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Tijdschrift voor Psychiatrie 47 (2005) 2, 63 - 73

New research

Can a pain-control course help patients to fixate less on physical pain and become more aware of their psychological and emotional problems?

C.E. Flik, W.A. van der Kloot, H. Koers

background   In clinical practice it is generally recognised that chronic pain is very difficult to treat.

aim To determine whether a pain-control course can improve the quality of life of patients with chronic pain and reduce their use of health services.

method All patients assigned to the pain-control course at a psychiatric outpatients clinic from February 1998 to October 2002 received questionnaires prior to intake, after participation and six months later. The questionnaires included the McGill Pain Questionnaire, the Multidimensional Pain Inventory, and the Symptom Checklist-90. The results were analysed from two angles: the pre-measurements of participants were compared with the post-measurements of participants and some data of the participants were compared with comparable data collected from a control group of patients on the waiting list.

results The comparison of the pre- and post-measurements of the course group reveal a reduction in pain intensity and in the use of morphine-like substances, but there is an increase in psychological problems and in the use of antidepressants. This result points to a shift from somatic pain to the acknowledgement of psychological problems. The outcome of the comparison between the course group and the control group is less clear.

conclusion For patients with chronic pain the pain-control course seems to be a first step on a road leading from fixation on physical sensations to greater awareness and recognition of emotional problems.


keywords chronic pain, health services, pain-control course, use