Relationship of patient semantic pain descriptions to physician diagnostic judgments, activity level measures and...

A consecutive sample of chronic pain patients presenting themselves for evaluation was studied. A set of 25 bi-polar adjectives was developed from medical records of previous pain patients' descriptions of their pain. Using the Semantic Differential (S-D) method, each patient rated the extent to which his/her pain was best described by either of the adjective pairs. The S-D findings were then compared with three other data sets and those data sets were compared with each other. First, six physicians classified each patient along an "organic"--"non-organic" continuum based on ratings derived from the full set of medical diagnostic labels each patient had accrued. Secondly, each patient, prior to examination, had completed up to two weeks of diary forms at home on which were recorded amount and distribution of time among sitting, standing/walking, and reclining. Finally, each patient completed a Minnesota Multiphasic Personality Inventory (MMPI). Few and only marginally significant relationships between patient semantic descriptions of their pain and the other measures were found. Secondly, physician agreement ot the "organic"--"non-organic" criterion, using diagnostic labels as their data, was statistically significant but clinically modest. The most substantial findings were between walking hours per week recorded on diary forms and five MMPI scales. Patients who walked more were less depressed, had fewer diffuse somatic complaints, and described themselves as less frustrated or angry and as less hypersensitive in interpersonal situations. The major conclusion of the study is that chronic pain patients present sets of interrelated problems too complex to be discriminated reliably by a single set of measures; particularly, by simple word sets.