Basal and post-dexamethasone cortisol and prolactin concentrations in depressed and non-depressed patients with chronic pain syndromes.

To assess the behavior of two putative neuroendocrine markers of depression in chronic pain, the authors determined plasma cortisol and prolactin concentrations before and after dexamethasone in 52 hospitalized male chronic pain patients. Their psychiatric diagnoses by Research Diagnostic Criteria (RDC) were: major depression (N = 24; 44.2%), minor depression (N = 10; 19.

The language of pain: affective descriptors of pain are a better predictor of psychological disturbance than pattern of sensory and affective descriptors.

The language used by chronic benign pain patients to characterize their pain complaint was analyzed to determine the best predictor of psychiatric disturbance. Using the 78 adjectives provided by the McGill Pain Questionnaire, the number of affective descriptors used was the best predictor of psychiatric disturbance. Addition of sensory descriptors either to augment the total number of descriptors used (magnitude) or as a pattern of sensory greater than affective or sensory less than affective failed to increase predictive strength.

Diffusion of pain language with affective disturbance confounds differential diagnosis.

Two experiments examined the use of pain descriptors by chronic pain patients with different medical and/or psychiatric diagnoses. Experiment I subjected patients' responses to the 20 descriptor categories on the McGill Pain Questionnaire to 3 separate multiple discriminant analyses to examine the differential diagnostic properties of pain language. None of the analyses generated a discriminant function, indicating that chronic pain patients do not use pain descriptors in a precise and systematic manner.

Pain measurement: the affective dimensional measure of the McGill pain questionnaire with a cancer pain population.

Two experiments used the McGill Pain Questionnaire (MPQ) to examine the affective dimension of pain in patients whose pain was secondary to malignancy. In experiment I, segregating groups of cancer patients on the basis of extreme scores (high versus low) on the MPQ failed to produce segregation on independent measures of affect and infirmity. This outcome contrasts with earlier work with chronic benign pain patients.

Behavioral treatment of chronic pain: the spouse as a discriminative cue for pain behavior.

Twenty married chronic pain patients (pain duration > 8 mo.) consecutively admitted to a pain management program were administered a taped structured interview designed to elucidate the responses of their spouses to pain behavior. Additionally, patients were required to report their pain levels in two different observational conditions: when observed by their spouse and when observed by a "neutral observer", the ward clerk.