Analysis of psychological characteristics impacting spinal cord stimulation treatment outcomes: A prospective cohort assessment

Sparkes, E. and Duarte, R.V. and Mann, S. and Lawrenc, T.R. and Raphael, J.H. (2015) Analysis of psychological characteristics impacting spinal cord stimulation treatment outcomes: A prospective cohort assessment. Pain Physician, 18 (3). E369-E378. ISSN 15333159 (ISSN)

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Background: Psychological factors are recognised as influencing the outcome of spinal cord stimulation (SCS) although there is currently no consensus as to which factors impact upon SCS efficacy. Objective: To identify psychological characteristics that may impact the efficacy of SCS. Study Design: Prospective evaluation. Setting: Single secondary care center in Dudley, United Kingdom. Methods: Patients: Seventy-five patients were initially recruited and 56 patients (31 women and 25 men) were followed-up for 12-months. Intervention: SCS for the management of chronic non-cancer pain. Main Outcome Measures: Outcome measures assessed at baseline, 6 months, and 12 months following SCS implantation included the visual analogue scale (VAS), Oswestry disability index (ODI), hospital anxiety and depression (HAD) scale, and the pain coping strategies questionnaire (PCSQ). Results: Statistically significant improvements were observed for the VAS (P < 0.001), ODI (P = 0.011), anxiety (P = 0.042), and depression (P = 0.010) in the HAD scale and for the subscales reinterpreting pain sensation (P = 0.018), control over pain (P = 0.001), and ability to decrease pain (P < 0.001) of the PCSQ. We observed that depression and autonomous coping (control over pain, ability to reduce pain, and catastrophizing) may impact sensory aspects such as pain intensity and disability scores affecting the outcome of SCS treatment. Age at time of implant and duration of pain prior to implant were also found to impact SCS efficacy. Limitations: It has been reported that loss of analgesia may be experienced within 12 to 24 months following SCS implantation and therefore, it would be of interest to follow patients over a longer period. Conclusions: This study demonstrates that psychological aspects such as depression and autonomous coping may impact SCS treatment. Addressing these issues prior to SCS implantation may improve SCS long-term outcome. © 2015, American Society of Interventional Pain Physicians. All Rights Reserved.

Item Type: Article
Uncontrolled Keywords: Autonomous coping, Chronic pain, Depression, PSychological characteristics, Spinal cord stimulation, adult, aged, anxiety, Article, depression, disability, disease assessment, disease duration, female, Hospital Anxiety and Depression Scale, human, implantation, major clinical study, male, nociception, Oswestry Disability Index, outcome assessment, pain coping strategies questionnaire, pain intensity, prospective study, psychoanalysis, questionnaire, regression analysis, spinal cord stimulation, topography, treatment outcome, visual analog scale, analgesia, chronic pain, depression, follow up, middle aged, pain measurement, procedures, psychology, spinal cord stimulation, treatment outcome, United Kingdom, Adult, Aged, Anxiety, Chronic Pain, Depression, Female, Follow-Up Studies, Great Britain, Humans, Male, Middle Aged, Pain Management, Pain Measurement, Prospective Studies, Spinal Cord Stimulation, Treatment Outcome
Subjects: CAH01 - medicine and dentistry > CAH01-01 - medicine and dentistry > CAH01-01-01 - medical sciences (non-specific)
CAH04 - psychology > CAH04-01 - psychology > CAH04-01-01 - psychology (non-specific)
Divisions: Faculty of Health, Education and Life Sciences > Centre for Social Care, Health and Related Research (C-SHARR)
Depositing User: Yasser Nawaz
Date Deposited: 05 Jan 2017 10:43
Last Modified: 03 Mar 2022 17:15

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