Psychological factors can cause false pain classification on painDETECT

Area of Science:

• Pain Medicine
• Psychosomatic Medicine
• Neurology

Background:

• The painDETECT questionnaire (PD-Q) is a common screening tool for neuropathic pain (NeP).
• Unlike other tools, PD-Q uses weighted sensory descriptors.
• Psychological factors may influence PD-Q scores and lead to misclassification of NeP.

Purpose of the Study:

• To investigate the relationship between psychological factors (catastrophizing, anxiety, depression, stress) and PD-Q scores.
• To determine if psychological factors are associated with false positive NeP classifications on the PD-Q.

Main Methods:

• Retrospective review of 1,101 patients from an outpatient pain center.
• Patients completed PD-Q, Pain Catastrophizing Scale (PCS), Depression, Anxiety and Stress Scale (DASS), and Brief Pain Inventory (BPI).
• Medical records were reviewed for clinical NeP diagnosis in PD-Q positive patients.

Main Results:

• Complete data from 652 patients were analyzed.
• Depression, anxiety, stress, and catastrophizing were significantly related to higher PD-Q scores (p < 0.0001).
• Only 50% of PD-Q positive patients had a clinical NeP diagnosis; anxiety was linked to false positives (p = 0.0036).

Conclusions:

• Psychological factors significantly influence PD-Q scores.
• A high rate of false positive NeP classifications was observed, particularly associated with anxiety.
• Clinicians must consider patient psychological state when interpreting PD-Q results for NeP.