Psychological factors can cause false pain classification on painDETECT

Brigitte Tampin, Jane Royle, Chrianna Bharat, Michelle Trevenen, Lisa Olsen, Roger Goucke

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background and aims: The painDETECT questionnaire (PD-Q) has been widely used as a screening tool for the identification of neuropathic pain (NeP) as well as a tool for the characterization of patients' pain profile. In contrast to other NeP screening tools, the PD-Q is the only screening tool with weighted sensory descriptors. It is possible that responses to the PD-Q sensory descriptors are influenced by psychological factors, such as catastrophizing or anxiety, which potentially might contribute to an overall higher score of PD-Q and a false positive identification of NeP. This study aimed to explore (i) the relationship between psychological factors (catastrophizing, anxiety, depression and stress) and the total PD-Q score and (ii) if psychological factors are associated with false positive identifications of NeP on the PD-Q compared to clinically diagnosed NeP.

Methods: The study was a retrospective review of 1,101 patients attending an outpatient pain centre. Patients were asked to complete the PD-Q, the Pain Catastrophizing Scale (PCS), the Depression, Anxiety and Stress Scale (DASS) and the Brief Pain Inventory (BPI). For patients who were identified by PD-Q as having NeP, their medical records were reviewed to establish if they had a clinical diagnosis of NeP.

Results: Accounting for missing data, complete datasets of 652 patients (mean age 51 (SD14) years, range 18-88; 57% females) were available for analysis. Based on PD-Q scoring, NeP was likely present in 285 (44%) patients. Depression, anxiety, stress, catastrophizing, BPI pain and BPI interference were all significantly related to each other (p <0.0001) and patients displaying these traits were significantly more likely to have a positive PD-Q score (p <0.0001). For patients classified by PD-Q as having NeP, only 50% of patients had a clinical diagnosis of NeP. Anxiety was significantly associated with a false positive classification of NeP on PD-Q (p = 0.0036).

Conclusions: Our retrospective study showed that psychological factors including catastrophizing, depression, anxiety, and stress were all influential in producing a higher score on the PD-Q. We observed a high rate of false positive NeP classification which was associated with the presence of anxiety.

Original languageEnglish
Pages (from-to)501-512
Number of pages12
JournalScandinavian Journal of Pain
Volume19
Issue number3
DOIs
Publication statusPublished - Jul 2019

Cite this

Tampin, Brigitte ; Royle, Jane ; Bharat, Chrianna ; Trevenen, Michelle ; Olsen, Lisa ; Goucke, Roger. / Psychological factors can cause false pain classification on painDETECT. In: Scandinavian Journal of Pain. 2019 ; Vol. 19, No. 3. pp. 501-512.
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title = "Psychological factors can cause false pain classification on painDETECT",
abstract = "Background and aims: The painDETECT questionnaire (PD-Q) has been widely used as a screening tool for the identification of neuropathic pain (NeP) as well as a tool for the characterization of patients' pain profile. In contrast to other NeP screening tools, the PD-Q is the only screening tool with weighted sensory descriptors. It is possible that responses to the PD-Q sensory descriptors are influenced by psychological factors, such as catastrophizing or anxiety, which potentially might contribute to an overall higher score of PD-Q and a false positive identification of NeP. This study aimed to explore (i) the relationship between psychological factors (catastrophizing, anxiety, depression and stress) and the total PD-Q score and (ii) if psychological factors are associated with false positive identifications of NeP on the PD-Q compared to clinically diagnosed NeP.Methods: The study was a retrospective review of 1,101 patients attending an outpatient pain centre. Patients were asked to complete the PD-Q, the Pain Catastrophizing Scale (PCS), the Depression, Anxiety and Stress Scale (DASS) and the Brief Pain Inventory (BPI). For patients who were identified by PD-Q as having NeP, their medical records were reviewed to establish if they had a clinical diagnosis of NeP.Results: Accounting for missing data, complete datasets of 652 patients (mean age 51 (SD14) years, range 18-88; 57{\%} females) were available for analysis. Based on PD-Q scoring, NeP was likely present in 285 (44{\%}) patients. Depression, anxiety, stress, catastrophizing, BPI pain and BPI interference were all significantly related to each other (p <0.0001) and patients displaying these traits were significantly more likely to have a positive PD-Q score (p <0.0001). For patients classified by PD-Q as having NeP, only 50{\%} of patients had a clinical diagnosis of NeP. Anxiety was significantly associated with a false positive classification of NeP on PD-Q (p = 0.0036).Conclusions: Our retrospective study showed that psychological factors including catastrophizing, depression, anxiety, and stress were all influential in producing a higher score on the PD-Q. We observed a high rate of false positive NeP classification which was associated with the presence of anxiety.",
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Psychological factors can cause false pain classification on painDETECT. / Tampin, Brigitte; Royle, Jane; Bharat, Chrianna; Trevenen, Michelle; Olsen, Lisa; Goucke, Roger.

In: Scandinavian Journal of Pain, Vol. 19, No. 3, 07.2019, p. 501-512.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Psychological factors can cause false pain classification on painDETECT

AU - Tampin, Brigitte

AU - Royle, Jane

AU - Bharat, Chrianna

AU - Trevenen, Michelle

AU - Olsen, Lisa

AU - Goucke, Roger

PY - 2019/7

Y1 - 2019/7

N2 - Background and aims: The painDETECT questionnaire (PD-Q) has been widely used as a screening tool for the identification of neuropathic pain (NeP) as well as a tool for the characterization of patients' pain profile. In contrast to other NeP screening tools, the PD-Q is the only screening tool with weighted sensory descriptors. It is possible that responses to the PD-Q sensory descriptors are influenced by psychological factors, such as catastrophizing or anxiety, which potentially might contribute to an overall higher score of PD-Q and a false positive identification of NeP. This study aimed to explore (i) the relationship between psychological factors (catastrophizing, anxiety, depression and stress) and the total PD-Q score and (ii) if psychological factors are associated with false positive identifications of NeP on the PD-Q compared to clinically diagnosed NeP.Methods: The study was a retrospective review of 1,101 patients attending an outpatient pain centre. Patients were asked to complete the PD-Q, the Pain Catastrophizing Scale (PCS), the Depression, Anxiety and Stress Scale (DASS) and the Brief Pain Inventory (BPI). For patients who were identified by PD-Q as having NeP, their medical records were reviewed to establish if they had a clinical diagnosis of NeP.Results: Accounting for missing data, complete datasets of 652 patients (mean age 51 (SD14) years, range 18-88; 57% females) were available for analysis. Based on PD-Q scoring, NeP was likely present in 285 (44%) patients. Depression, anxiety, stress, catastrophizing, BPI pain and BPI interference were all significantly related to each other (p <0.0001) and patients displaying these traits were significantly more likely to have a positive PD-Q score (p <0.0001). For patients classified by PD-Q as having NeP, only 50% of patients had a clinical diagnosis of NeP. Anxiety was significantly associated with a false positive classification of NeP on PD-Q (p = 0.0036).Conclusions: Our retrospective study showed that psychological factors including catastrophizing, depression, anxiety, and stress were all influential in producing a higher score on the PD-Q. We observed a high rate of false positive NeP classification which was associated with the presence of anxiety.

AB - Background and aims: The painDETECT questionnaire (PD-Q) has been widely used as a screening tool for the identification of neuropathic pain (NeP) as well as a tool for the characterization of patients' pain profile. In contrast to other NeP screening tools, the PD-Q is the only screening tool with weighted sensory descriptors. It is possible that responses to the PD-Q sensory descriptors are influenced by psychological factors, such as catastrophizing or anxiety, which potentially might contribute to an overall higher score of PD-Q and a false positive identification of NeP. This study aimed to explore (i) the relationship between psychological factors (catastrophizing, anxiety, depression and stress) and the total PD-Q score and (ii) if psychological factors are associated with false positive identifications of NeP on the PD-Q compared to clinically diagnosed NeP.Methods: The study was a retrospective review of 1,101 patients attending an outpatient pain centre. Patients were asked to complete the PD-Q, the Pain Catastrophizing Scale (PCS), the Depression, Anxiety and Stress Scale (DASS) and the Brief Pain Inventory (BPI). For patients who were identified by PD-Q as having NeP, their medical records were reviewed to establish if they had a clinical diagnosis of NeP.Results: Accounting for missing data, complete datasets of 652 patients (mean age 51 (SD14) years, range 18-88; 57% females) were available for analysis. Based on PD-Q scoring, NeP was likely present in 285 (44%) patients. Depression, anxiety, stress, catastrophizing, BPI pain and BPI interference were all significantly related to each other (p <0.0001) and patients displaying these traits were significantly more likely to have a positive PD-Q score (p <0.0001). For patients classified by PD-Q as having NeP, only 50% of patients had a clinical diagnosis of NeP. Anxiety was significantly associated with a false positive classification of NeP on PD-Q (p = 0.0036).Conclusions: Our retrospective study showed that psychological factors including catastrophizing, depression, anxiety, and stress were all influential in producing a higher score on the PD-Q. We observed a high rate of false positive NeP classification which was associated with the presence of anxiety.

KW - neuropathic pain

KW - screening tool

KW - psychological factors

KW - LOW-BACK-PAIN

KW - TAPENTADOL PROLONGED RELEASE

KW - PERIPHERAL NEUROPATHIC PAIN

KW - CULTURAL-ADAPTATION

KW - GRADING SYSTEM

KW - DOUBLE-BLIND

KW - LEEDS ASSESSMENT

KW - SCREENING TOOL

KW - S-LANSS

KW - VALIDATION

U2 - 10.1515/sjpain-2018-0355

DO - 10.1515/sjpain-2018-0355

M3 - Article

VL - 19

SP - 501

EP - 512

JO - Scandinavian Journal of Pain

JF - Scandinavian Journal of Pain

SN - 1877-8860

IS - 3

ER -