scholarly journals The Classification of Patients with Chronic Pain: Age and Sex Differences

2001 ◽  
Vol 6 (3) ◽  
pp. 142-151 ◽  
Author(s):  
Andrew J Cook ◽  
Dania C Chastain
Keyword(s):  
Chronic Pain ◽  
Sex Differences ◽  
Perceived Disability ◽  
Pain Disability ◽  
Clinical Presentations ◽  
Chronic Pain Patients ◽  
Pain Duration ◽  
Pain Patients ◽  
Age And Sex

OBJECTIVE: To further develop an empirically based classification system for chronic pain patients through the examination of age and sex differences, and incorporation of pain duration in the grouping algorithm.SUBJECTS: Three hundred seventy-four chronic pain patients (300 aged 13 to 59 years; 74 aged 60 to 89 years) assessed at an outpatient, multidisciplinary pain management centre.METHODS: Patients completed measures of demographic and descriptive information, pain intensity (box rating scale), perceived disability (modified Pain Disability Index) and affective distress (Symptom Checklist-90 Revised) before multidisciplinary treatment. Standardized scores from the assessment measures were entered into a series of hierarchical, multivariate cluster analyses to identify underlying patient subgroups.RESULTS: Age-based patient groupings from prior research were partially replicated. Significant differences in clinical presentations were observed across age and sex groups. Pain duration was found to make an important contribution to the patient groupings. 'Good control' (low pain, disability, distress) and variants of 'chronic pain syndrome' (elevated pain, disability, distress) groupings were identified across all analyses. Two variants of a 'stoic' profile were identified among older patients, with low levels of distress relative to pain and perceived disability. One of these profiles was associated with long pain duration and was found only among males. Several unique clinical profiles were identified for female patients.CONCLUSIONS: There are important age and sex differences in the clinical presentations of chronic pain patients. Some older patients present with unique clinical profiles that may reflect cohort differences, and/or physiological or psychological adjustment processes. There appears to be a greater number of distinct chronic pain presentations among females. Research on the classification of chronic pain patients within homogeneous diagnostic subgroups is needed.

scholarly journals Pain Characteristics and Demographics of Patients Attending a University-Affiliated Pain Clinic in Toronto, Ontario

2007 ◽  
Vol 12 (2) ◽  
pp. 93-99 ◽  
Author(s):  
Angela Mailis-Gagnon ◽  
Balaji Yegneswaran ◽  
SF Lakha ◽  
Keith Nicholson ◽  
Amanda J Steiman ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Tertiary Care ◽  
Pain Clinic ◽  
Pain Clinics ◽  
Chronic Pain Patients ◽  
Musculoskeletal Problems ◽  
Pain Duration ◽  
Study Population ◽  
Age Range ◽  
Pain Patients

BACKGROUND: Pain clinics tend to see more complex chronic pain patients than primary care settings, but the types of patients seen may differ among practices.OBJECTIVE: The aim of the present observational study was to describe the pain and demographic characteristics of patients attending a university-affiliated tertiary care pain clinic in Toronto, Ontario.METHODS: Data were collected on 1242 consecutive new patients seen over a three-year period at the Comprehensive Pain Program in central Toronto.RESULTS: Musculoskeletal problems affecting large joints and the spine were the predominant cause of pain (more prevalent in women), followed by neuropathic disorders (more prevalent in men) in patients with recognizable physical pathology. The most affected age group was in the 35- to 49-year age range, with a mean pain duration of 7.8 years before the consultation. While 77% of the Comprehensive Pain Program patients had relevant and detectable physical pathology for pain complaints, three-quarters of the overall study population also had significant associated psychological or psychiatric comorbidity. Women, in general, attended the pain clinic in greater numbers and had less apparent physical pathology than men. Finally, less than one in five patients was employed at the time of referral.CONCLUSIONS: The relevance of the data in relation to other pain clinics is discussed, as well as waiting lists and other barriers faced by chronic pain patients, pain practitioners and pain facilities in Ontario and Canada.

scholarly journals Computer Assessment and Diagnostic Classification of Chronic Pain Patients

Pain Medicine ◽  
2007 ◽  
Vol 8 (suppl 3) ◽  
pp. S167-S175 ◽  
Author(s):  
David A. Provenzano ◽  
Gilbert J. Fanciullo ◽  
Robert N. Jamison ◽  
Gregory J. McHugo ◽  
John C. Baird
Keyword(s):  
Chronic Pain ◽  
Diagnostic Classification ◽  
Computer Assessment ◽  
Chronic Pain Patients ◽  
Pain Patients

scholarly journals Influences of Sex, Education, and Country of Birth on Clinical Presentations and Overall Outcomes of Interdisciplinary Pain Rehabilitation in Chronic Pain Patients: A Cohort Study from the Swedish Quality Registry for Pain Rehabilitation (SQRP)

2020 ◽  
Vol 9 (8) ◽  
pp. 2374
Author(s):  
Björn Gerdle ◽  
Katja Boersma ◽  
Pernilla Åsenlöf ◽  
Britt-Marie Stålnacke ◽  
Britt Larsson ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Sex Education ◽  
Clinical Situation ◽  
Effect Sizes ◽  
Country Of Birth ◽  
Quality Registry ◽  
Clinical Presentations ◽  
Chronic Pain Patients ◽  
Pain Patients ◽  
European Women

This study investigates the effects of sex, education, and country of birth on clinical presentations and outcomes of interdisciplinary multimodal pain rehabilitation programs (IMMRPs). A multivariate improvement score (MIS) and two retrospective estimations of changes in pain and ability to handle life situations were used as the three overall outcomes of IMMRPs. The study population consisted of chronic pain patients within specialist care in the Swedish Quality Registry for Pain Rehabilitation (SQRP) between 2008 and 2016 at baseline (n = 39,916), and for the subset participating in IMMRPs (n = 14,666). A cluster analysis based on sex, education, and country of origin revealed significant differences in the following aspects: best baseline clinical situation was for European women with university educations and the worst baseline clinical situation was for all patients born outside Europe of both sexes and different educations (i.e., moderate-large effect sizes). In addition, European women with university educations also had the most favorable overall outcomes in response to IMMRPs (small effect sizes). These results raise important questions concerning fairness and equality and need to be considered when optimizing assessments and content and delivery of IMMRPs for patients with chronic pain.

scholarly journals Depressed Mood Differentially Mediates the Relationship between Pain Intensity and Pain Disability Depending on Pain Duration: A Moderated Mediation Analysis in Chronic Pain Patients

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Thomas Probst ◽  
Susanne Neumeier ◽  
Jürgen Altmeppen ◽  
Michael Angerer ◽  
Thomas Loew ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Depressed Mood ◽  
Significant Proportion ◽  
Moderated Mediation ◽  
Mediation Model ◽  
Cross Sectional ◽  
Chronic Pain Patients ◽  
Pain Duration ◽  
The Relationship ◽  
Pain Patients

Research has shown that pain is associated with disability and that depressed mood mediates the relationship between pain and disability. The question of whether duration of pain moderates these effects was addressed in this cross-sectional study with 356 chronic pain patients. A simple mediation model replicated the notion that depressed mood explains a significant proportion of the relationship between pain and disability (in the study at hand: 12%). A moderated mediation model revealed that the indirect effect of pain on disability through depressed mood is moderated by pain duration: while depressed mood did not mediate the effect of pain on disability in chronic pain patients with shorter pain duration, depressed mood significantly mediated the effect pain exerts on disability in chronic pain patients with longer pain duration. Pain duration did not moderate the direct effect of pain on disability. Implications of these findings for the treatment of chronic pain might be that targeting depressed mood is especially relevant in chronic pain patients with longer pain duration to reduce the effect of pain on disability.

Sex differences among opioid-abusing chronic pain patients in a clinical trial

2014 ◽  
Vol 140 ◽  
pp. e133
Author(s):  
Jeanne M. Manubay ◽  
J.W. Davidson ◽  
S.K. Vosburg ◽  
Jermaine D. Jones ◽  
Ziva D. Cooper ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Chronic Pain ◽  
Sex Differences ◽  
Chronic Pain Patients ◽  
Pain Patients

scholarly journals Is Pain Time Pattern Predictive of Future Time Perspective in Older Chronic Pain Patients?

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 431-431
Author(s):  
Gillian Fennell ◽  
Abby Pui Wang Yip ◽  
M Cary Reid ◽  
Susan Enguidanos ◽  
Elizabeth Zelinski ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Temporal Pattern ◽  
Time Perspective ◽  
Subjective Health ◽  
Future Time Perspective ◽  
Future Time ◽  
Time Pattern ◽  
Chronic Pain Patients ◽  
Pain Duration ◽  
Pain Patients

Abstract Chronic pain patients constitute 65% of those ages 65 and older in the US. Many affected older adults are challenged to manage physical and psychological consequences tied to the intensity, interference, and temporal pattern of their pain. However, little quantitative research highlights the psychological impact of constant versus intermittent or ever-present-yet-variable pain, even though temporal pain pattern may have meaningful predictive power for wellbeing and future time perspective (FTP). A positive and expansive view of the future is particularly adaptive for this population because it is positively associated with treatment adherence. In this study, we analyzed secondary data to determine whether pain temporal pattern and pain duration are associated with differences in participant scores on Carstensen & Lang’s Future Time Perspective scale. All participants (N=142) were 45 years old and older with non-cancer chronic pain lasting three months or more. There was no significant association between pain time pattern and FTP (p=.35). Additionally, controlling for pain duration, average FTP scores did not vary significantly as a function of time pattern (p=.07). Our analyses demonstrated no significant relationship between pain time pattern and FTP and no significant moderating effect of pain duration. However, in contrast to the previous literature, FTP was not significantly associated with age and negatively (rather than positively) associated with subjective health (r=-.08, p=.35; r=-.24, p<.01), thus raising concerns about the generalizability of these findings. Implications for understanding time perceptions in older pain patients are discussed.

scholarly journals Measuring opioid dependence in chronic pain patients: A comparison between addiction clinic and pain clinic patient populations

2019 ◽  
Vol 15 (4) ◽  
pp. 285-293
Author(s):  
Mike McDonough, MBBS ◽  
Jacinta L. Johnson, PhD ◽  
Jason M. White, PhD ◽  
Femke T. A. Buisman-Pijlman, PhD
Keyword(s):  
Chronic Pain ◽  
Opioid Dependence ◽  
Pain Clinic ◽  
Addiction Medicine ◽  
Pain Disability Index ◽  
Pain Disability ◽  
Chronic Pain Patients ◽  
Problem Checklist ◽  
Pain Patients ◽  
Clinic Group

Objective: To compare dependence characteristics between patients with chronic pain treated within an addiction medicine setting with those attending specialist pain clinics.Setting and patients: Forty patients with chronic non-cancer pain taking opioid analgesics for 1 year were recruited from university-affiliated, tertiary teaching hospital clinics; 20 from an addiction medicine clinic (addiction clinic group) and 20 from specialist pain clinics (pain clinic group).Design and main outcome measures: Data regarding demographics, past and current substance use, pain history and current daily opioid intake were collected. Patients completed three questionnaires: the Severity of Opioid Dependence Questionnaire, Leeds Dependence Questionnaire, and Pain Disability Index. A novel “Opioid Problem Checklist score” assessing drug-related problems was also determined for each patient.Results: The addiction clinic group were younger, more likely to have experienced drug overdose and had a shorter duration of chronic pain. No significant differences in dependence questionnaire scores were found between groups. However, higher Pain Disability Index scores and higher Opioid Problem Checklist scores (indicating more drug-related problems) were found for the addiction clinic group.Conclusions: Some degree of dependence was present across both addiction and pain clinic groups, supporting the notion a state of dependence can be identified among chronic pain patients taking opioids long term. Aberrant behaviors were not common in the pain clinic sample, suggesting these patients are unlikely to meet Diagnostic and Statistical Manual of Mental Disorders-V criteria for Substance Use Disorder. However, opioid dependence carries significant risks for relapse, chronicity, morbidity and mortality, warranting specific medical management. Management of such risks should be considered routine care in chronic pain patients taking opioids long term.

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