ABSTRACT
The validity of the 28-item version of the General Health Questionnaire (GHQ-28) was determined by comparison with the Clinical Interview Schedule (CIS) in 56 pain clinic patients. Despite some limitations, the GHQ can be used effectively and cheaply as the first stage of an assessment to identify potential "cases" of mental disorder which must then be verified using a second-stage clinical interview such as the CIS. This process can result in a considerable reduction in the proportion of patients requiring a psychiatric interview and, therefore, in reduced service costs. Factors associated with lower validity coefficients include female sex, age above 60 years and pain with a duration of less than 2 years.
Subject(s)
Mental Disorders/diagnosis , Pain/psychology , Surveys and Questionnaires , Adult , Aged , Female , Humans , Male , Mental Disorders/complications , Mental Disorders/epidemiology , Middle Aged , Predictive Value of TestsABSTRACT
One hundred and six consecutive new attenders at a regional pain relief clinic were assessed using ratings of pain, standardized psychiatric interviews and physical examination by independent assessors. Approximately half the subjects had diagnosed mental illness and two-thirds had diagnosed organic disease. Pain ratings were higher in those with mental illness but were not related to the presence of organic pathology. The distribution of mental illnesses was not related to the organic status and those without physical disease had the lowest ratings on psychiatric assessments. All major findings were confirmed at a follow-up assessment. There is no evidence that these subjects can be divided into a simple dichotomy of those with physical or mental illnesses, or that pain measures can discriminate between them. It is concluded that all chronic pain patients require both physical and mental state assessment.
