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BOSTON – A test measuring somatization can predict which patients with chronic headaches will benefit from outpatient care and which ones won't–and will instead require intensive inpatient therapy, according to a new study.
The next step is to explore whether it is possible to calculate an exact cutoff score that would signal which patients should skip outpatient care and go directly to inpatient therapy, Dana Brendza, Psy.D., and associates suggested in a poster presented at the annual meeting of the American Pain Society.
Dr. Brendza and associates at the Cleveland Clinic studied the medical records of 213 patients enrolled in the multidisciplinary treatment program of an outpatient neurology headache clinic. Neurologists had referred the patients, predominantly white women aged 17–85, for psychological evaluation. All patients filled out the 344-item Personality Assessment Inventory (PAI), a tool used for assessing personality and psychopathology.
As a group, the patients' scores on the Somatic Complaints subscale were significantly elevated (two standard deviations above normal). Individually, the scores of more than half (51.6%) were considered clinically elevated.
The researchers took a closer look at the patients who failed outpatient treatment and required referral to the inpatient pain program. Their scores on the Somatic Complaints scale were significantly higher than the scores of patients who did not fail outpatient therapy.
Elevated scores on another measure (the Physical Symptoms subscale of the Depression scale) showed they were also more likely to be tuned in to physical symptoms.
The findings are consistent with a common belief among chronic headache patients that their malady is rooted in physical causes, not primarily psychological ones, coauthor Kathleen Ashton, Ph.D., explained in an interview.
The results also reinforce previous research suggesting that disability is often more intractable in headache patients who suffer from anxiety and mood disorders.
“The PAI Somatic Complaints scale may be useful in identifying patients who are most likely to be referred to an intensive, inpatient chronic pain treatment program after failure to improve in traditional outpatient treatment for their headache disorders,” the researchers concluded.
In patients with high scores, “there is probably an underlying emotional component to this pain that's not being addressed in outpatient therapy,” Dr. Ashton suggested. In addition, headache patients scoring lower on the Somatic Complaints scale are probably more amenable to psychological therapy, she said.
BOSTON – A test measuring somatization can predict which patients with chronic headaches will benefit from outpatient care and which ones won't–and will instead require intensive inpatient therapy, according to a new study.
The next step is to explore whether it is possible to calculate an exact cutoff score that would signal which patients should skip outpatient care and go directly to inpatient therapy, Dana Brendza, Psy.D., and associates suggested in a poster presented at the annual meeting of the American Pain Society.
Dr. Brendza and associates at the Cleveland Clinic studied the medical records of 213 patients enrolled in the multidisciplinary treatment program of an outpatient neurology headache clinic. Neurologists had referred the patients, predominantly white women aged 17–85, for psychological evaluation. All patients filled out the 344-item Personality Assessment Inventory (PAI), a tool used for assessing personality and psychopathology.
As a group, the patients' scores on the Somatic Complaints subscale were significantly elevated (two standard deviations above normal). Individually, the scores of more than half (51.6%) were considered clinically elevated.
The researchers took a closer look at the patients who failed outpatient treatment and required referral to the inpatient pain program. Their scores on the Somatic Complaints scale were significantly higher than the scores of patients who did not fail outpatient therapy.
Elevated scores on another measure (the Physical Symptoms subscale of the Depression scale) showed they were also more likely to be tuned in to physical symptoms.
The findings are consistent with a common belief among chronic headache patients that their malady is rooted in physical causes, not primarily psychological ones, coauthor Kathleen Ashton, Ph.D., explained in an interview.
The results also reinforce previous research suggesting that disability is often more intractable in headache patients who suffer from anxiety and mood disorders.
“The PAI Somatic Complaints scale may be useful in identifying patients who are most likely to be referred to an intensive, inpatient chronic pain treatment program after failure to improve in traditional outpatient treatment for their headache disorders,” the researchers concluded.
In patients with high scores, “there is probably an underlying emotional component to this pain that's not being addressed in outpatient therapy,” Dr. Ashton suggested. In addition, headache patients scoring lower on the Somatic Complaints scale are probably more amenable to psychological therapy, she said.
BOSTON – A test measuring somatization can predict which patients with chronic headaches will benefit from outpatient care and which ones won't–and will instead require intensive inpatient therapy, according to a new study.
The next step is to explore whether it is possible to calculate an exact cutoff score that would signal which patients should skip outpatient care and go directly to inpatient therapy, Dana Brendza, Psy.D., and associates suggested in a poster presented at the annual meeting of the American Pain Society.
Dr. Brendza and associates at the Cleveland Clinic studied the medical records of 213 patients enrolled in the multidisciplinary treatment program of an outpatient neurology headache clinic. Neurologists had referred the patients, predominantly white women aged 17–85, for psychological evaluation. All patients filled out the 344-item Personality Assessment Inventory (PAI), a tool used for assessing personality and psychopathology.
As a group, the patients' scores on the Somatic Complaints subscale were significantly elevated (two standard deviations above normal). Individually, the scores of more than half (51.6%) were considered clinically elevated.
The researchers took a closer look at the patients who failed outpatient treatment and required referral to the inpatient pain program. Their scores on the Somatic Complaints scale were significantly higher than the scores of patients who did not fail outpatient therapy.
Elevated scores on another measure (the Physical Symptoms subscale of the Depression scale) showed they were also more likely to be tuned in to physical symptoms.
The findings are consistent with a common belief among chronic headache patients that their malady is rooted in physical causes, not primarily psychological ones, coauthor Kathleen Ashton, Ph.D., explained in an interview.
The results also reinforce previous research suggesting that disability is often more intractable in headache patients who suffer from anxiety and mood disorders.
“The PAI Somatic Complaints scale may be useful in identifying patients who are most likely to be referred to an intensive, inpatient chronic pain treatment program after failure to improve in traditional outpatient treatment for their headache disorders,” the researchers concluded.
In patients with high scores, “there is probably an underlying emotional component to this pain that's not being addressed in outpatient therapy,” Dr. Ashton suggested. In addition, headache patients scoring lower on the Somatic Complaints scale are probably more amenable to psychological therapy, she said.