The Comorbidity of Emotional Distress with Two Common Acute Pain Populations: Jaw and Low Back
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The present study was undertaken to evaluate emotional distress in two common acute pain populations: jaw pain (JAW; n = 135) and low back pain (LB; n=71). Prevalence of psychopathology in each group was evaluated, using the Structured Clinical Interview of Diagnostic and Statistical Manual IV - I and II, and compared to general population estimates. Analyses also examined discrepancies between low risk (LR) JAW and LR LB and high risk (HR) JAW and HR LB. Additionally, medication usage was evaluated to see if differences existed in types of medications used in these groups. Subjects were evaluated on a variety of psychosocial and functional measures, including the Beck Depression Inventory, Multidimensional Pain Inventory, Characteristic Pain Intensity, and Ways of Coping measures. Analyses revealed that there were significant differences between the JAW and LB groups, as well as differences between both risk status groups and the general population and specifically for DSM-IV Diagnoses. JAW subjects were found to have lower BDI and CPI scores, as well as a higher level of functioning on the Global Assessment of Functioning (GAF) from the DSM-IV. JAW patients had significantly more current Axis I and II diagnoses, while the LB group had significantly more lifetime Axis I and II disorders. Both acute pain groups had significantly more Axis I and II disorders than the general population. Additionally, it was discovered that the JAW group used more benzodiazepines, while the LB group used more Schedule II Narcotics. A logistic regression created from significant variables found a six-factor solution, created by the Characteristic Pain Intensity, MPI Coping Style Anomalous, Ways of Coping Problem-Solving, Global Assessment of Functioning, Anxiety Disorders, and Cluster C personality disorder diagnoses, that differentiates the JAW from the LB group. Overall, differences identified between these two groups indicate that the JAW group has increased current psychopathology, while the LB group has more enduring psychopathology. Future treatment should more uniquely correspond to the specific acute pain group.