Jaap Wijnen, Marciano Wilhelmina Henricus Geijselaers, Marc Lucas Pont, Geert Van't Hullenaar, Jessica Van Oosterwijck, Jeroen de Jong
{"title":"An Interdisciplinary Multimodal Integrative Healthcare Program for Chronic Spinal Pain and Comorbid Mental Disorders.","authors":"Jaap Wijnen, Marciano Wilhelmina Henricus Geijselaers, Marc Lucas Pont, Geert Van't Hullenaar, Jessica Van Oosterwijck, Jeroen de Jong","doi":"10.1097/PSY.0000000000001316","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Previous studies evaluating interdisciplinary multimodal interventions for chronic spinal pain often excluded patients with comorbid mental disorders. This study aims to assess the effectiveness of an outpatient secondary care interdisciplinary multimodal integrative healthcare program for individuals experiencing co-occurring chronic spinal pain and mental disorders.</p><p><strong>Methods: </strong>Participants were 944 patients with chronic spinal pain and comorbid mental disorders. Primary outcomes were health-related quality of life, assessed using the Research and Development-36 (RAND-36), and pain-related disability, assessed using the Quebec Back Pain Disability Scale (QBPDS). Secondary outcomes included pain intensity, pain catastrophizing, kinesiophobia, fatigue, lumbar mobility, and isometric strength. Data were collected during the healthcare program at four time points: pretreatment (T0), midway through 20-week treatment (T1), end of 20-week treatment (T2), and at completion of 12-month relapse prevention program (T3). Multilevel regression analyses were conducted to examine the effects of the healthcare program on primary outcomes over time.</p><p><strong>Results: </strong>The 20-week treatment period yielded significant improvements in both mental ( B = 0.44, t (943) = 19.42, p < .001) and physical component summary scores ( B = 0.45, t (943) = 18.24, p < .001) of the RAND-36, as well as in QBPDS total score ( B = -0.77, t (943) = -26.16 p < .001). Pretreatment scores indicated the presence of problematic fatigue, kinesiophobia, and clinical levels of pain catastrophizing, all of which resolved by the end of the 12-month relapse prevention program.</p><p><strong>Conclusions: </strong>An interdisciplinary multimodal integrative healthcare program seems effective for patients with chronic spinal pain and comorbid mental disorders.</p>","PeriodicalId":20918,"journal":{"name":"Psychosomatic Medicine","volume":null,"pages":null},"PeriodicalIF":2.9000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Psychosomatic Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/PSY.0000000000001316","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/5/1 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"PSYCHIATRY","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: Previous studies evaluating interdisciplinary multimodal interventions for chronic spinal pain often excluded patients with comorbid mental disorders. This study aims to assess the effectiveness of an outpatient secondary care interdisciplinary multimodal integrative healthcare program for individuals experiencing co-occurring chronic spinal pain and mental disorders.
Methods: Participants were 944 patients with chronic spinal pain and comorbid mental disorders. Primary outcomes were health-related quality of life, assessed using the Research and Development-36 (RAND-36), and pain-related disability, assessed using the Quebec Back Pain Disability Scale (QBPDS). Secondary outcomes included pain intensity, pain catastrophizing, kinesiophobia, fatigue, lumbar mobility, and isometric strength. Data were collected during the healthcare program at four time points: pretreatment (T0), midway through 20-week treatment (T1), end of 20-week treatment (T2), and at completion of 12-month relapse prevention program (T3). Multilevel regression analyses were conducted to examine the effects of the healthcare program on primary outcomes over time.
Results: The 20-week treatment period yielded significant improvements in both mental ( B = 0.44, t (943) = 19.42, p < .001) and physical component summary scores ( B = 0.45, t (943) = 18.24, p < .001) of the RAND-36, as well as in QBPDS total score ( B = -0.77, t (943) = -26.16 p < .001). Pretreatment scores indicated the presence of problematic fatigue, kinesiophobia, and clinical levels of pain catastrophizing, all of which resolved by the end of the 12-month relapse prevention program.
Conclusions: An interdisciplinary multimodal integrative healthcare program seems effective for patients with chronic spinal pain and comorbid mental disorders.
期刊介绍:
Psychosomatic Medicine is the official peer-reviewed journal of the American Psychosomatic Society. The journal publishes experimental, clinical, and epidemiological studies on the role of psychological and social factors in the biological and behavioral processes relevant to health and disease. Psychosomatic Medicine is an interdisciplinary peer-reviewed journal devoted to high-quality science on biobehavioral mechanisms, brain-behavior interactions relevant to physical and mental disorders, as well as interventions in clinical and public health settings.
Psychosomatic Medicine was founded in 1939 and publishes interdisciplinary research articles relevant to medicine, psychiatry, psychology, and other health-related disciplines. The print journal is published nine times a year; most articles are published online ahead of print. Supplementary issues may contain reports of conferences at which original research was presented in areas relevant to the psychosomatic and behavioral medicine.