Williams David A, Urban Bruno, Keefe Francis J, Shutty Michael S, France Randall
Georgetown University Medical Center, Washington, DC 20007 USA Duke University Medical Center, Durham, NC 27710 USA Western State Hospital, Department of Mental Health and Mental Retardation, Staunton, VA 24401 USA.
Pain. 1995 Apr;61(1):81-91. doi: 10.1016/0304-3959(94)00165-B.
This study sought to identify distinct subgroups of chronic pain patients based on responses to the Symptom Checklist 90-revised (SCL-90R), a measure of psychological distress. Two scoring methods were used: the standard scoring that accompanies the manual, and a scoring method based upon factor scores obtained in an earlier study using low back pain patients. Two separate cluster analyses assigned patients into 2 groups: one based on standard scores and one based on factor scores. Results of this study support the hypothesis that distinct and replicable subgroups of chronic pain patients can be identified using the SCL-90R. Depending upon group membership, patients significantly differed on measures of qualitative pain and quantitative pain report, depressive symptoms, medication usage, and pain-related behaviors. This study supports the use of SCL-90R factor scoring with pain patients as greater differentiation between clusters was found for pain report and pain-related behavior when this method was used. Guidelines for clinical application of SCL-90R cluster groups is provided.
本研究旨在根据症状自评量表90修订版（SCL - 90R）（一种心理困扰测量工具）的反应，识别慢性疼痛患者的不同亚组。使用了两种评分方法：手册附带的标准评分，以及基于早期一项使用腰痛患者的研究中获得的因子得分的评分方法。两项独立的聚类分析将患者分为两组：一组基于标准得分，另一组基于因子得分。本研究结果支持这样的假设，即使用SCL - 90R可以识别出不同的、可重复的慢性疼痛患者亚组。根据所属组别，患者在定性疼痛和定量疼痛报告、抑郁症状、药物使用以及疼痛相关行为的测量上存在显著差异。本研究支持对疼痛患者使用SCL - 90R因子评分，因为使用该方法时，在疼痛报告和疼痛相关行为方面发现聚类之间有更大的差异。提供了SCL - 90R聚类组临床应用指南。
