The social adjustment and psychological characteristics of a group of patients with lesions presumed to be representative of an 'ordinary' pain clinic population have been examined. As expected there was a significant degree of disturbance of work, sleep, sport, exercise, leisure and social activities and sexual relationships. Patients with back pain found sitting to be particularly troublesome (P less than 0.0001) which suggests that they would have physical reasons for responding to programmes emphasizing 'activity.' They used more affective words proportionately to describe it than those with pain elsewhere, but both groups used far more sensory words overall than affective ones. Formal depression of the type measured by the Levine-Pilowsky Depression Questionnaire which corresponds to the psychiatric interview was not prominent. On the SCL-90, a more widely ranging type of psychological test, there were marked elevations on the somatization scale which are partly artifact, and also significant elevations for obsessive traits, depression, anxiety and general symptoms. Questions in the tests concerning irritability and frustration were frequently answered affirmatively. Low-back pain patients and compensation patients did not differ significantly from the remainder on the SCL-90 or on the Levine-Pilowsky Questionnaire. The findings are taken to indicate an understandable pattern of emotional response to chronic pain whether in the low back or elsewhere, as well as a specific difference in descriptions in patients with low-back pain. They are held to support the view that many patients receiving compensation have the same pattern of emotional response as those who do not obtain financial payment because of their illness.
对一组病变患者的社会适应和心理特征进行了检查，这些病变被认为代表了“普通”疼痛门诊人群。不出所料，他们在工作、睡眠、运动、锻炼、休闲和社交活动以及性关系方面存在显著程度的困扰。背痛患者发现坐着特别麻烦（P小于0.0001），这表明他们有身体上的原因对强调“活动”的方案做出反应。与其他部位疼痛的患者相比，他们在描述疼痛时使用的情感词汇比例更高，但两组总体上使用的感官词汇都远远多于情感词汇。通过与精神科访谈相对应的莱文 - 皮洛斯基抑郁问卷测量的那种形式的抑郁症并不突出。在更广泛使用的心理测试SCL - 90上，躯体化量表有明显升高，部分是人为因素造成的，强迫特质、抑郁、焦虑和一般症状也有显著升高。测试中关于易怒和沮丧的问题经常得到肯定回答。在SCL - 90或莱文 - 皮洛斯基问卷上，腰痛患者和索赔患者与其余患者没有显著差异。这些发现表明，无论是下背部还是其他部位的慢性疼痛，都有可理解的情绪反应模式，以及腰痛患者在描述上的特定差异。这些发现支持了这样一种观点，即许多获得赔偿的患者与那些因疾病未获得经济赔偿的患者有相同的情绪反应模式。
