title: [Pelvi-perineal chronic pain, urgent demands of care and decision-making].
abstract: OBJECTIVE
  Some patients suffering from pelvi-perineal chronic pain express urgent, even vital, demands of care. The objective was to compare the profile and the psychological functioning of the patients, who have shown an imperious demand of care, in that of the patients who do not have an imperious demand of care.
  
  
  METHODS
  From the medical consultations for chronic pelviperineal pain, we realized a comparative study including 26 patients (experimental group) expressing an urgent demand of care (i.e., patients who, during the last 3months, called an emergency service concerning the pains for which they consult in the service) and 28 patients (control group) without an urgent demand of care (i.e., patient who, during the last 3months, did not call an emergency service concerning the pains for which they consult in the service). All the patients were tested through a cognitive task of decision-making (Iowa Gambling Task) and through explicit measures of pain and its main psychological associated factors (anxiety, depression, impulsivity an catastrophism).
  
  
  RESULTS
  In the first place, the patients from the experimental group possess decision-making abilities equivalent to the patients of the control group; however, both groups of patients show, in the beginning of the test, a deficit in the decision-making (F(4.208)=3.4116; P=.009). Secondly, the measures to questionnaires reveal that the patients of the control group have less severe scores in the scales of depression (t(52)=-2.068; P<04), catastrophism (amplification : t(52)=-3.069; P<0035; powerlessness: t(52)=-2.866, P<.006) and impulsivity (positive urgency: t(52)=-2.246, P<029; lack of premeditation: t(52)=-2.175, P<035) than the patients of the experimental group.
  
  
  CONCLUSIONS
  The use of explicit measures (questionnaire) and implicit measures (experimental task) allowed to objectify more precisely the differences between the chronic pain patients in urgent demand of care and the other chronic pain patients. This psychological specificity obliges us to approach differently the caring of these patients in particular by proposing adapted cognitivo-behavioral techniques.
  
  
  METHODS
  3.
authors.affiliation: Centre fédératif douleur soins de support éthique clinique, Hôtel-Dieu, CHU de Nantes, 1, place Alexis-Ricordeau, 9(e) étage, aile Nord, 44093 Nantes cedex 1, France; UPRES EA 4638, laboratoire de psychologie des Pays-de-la-Loire, université de Nantes, 44312 Nantes cedex 3, France. Electronic address: virginie.quistrebertdavanne@chu-nantes.fr.
authors.forename: V
authors.initials: V
authors.lastname: Quistrebert-Davanne
authors.affiliation: UPRES EA 4638, laboratoire de psychologie des Pays-de-la-Loire, université de Nantes, 44312 Nantes cedex 3, France.
authors.forename: A-H
authors.initials: AH
authors.lastname: Boudoukha
authors.affiliation: Centre fédératif douleur soins de support éthique clinique, Hôtel-Dieu, CHU de Nantes, 1, place Alexis-Ricordeau, 9(e) étage, aile Nord, 44093 Nantes cedex 1, France; Centre fédératif de pelvipérinéologie et clinique urologique, CHU de Nantes, 44093 Nantes cedex 1, France.
authors.forename: A
authors.initials: A
authors.lastname: Levesque
authors.affiliation: UPRES EA 4638, laboratoire de psychologie des Pays-de-la-Loire, université de Nantes, 44312 Nantes cedex 3, France.
authors.forename: P
authors.initials: P
authors.lastname: Guérin
authors.affiliation: Centre fédératif douleur soins de support éthique clinique, Hôtel-Dieu, CHU de Nantes, 1, place Alexis-Ricordeau, 9(e) étage, aile Nord, 44093 Nantes cedex 1, France.
authors.forename: J
authors.initials: J
authors.lastname: Nizard
authors.affiliation: Centre fédératif de pelvipérinéologie et clinique urologique, CHU de Nantes, 44093 Nantes cedex 1, France.
authors.forename: J-J
authors.initials: JJ
authors.lastname: Labat
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D059350:Chronic Pain / Q000523:psychology* / Q000628:therapy*; D003657:Decision Making; D004632:Emergency Medical Services; D006801:Humans; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D017699:Pelvic Pain / Q000523:psychology* / Q000628:therapy*; D010502:Perineum; D055815:Young Adult
keywords: Catastrophism; Decision-making; Douleur chronique pelvipérinéale; Impulsivity; Impulsivité; Pelviperineal chronic pain; Pensées catastrophiques; Prise de décision