Cluster analyses of pain patients' responses to the SCL-90R.

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.

Analyzing chronic low back pain: the relative contribution of pain coping strategies.

Sixty-two chronic low back pain patients were administered the Coping Strategies Questionnaire (CSQ) to assess the frequency of use and perceived effectiveness of a variety of cognitive and behavioral pain coping strategies. Analysis of individual variables revealed that CSQ factors, gender, physical examination findings, and chronicity of pain had significant effects on one or more of a series of pain, psychological distress or behavioral measures. To assess the relative contribution of each of these variables hierarchical stepwise regression analyses were carried out.

Alterations in cerebrospinal fluid concentrations of somatostatin-like immunoreactivity in chronic pain patients.

Concentrations of somatostatin-like immunoreactivity in cerebrospinal fluid were significantly reduced in chronic pain patients compared to control patients without chronic pain. This difference was not influenced by demographic or clinical characteristics. Somatostatin has been shown to be a neurotransmitter in animal nociception; pharmacologic doses of this substance have moderated human pain.

CSF monoamine metabolites in chronic pain.

Metabolites of selected neurotransmitters (5-HIAA, HVA and DOPAC) and beta-endorphin were measured in the CSF of 39 chronic pain patients and compared to controls. Twelve of the pain patients also fulfilled criteria for major depression. The concentration of 5-HIAA was increased in female but not male pain patients; there was no significant difference in the CSF concentrations of HVA and DOPAC.

Long-term use of narcotic/antidepressant medication in the management of phantom limb pain.

The successful management of 5 consecutive patients with intractable phantom limb pain is described. The main therapy is a combination of a narcotic and antidepressant. Medication remained effective during the average observation time of 22 months.

Chronic pain and depression. II. Symptoms of anxiety in chronic low back pain patients and their relationship to subtypes of depression.

The relationship between anxiety and chronic pain has been poorly studied. The authors studied the occurrence of symptoms of anxiety in chronic low back pain patients. Anxious mood and other symptoms of anxiety were commonly seen in patients with chronic low back pain.

Chronic pain and depression. I. Classification of depression in chronic low back pain patients.

An association between chronic pain and depression has been recognized for a long time. However, the exact nature of this relationship remains unclear. The authors studied 71 patients for affective disorders and schizophrenia-lifetime version (SADS-L).

A study of psychophysical scaling in chronic pain patients.

Chronic pain patients were asked to psychophysically scale two sets of word descriptors (intensity and unpleasantness) using a crossmodality matching procedure with line length and numerical estimates. In 22 patients (group I) descriptor scaling was performed once, in another 20 patients (group II) the procedure was repeated 3 times. 72.

Local anesthetic effect of intrathecal normal saline.

The effects of intrathecally administered normal saline have been studied in patients undergoing graduated spinal anesthesia. The injection of 5 or 10 ml volumes resulted in segmental hypesthesia to pin-scratch and cold stimuli extending from the lower thoracic to the sacral dermatomes. There was also partial sympathetic block evidenced by a diminished psychogalvanic skin reflex.