Messinis, L. and Andoniadis, G., Tei Patras Greece
Chronic musculoskeletal pain (CMP) is the primary symptom for which patients seek medical treatment in primary health care settings. Pharmacological / biomedical treatment of CMP is however costly and presents a tremendous challenge to health care professionals. In this regard, alternative behavioral treatments have been developed and seem to produce significant reductions in pain intensity ratings, pain behaviors and negative mood states. In the present study, 32 participants (15 treatment, 17 normal controls) were randomized to receive either 10 sessions of Cognitive Behavioral Treatment (CBT) or to a waiting-list control group (NC). Participants were included based on (DSM-IV, 1994) criteria of Chronic Pain Disorder. They were excluded if psychotic, dependent on alcohol or drugs, or if they had participated in any formal intervention for the prior 6 months to remove extraneous effects of any concurrent treatments on outcome measures. The study was designed to investigate the efficacy of CBT on levels of pain, mood states, anxiety and coping strategies. Participants completed the (BDI, STAI, POMS and SPS) at baseline following a structured interview, post treatment and at 3 and 6 month follow-up phases. The treatment package focused on understanding and managing pain complexities. Behavioral and cognitive coping strategies were utilized to improve management of emotional, cognitive and sensory aspects of pain. Pre-treatment data indicated no statistically significant differences between the groups on dependent measures or on age, education, and socio-economic status. Post-treatment results indicated that treatment group participants (CBT) significantly reduced their pain intensity (p< 001), showed improved mood states (p<.05), and less depression (p<.01), and less state anxiety than the (NC) group. These findings were retained at 3 and 6-month follow-up phases. The above findings, although preliminary and limited due to sample size, demonstrate the clear potential of CBT interventions in assisting CMP patients to better manage their pain and improve interpersonal coping and total mood disturbances related to the CMP.