PAIN EPIDEMIOLOGY AND HEALTH-RELATED QUALITY-OF-LIFE IN CHRONIC NONMALIGNANT PAIN PATIENTS REFERRED TO A DANISH MULTIDISCIPLINARY PAIN CENTER

This paper presents the results of a detailed study of the pain epidem iology and health related quality of life (HRQL) in 150 chronic non-ma lignant pain patients consecutively referred to a Danish multidiscipli nary pain center. Mean pain severity was 71.6 (SD = 18.5) on the VAS s cale. Forty-two percent reported poor quality of sleep. HRQL was evalu ated with the Medical Outcome Study-Short Form (SF-36), the Hospital A nxiety and Depression scale (HAD) and the Psychological General Well-B eing Scale (PGWB). Compared with the normal population (NP) both SF-36 scores and PGWB scores were significantly reduced (P < 0.001) indicat ing that physical, psychological and social well-being were severely r educed. On the HAD scale 58% were found to have a depressive or anxiet y disorder. Statistically significant but modest correlations were fou nd between pain severity and HRQL. Psychological and social well-being was closely correlated. Sixty-three percent of the referred patients had neurogenic pain conditions. Of these, only 25% were treated with a ntidepressants or anticonvulsants at referral. Seventy-three percent w ere treated with opioids at referral. Mean opioid consumption was 64 m g of morphine per day (range 1-280 mg). Compared with the NP the chron ic pain patients had used the health care system five times more often in the years prior to referral (P < 0.001). The study confirms the se vere multidimensional impact of chronic pain and demonstrates that HRQ L of chronic non-malignant pain patients is among the lowest observed for any medical condition. (C) 1997 International Association for the Study of Pain. Published by Elsevier Science B.V.