A comparative study of iatrogenesis, medication abuse, and psychiatric morbidity in chronic pain patients with and without medically explained symptoms.
We report a case control study comparing patients attending a pain clinic whose symptoms were not considered medically explained (cases) with those whose symptoms were considered medically explained (controls). Principal comparisons were psychiatric morbidity, medication use, and iatrogenic factors assessed by interview, and questionnaire measures of anxiety, depression, functional impairment, coping strategies and pain beliefs. Medically unexplained symptoms were associated with the presence of psychiatric morbidity (odds ratio = 3.4, 95% C.I.: 1.4,8.2), and of possible iatrogenic factors. There were no significant differences with regards to medication abuse/dependence.
King's College School of Medicine and Dentistry and the Institute of Psychiatry, 103 Denmark Hill, London SE5 8AZ, UK INPUT Pain Management Unit, St. Thomas' Hospital, London, UK.
Kyriaki
K
Kouyanou
Charles E
CE
Pither
Sophia
S
Rabe-Hesketh
Simon
S
Wessely
D000328:Adult; D000367:Age Factors; D016022:Case-Control Studies; D002908:Chronic Disease; D003071:Cognition / Q000502:physiology; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease; D008297:Male; D001523:Mental Disorders / Q000150:complications / Q000523:psychology*; D010146:Pain / Q000150:complications / Q000523:psychology*; D010147:Pain Measurement; D011569:Psychiatric Status Rating Scales; D012737:Sex Factors; D019966:Substance-Related Disorders / Q000150:complications / Q000523:psychology*