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Quantitative assessment of psychosocial distress of individuals with poly-trauma and with chronic pain, according to the ama guides sixth edition

Published online by Cambridge University Press:  16 April 2020

A. Miciano*
Affiliation:
Nevada Rehabilitation Institute, Las Vegas, NV, USA

Abstract

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The objective was to examine the psychosocial distress (PD) status of Poly-Trauma individuals > two years (PTI) and with chronic pain using the Pain Disability Questionnaire (PDQ), a formal assessment for rating pain-related impairments (PRI) by the AMA Guides to Evaluation of Permanent Impairment, Sixth Edition.

Results from the Self-Administered Comorbidity Questionnaire (SCQ) were used to identify 60 out of 100 outpatient PTI with chronic pain. The PDQ and Physical Performance Tests (PPT): 6-Minute Walk Test, Berg Balance Scale, & Dynamic Gait Index scores were also recorded.

The PDQ was sub-categorized to: 19% mild PRI, 38% moderate, 38% severe and 5% extreme PRI and was also further divided into Functional Status (FS) versus Psychosocial Distress (PD) Status. The PD scores ranged from 8 to 55/60 points with an average 37/60 points. Comparing the effect of the PD over FS revealed that 25% of the total PDQ score (range 5–37%) was due to PD of the PTI.

The PRI rating demonstrated a close trend relationship between total PDQ and low PPT scores. The majority of PTI scored in the moderate & severe PRI. The FS/PD ratio in relationship to total PDQ remained consistent when subjects were separated based on PRI, and there was little variation in PPT. These findings suggest that the pain disability of PTI, regardless of severity, results in significant loss in health-related quality of life attributed to the PD status. Further research on FS & PD sub-scores and their correlations to decreased PPT scores would be beneficial.

Type
P02-403
Copyright
Copyright © European Psychiatric Association 2011
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