It’s Not Just the Pain:
Authors to present research results at IASP conference

Results of a recent exploratory study, conducted at the Texas Pain Clinic in Dallas, indicate certain areas in a chronic pain patient’s life relate to important indicators of treatment outcome. Study authors believe that medical practitioners can use this information to help them become more aware of areas that may need further investigation and treatment to help the pain patient’s recovery.

The purpose of the exploratory study was to look at the ability of the BHI™ (Battery for Health Improvement) test to predict treatment outcome and barriers to rehabilitation. Eighty one chronic pain patients at the clinic comprised the subject pool. From August 1999 through August 2001 all subjects participated eight hours per day, five days per week in a rehabilitation program that lasted from four to eight weeks. Subjects took the BHI test at the first visit. The MPI (Multidimensional Pain Inventory) was administered during the first week and again at discharge. The patients also participated in a telephone interview six months after discharge.

The BHI test helps measure factors such as depression, anxiety, hostility, symptom dependency, substance abuse, family dysfunction, job dissatisfaction, doctor dissatisfaction, and others. The MPI test helps measure whether the patient is functional or dysfunctional in various areas of their pain experience.

The results of the study indicate significant relationships in five areas:

1. Patients who did not show improvement on the MPI scored higher on the “Depression” scale of the BHI test.
   
   
2. Patients who did not show improvement on the MPI reported a higher number of body areas with pain on the BHI test.
   
   
3. Patients who continued to have surgeries for pain at six months following treatment had higher “Job Dissatisfaction” scores on the BHI test.
   
   
4. Patients who were unemployed at six months had significantly higher “Symptom Dependency” scores on the BHI test.
   
   
5. Patients who were unemployed at six months had significantly lower “Substance Abuse” scores on the BHI test than those who were employed.

The authors note that, due to the limited number of patients examined, the results of the study cannot predict outcome. However, they can conclude that these five relation ships exist and that the relationships point to areas doctors should consider during diagnosis and treatment. “Doctors need to be aware that there are multiple reasons for people to be disabled, and multiple reasons there could be barriers to progress in rehabilitation,” says Robert Freedenfeld, PhD, Director of Clinical Research and Training at the Texas Pain Medicine Clinic. “It’s not just the pain,” he says.

The authors will present their data and its implications at a poster session at the International Association for the Study of Pain (IASP) conference in San Diego on Tuesday afternoon, August 20.

The study was conducted by: Freedenfeld; Berit E. Bailey, PhD, Clinical Psychology Fellow, Texas Pain Medicine Clinic; Daniel Bruns, PsyD, Health Psychology Associates, Greeley, CO; Perry N. Fuchs, PhD, Assistant Professor of Research Statistics and Design, University of Texas, Arlington; and R. Sanford Kiser, MD. Medical Director, Texas Pain Medicine Clinic.

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