title: Changes in perceived pain severity following interdisciplinary treatment for chronic pain.
abstract: BACKGROUND
  There is good support for the effectiveness of interdisciplinary chronic pain management programs in improving functional outcomes; however, relatively little is known about patients who report deterioration following participation in such programs.
  
  
  OBJECTIVE
  The present retrospective study investigated patients' reports of increased pain severity during participation in a cognitive-behaviourally oriented, outpatient treatment for chronic pain.
  
  
  METHODS
  Participants (n=280) completed a four-week, group-based, interdisciplinary chronic pain self-management program at a rehabilitation hospital. They completed pre- and post-treatment questionnaires, which included global change ratings of pain severity and clinically-relevant measures, including pain intensity ratings, functional limitations, pain catastrophizing and self-efficacy.
  
  
  RESULTS
  Statistically significant pre-post improvements were observed for all study variables. Almost all patients reported global improvement overall. Nevertheless, a subset of patients (n=99) reported increased pain severity on global ratings. These individuals were characterized by lower self-efficacy at baseline.
  
  
  CONCLUSIONS
  Participants endorsed significant pre- and post-treatment improvements in all domains. Nevertheless, some participants reported deterioration. The findings shed light on variables associated with negative treatment outcomes and have practical applications for interdisciplinary chronic pain management programs.
authors.affiliation: The Ottawa Hospital Rehabilitation Centre, Ottawa, Ontario, Canada. jkowal@ottawahospital.on.ca
authors.forename: John
authors.initials: J
authors.lastname: Kowal
authors.forename: Keith G
authors.initials: KG
authors.lastname: Wilson
authors.forename: Celia M
authors.initials: CM
authors.lastname: Geck
authors.forename: Peter R
authors.initials: PR
authors.lastname: Henderson
authors.forename: Joyce L
authors.initials: JL
authors.lastname: D'Eon
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D058443:Catastrophization / Q000209:etiology; D059350:Chronic Pain / Q000503:physiopathology / Q000523:psychology / Q000628:therapy; D003072:Cognition Disorders / Q000209:etiology; D015928:Cognitive Behavioral Therapy / Q000379:methods; D003863:Depression / Q000209:etiology; D005239:Fear; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement; D058748:Pain Perception / Q000502:physiology*; D012189:Retrospective Studies; D055815:Young Adult