Ist eine frühe Differenzierung psychogener von somatogenen Lumbago-Ischialgie-Syndrom(LIS)-Patienten mittels Anamnese möglich? Ergebnisse einer Screeningstudie [Is early differentiation between psychogenic and somatogenic lumbago-ischialgia syndrome patients possible by anamnesis? Results of a screening study]

Details

Serval ID
serval:BIB_BC291F70FBE5
Type
Article: article from journal or magazin.
Collection
Publications
Title
Ist eine frühe Differenzierung psychogener von somatogenen Lumbago-Ischialgie-Syndrom(LIS)-Patienten mittels Anamnese möglich? Ergebnisse einer Screeningstudie [Is early differentiation between psychogenic and somatogenic lumbago-ischialgia syndrome patients possible by anamnesis? Results of a screening study]
Journal
Psychotherapie, Psychosomatik, medizinische Psychologie
Author(s)
von Plessen K., Schultz-Venrath U.
ISSN
0937-2032 (Print)
ISSN-L
0937-2032
Publication state
Published
Issued date
11/1998
Peer-reviewed
Oui
Volume
48
Number
11
Pages
451-456
Language
german
Notes
Publication types: English Abstract ; Journal Article
Publication Status: ppublish
Abstract
Low back pain (LBP) is one of the most frequent causes for early retirement, hospital treatment and loss of days of work (Raspe u. Kohlmann 1993). Further differentiation and earlier diagnosis of psychogenic LBP could significantly reduce health costs. We interviewed 101 patients with LBP in the departments of Neurology and Neurosurgery (Gemeinschaftskrankenhaus Herdecke, University Witten/Herdecke) with the "structured biographical interview for patients with pain" (Egle 1992). This questionnaire has been used successfully differentiating between patients with organic and psychogenic chronic pain syndromes. It is a semi-standardised instrument based on observations, mainly made by Engel (1959), showing that many patients suffering from chronic benign pain syndromes had experienced psychic traumatisation during childhood. We compared a group of patients with clear neurological deficits and organic pain origin (n = 47) with a group of patients with psychogenic LBP (n = 25). Parameters were among others their biographical family constellations, their past medical history (also looking for symptoms of dissociation [conversion]), their present life and their coping with pain. In comparison with other studies examining similar aspects in patients who had pain in other parts of the body (Egle et al. 1991), our groups showed less discriminating results concerning biographical aspects. We found that also 40% of patients with organic pain origin hat traumatic constellations in their childhood. The following factors differentiated best between the both groups and characterised the psychogenic group: Intensity of pain was judged to be significantly higher with the "visual analog scale": age of the patient less than 40 years; distraction does not alter the pain; preceding experiences with physicians had often been negative; pain leads to impairment of familiar contacts; conflicts with parents during childhood could not adequately discussed with them at that time. These seven aspects can very well be part of a clinical history taking in a general medical setting, so that patients with LBP can be differentiated more effectively.
Keywords
Adult, Diagnosis, Differential, Female, Humans, Low Back Pain/psychology, Male, Medical History Taking, Middle Aged, Personality Assessment/statistics & numerical data, Psychometrics, Psychophysiologic Disorders/diagnosis, Psychophysiologic Disorders/psychology, Sick Role, Somatoform Disorders/diagnosis, Somatoform Disorders/psychology, Spinal Diseases/diagnosis, Spinal Diseases/psychology
Pubmed
Web of science
Create date
21/02/2019 10:22
Last modification date
20/08/2019 15:30
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