Group dynamics and therapy outcome of multimodal pain therapies: A prospective observational trial.

IF 3.5 2区 医学 Q1 ANESTHESIOLOGY
Lorenz Leopold Mihatsch, Benjamin Luchting, Nannette Baumann, Isabel Kiesewetter, Hans Peter Richter
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Abstract

Background: For the treatment of chronic pain, interdisciplinary treatment programs are recommended. Despite continuous adaptation and optimization of this cost- and time-intensive and comprehensive form of therapy, it is not successful in some patients. As personality disorders have an important influence on social interaction and behaviour, the aim of our study was to identify the possible impact of patients with personality disorders on group dynamics and to analyse the influence of group dynamics on individual therapy outcomes.

Methods: We conducted a prospective observational study in patients with chronic pain (N = 104) who participated in a 5-week interdisciplinary treatment program. The main outcome parameters were psychological state and pain intensity before and after the program.

Results: In contrast to our clinical assumption, we found that neither the type nor the number of patients with personality accentuation or personality disorders had a clinically relevant influence on group dynamics and that even a negative group dynamic did not negatively influence the individual therapy outcome.

Discussion: This trial analysed the connection between group dynamics and therapy outcome of multimodal pain therapies in chronic pain patients considering the factor of personality disorders. Our data demonstrated that neither the type nor the number of patients with personality disorders had a clinically relevant influence on group dynamics and that even a negative group dynamic did not negatively influence the individual therapy outcome. Hence, clinicians should not be afraid to include patients with personality disorders in their treatment programs.

Significance statement: The study emphasizes that clinicians may include patients with personality disorders in multimodal pain treatment programs and groups, provided that the maintenance of a close therapeutic bond with the patient and within the interdisciplinary team is given.

多模式疼痛疗法的群体动力与治疗效果:前瞻性观察试验。
背景:为治疗慢性疼痛,建议采用跨学科治疗方案。尽管这种耗费大量成本和时间的综合治疗方式在不断调整和优化,但在一些患者身上并不成功。由于人格障碍会对社会交往和行为产生重要影响,我们的研究旨在确定人格障碍患者对群体动力学可能产生的影响,并分析群体动力学对个体治疗结果的影响:我们对参加为期 5 周的跨学科治疗项目的慢性疼痛患者(104 人)进行了前瞻性观察研究。主要结果参数为项目前后的心理状态和疼痛强度:结果:与我们的临床假设相反,我们发现人格突出或人格障碍患者的类型和数量都不会对小组动态产生临床影响,即使是消极的小组动态也不会对个体治疗结果产生负面影响:本试验分析了慢性疼痛患者多模式疼痛疗法的团体动力与治疗效果之间的联系,并考虑了人格障碍的因素。我们的数据表明,人格障碍患者的类型和数量都不会对小组动态产生临床影响,即使是消极的小组动态也不会对个体治疗效果产生负面影响。因此,临床医生不应害怕将人格障碍患者纳入治疗计划:本研究强调,临床医生可将人格障碍患者纳入多模式疼痛治疗项目和小组,但前提是必须与患者及跨学科小组保持密切的治疗联系。
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来源期刊
European Journal of Pain
European Journal of Pain 医学-临床神经学
CiteScore
7.50
自引率
5.60%
发文量
163
审稿时长
4-8 weeks
期刊介绍: European Journal of Pain (EJP) publishes clinical and basic science research papers relevant to all aspects of pain and its management, including specialties such as anaesthesia, dentistry, neurology and neurosurgery, orthopaedics, palliative care, pharmacology, physiology, psychiatry, psychology and rehabilitation; socio-economic aspects of pain are also covered. Regular sections in the journal are as follows: • Editorials and Commentaries • Position Papers and Guidelines • Reviews • Original Articles • Letters • Bookshelf The journal particularly welcomes clinical trials, which are published on an occasional basis. Research articles are published under the following subject headings: • Neurobiology • Neurology • Experimental Pharmacology • Clinical Pharmacology • Psychology • Behavioural Therapy • Epidemiology • Cancer Pain • Acute Pain • Clinical Trials.
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