Pain threshold reflects psychological traits in patients with chronic pain: a cross-sectional study

Abstract

BackgroundChronic pain enhances sensory sensitivity and induces the biased development of psychological traits such as depression and pain catastrophizing, leading to the formation of heterogeneous conditions. Fluctuations in the sensory-related thresholds of non-injured sites (with normal peripheral tissue) in patients with chronic pain are thought to be related to central sensitization. The objectives of this study were to analyze the association between pain tolerance thresholds (PTTs) in non-injured sites and the psychological traits of patients with chronic pain and to evaluate the usefulness of PTT measures in assessments of pathological conditions related to chronic pain.MethodsThis study included 57 patients with chronic pain. The PTTs were measured in non-injured sites with quantitative sensory testing (QST) with electrical stimulation and then classified with cluster analysis. The Short-Form McGill Pain Questionnaire was used to subjectively assess pain in the injured sites. The Minnesota Multiphasic Personality Inventory (MMPI) was used to assess the patients’ psychological traits.ResultsBased on the cluster analysis of PTTs, the patients were classified into a High-Sensitivity group and an Others group consisting of the remaining patients. The results of the MMPI profiles showed that the High-Sensitivity group included significantly more patients with the Neurotic Triad pattern and no patients with the Conversion V pattern. The scores of the hypochondriasis and hysteria scales were significantly lower in the High-Sensitivity group than in the Others group.ConclusionsThis study indicated that patients with chronic pain can be classified according to PTTs in non-injured sites and suggests that patients with High-Sensitivity have characteristic psychological traits. Assessment of PTTs in non-injured sites would be useful for evaluating the psychological condition of patients with chronic pain.

Efficacy of virtual reality to reduce chronic low back pain: Proof-of-concept of a non-pharmacological approach on pain, quality of life, neuropsychological and functional outcome

“…In line with previous reports, our patients presented with abnormal levels of hypochondria, depression, hysteria and health concerns, as shown by the MMPI analyses [6–9]. The MMPI has been used to classify psychological traits of patients with chronic pain.…”

“…Indeed, many studies demonstrated depressive symptoms and deficits in attention, verbal memory and executive functions within this syndrome [5]. It should also be said that altered personality profiles such as hysteria, hypochondria, depression or anxiety have been often reported following clinical measurements of personality traits in people with this condition [6–9]. All these notions lead to the conclusion that chronic pain, which refers to a multimodal experience, may contribute to disability, anxiety, depression, sleep disturbances, poor quality of life (QoL), and elevated healthcare costs [10–12].…”

Prognostic factors for pain chronicity in low back pain: a systematic review

“…In a study of pain thresholds in patients with chronic pain, there was a correlation between lower pain threshold and depressive tendency and hypochondriac concerns. 75 …”

<p>Psychological Characteristics in Patients with Chronic Complex Regional Pain Syndrome: Comparisons with Patients with Major Depressive Disorder and Other Types of Chronic Pain</p>

“…17,28 The neurotic triad pattern is related to depressive tendencies, introversion, hypochondriacal anxiety, and catastrophizing often involved in pathological conditions associated with chronic pain; it has also been associated with low tolerance for and high sensitivity to pain. 43 However, few studies have investigated the specific personality traits of CRPS patients. A study of 17 patients with CRPS reported that their MMPI-2 profiles were similar to those of patients with conversion disorder.…”