[Long-term follow-up after participation in an integrated group treatment program for patients with intractable musculoskeletal pain].
METHODS
Long-term outcome in terms of well-being, depression and ability to cope was evaluated by means of a mailed questionnaire up to 5 years after participation in an integrated group treatment program for chronic musculoskeletal pain (mostly back pain). Sixty-one completed questionnaires were available for analysis, representing 69% of all 89 participants.


RESULTS
Comparison of responders and non-responders yielded no important differences. On the basis of their further need for treatment, their working ability and global rating of outcome, patients were divided into three groups: In 18 cases the situation had further improved, 33 were unchanged and 10 had worsened. Sociodemographic data and pain history did not differ among the three groups. Patients with a favorable outcome scored significantly lower than the rest of the patients on a symptom check list and showed the greatest decrease from pretreatment values (if available). They rated themselves significantly higher on the two-dimensional health locus of control scale and were aware of significantly more factors influencing their pain than were the unimproved (unchanged or worsened) patients. Cognitive-behavioral strategies had been continued long-term by 83.6% of the patients and were rated most helpful. Physical training and at least one relaxation technique were continued in 80.3% of the patients, with a slightly lower rating of helpfulness. Improved patients gave generally higher ratings for helpfulness and applied these strategies also to problems other than pain (e.g. anxiety).


CONCLUSIONS
The majority of patients maintained at least two of the self-help strategies over many years and seem to profit from their use. Positive long-term effects on well-being were visible in 30% of all participants, and these were clearly more orientated towards self-control than the unimproved subgroups.
Keel
P
P
Psychiatrische Universitätspoliklinik, Basel.
Schmid
A
A
Wirz
R
R