title: Pain catastrophizing predicts poor response to topical analgesics in patients with neuropathic pain.
abstract: BACKGROUND
  Previous research suggests that high levels of pain catastrophizing might predict poorer response to pharmacological interventions for neuropathic pain.
  
  
  OBJECTIVE
  The present study sought to examine the clinical relevance of the relation between catastrophizing and analgesic response in individuals with neuropathic pain. Clinically meaningful reductions were defined in terms of the magnitude of reductions in pain through the course of treatment, and in terms of the number of patients whose end-of-treatment pain ratings were below 4⁄10.
  
  
  METHODS
  Patients (n=82) with neuropathic pain conditions completed a measure of pain catastrophizing at the beginning of a three-week trial examining the efficacy of topical analgesics for neuropathic pain.
  
  
  RESULTS
  Consistent with previous research, high scores on the measure of pain catastrophizing prospectively predicted poorer response to treatment. Fewer catastrophizers than noncatastrophizers showed moderate (≥ 2 points) or substantial reductions in pain ratings through the course of treatment. Fewer catastrophizers than noncatastrophizers achieved end-of-treatment pain ratings below 4⁄10.
  
  
  CONCLUSIONS
  The results of the present study suggest that the development of brief interventions specifically targeting catastrophic thinking might be useful for enhancing the effects of pharmacological interventions for neuropathic pain. Furthermore, failure to account for the level of catastrophizing might contribute to null findings in clinical trials of analgesic medication.
authors.affiliation: Department of Psychology, McGill University, Montreal, Quebec.
authors.forename: Tsipora
authors.initials: T
authors.lastname: Mankovsky
authors.forename: Mary
authors.initials: M
authors.lastname: Lynch
authors.forename: Aj
authors.initials: A
authors.lastname: Clark
authors.forename: Jana
authors.initials: J
authors.lastname: Sawynok
authors.forename: Michael Jl
authors.initials: MJ
authors.lastname: Sullivan
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000700:Analgesics / Q000008:administration & dosage*; D058443:Catastrophization / Q000188:drug therapy*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009437:Neuralgia / Q000188:drug therapy* / Q000523:psychology*; D010147:Pain Measurement; D011569:Psychiatric Status Rating Scales; D055815:Young Adult
chemical_list: D000700:Analgesics