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The assessment of pain experience in fibromyalgia syndrome and major depressive disorder
TEE ASSESSWENT OF PAIN EXPERIENCE IN FIBROMYAIGIA SYNDROHE AND MAJOR DEPRESSIVE DISORDER.
D. Berntzen, T. C. Stiles* and H. Sletvold*, Department of Psychiatry and Behavioral medicine, The University of Trondheim, Trondheim, Norway.
Poster 35 GREY Th-Fri Exhibit Hall
Abs No 575 l------
AIM OF INVESTIGATION: This study assessed pain experience and personality measures in fibromyalgia syndrome and major depressive disorder (MD) in 59 patients (36 fibromyalgia (31-71 years - mean 47.1) and 23 MD (23-68 years mean 39)). METHODS:The 36 fibromyalgia patients were classified according to the and the 23 patients with :najor criteria of Smyth (1983) and Yunus (1988), depressive disorder were diagnosed according to DSM-III criteria. Patients depression intensity were measured with Beck Depression Inventory (BDI), pain intensity was measured with Verbal Pain Scale (VPS) and Visual Analoge Scale (VAS). Patients pain tolerance were assessed using an addapted form of the Submaximum Effort Tourniquet Technique (SETT). Patients personality were assessed through clinical interview and classification according to DSM-III axis II and Pilowsky Illness Behavior Questionnaire. RESULTS AND CONCLUSION: The fibromyalgia patients were found to have lower pain tolerance and higher subjective pain experience (more pain) than MD patients on the SETT test. When classifying patients with a score of 25 or more on BDI wether they were diagnosed as having fibromyalgia or MD resulted in an increased difference in pain tolerance and pain experience. Without considering other factors patients with a high BDI score tolerated more pain and experienced less pain than paints who had a low BDI score. An evaluation of how different personality factors influence the patients pain level will be presented.
THE ASSESSMENTOF POSTOPEFIATIVEPAIN IN YOUNG CHILDREN. SalhrE.C and LT. Cohen, Dept. of Surgery, University of Massachusetts Medical Center, Worcester, MA, 01655, USA.
I Poster 36 GREY Th-Fri ( Exhibit Hall 1 Abs No
576
AlM OF INVFSTIGATION: This study attempts to develop a behavioral scale to assess postoperative pain in children aged 1-5 for clinical and research purposes. MFTHODS: Twenty-seven children between the ages of 12 and 64 months (Mean = 34 months), seen for repair of an inguinal hernia or hydrocele were the subjects of the study. Subjects were observed postoperatively for six S-minute intervals, commencing with their awakening from anesthesia, using the Pain Assessment Scale (PAS). The PAS consists of 15 pain behaviors divided among 3 Pain Behavior Categories: 1. Vocal Pain Expression; 2. Facial Pain Expression; and 3. Bodily Pain Expression. PAS scores were generated by adding up the number of individual pain behaviors occurring over the observation period and dividing by the number of observation intervals for each Pain Behavior Category. A Total PAS Score was also derived, and it is equal to the sum of the 3 Pain Category Scores. Two raters independently rated 10 of the children to assess interrater reliability. RESULTS: Findings revealed variability in PAS Scores both within subjects (across Pain Behavior Categories) and across subjects. While the sample size is too small to formally assess developmental differences in pain behavior, there was evidence of developmental trends, with l-2 year olds engaging in proportionately more bodily and less vocal expression of pain than the 3-5 years olds. The Mean Total PAS Score was 45 percent higher for the l-2 year olds than the 3-5 year olds which may be accounted for by the fact that only 6114 (43%) of the 1-2 year olds received intraoperative analgesia, whereas lo/13 (77%) of the 3-5 year olds received such medication. Interrater reliability (# Agreements/# Agreements and Disagreements) was 90% across all pain behavior ratings. CONCI USIQM: These preliminary results indicate that the PAS may prove to be a sensitive and reliable method for the assessment of postoperative pain in young children. Research plans are to increase the sample size in order to conduct formal statistical analyses of the reliability and validity of the PAS.
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D. Berntzen, T. C. Stiles* and H. Sletvold*, Department of Psychiatry and Behavioral medicine, The University of Trondheim, Trondheim, Norway.
Poster 35 GREY Th-Fri Exhibit Hall
Abs No 575 l------
AIM OF INVESTIGATION: This study assessed pain experience and personality measures in fibromyalgia syndrome and major depressive disorder (MD) in 59 patients (36 fibromyalgia (31-71 years - mean 47.1) and 23 MD (23-68 years mean 39)). METHODS:The 36 fibromyalgia patients were classified according to the and the 23 patients with :najor criteria of Smyth (1983) and Yunus (1988), depressive disorder were diagnosed according to DSM-III criteria. Patients depression intensity were measured with Beck Depression Inventory (BDI), pain intensity was measured with Verbal Pain Scale (VPS) and Visual Analoge Scale (VAS). Patients pain tolerance were assessed using an addapted form of the Submaximum Effort Tourniquet Technique (SETT). Patients personality were assessed through clinical interview and classification according to DSM-III axis II and Pilowsky Illness Behavior Questionnaire. RESULTS AND CONCLUSION: The fibromyalgia patients were found to have lower pain tolerance and higher subjective pain experience (more pain) than MD patients on the SETT test. When classifying patients with a score of 25 or more on BDI wether they were diagnosed as having fibromyalgia or MD resulted in an increased difference in pain tolerance and pain experience. Without considering other factors patients with a high BDI score tolerated more pain and experienced less pain than paints who had a low BDI score. An evaluation of how different personality factors influence the patients pain level will be presented.
THE ASSESSMENTOF POSTOPEFIATIVEPAIN IN YOUNG CHILDREN. SalhrE.C and LT. Cohen, Dept. of Surgery, University of Massachusetts Medical Center, Worcester, MA, 01655, USA.
I Poster 36 GREY Th-Fri ( Exhibit Hall 1 Abs No
576
AlM OF INVFSTIGATION: This study attempts to develop a behavioral scale to assess postoperative pain in children aged 1-5 for clinical and research purposes. MFTHODS: Twenty-seven children between the ages of 12 and 64 months (Mean = 34 months), seen for repair of an inguinal hernia or hydrocele were the subjects of the study. Subjects were observed postoperatively for six S-minute intervals, commencing with their awakening from anesthesia, using the Pain Assessment Scale (PAS). The PAS consists of 15 pain behaviors divided among 3 Pain Behavior Categories: 1. Vocal Pain Expression; 2. Facial Pain Expression; and 3. Bodily Pain Expression. PAS scores were generated by adding up the number of individual pain behaviors occurring over the observation period and dividing by the number of observation intervals for each Pain Behavior Category. A Total PAS Score was also derived, and it is equal to the sum of the 3 Pain Category Scores. Two raters independently rated 10 of the children to assess interrater reliability. RESULTS: Findings revealed variability in PAS Scores both within subjects (across Pain Behavior Categories) and across subjects. While the sample size is too small to formally assess developmental differences in pain behavior, there was evidence of developmental trends, with l-2 year olds engaging in proportionately more bodily and less vocal expression of pain than the 3-5 years olds. The Mean Total PAS Score was 45 percent higher for the l-2 year olds than the 3-5 year olds which may be accounted for by the fact that only 6114 (43%) of the 1-2 year olds received intraoperative analgesia, whereas lo/13 (77%) of the 3-5 year olds received such medication. Interrater reliability (# Agreements/# Agreements and Disagreements) was 90% across all pain behavior ratings. CONCI USIQM: These preliminary results indicate that the PAS may prove to be a sensitive and reliable method for the assessment of postoperative pain in young children. Research plans are to increase the sample size in order to conduct formal statistical analyses of the reliability and validity of the PAS.
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