Background factors for chronic low back pain resistant to cognitive behavioral therapy

Abstract This study examined the factors that inhibit the therapeutic effects of cognitive behavioral therapy (CBT) and clarify the adaptation judgment criteria of CBT. We included patients with chronic low back pain and allocated them to the adaptation (with visual analog scale [VAS] improvement) o...

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Autores principales: Keisuke Shimizu, Kazuhide Inage, Sumihisa Orita, Yawara Eguchi, Yasuhiro Shiga, Masao Koda, Yasuchika Aoki, Toshiaki Kotani, Tsutomu Akazawa, Takeo Furuya, Junichi Nakamura, Hiroshi Takahashi, Miyako Suzuki-Narita, Satoshi Maki, Shigeo Hagiwara, Masahiro Inoue, Masaki Norimoto, Hideyuki Kinoshita, Takashi Sato, Masashi Sato, Keigo Enomoto, Hiromitsu Takaoka, Norichika Mizuki, Takashi Hozumi, Ryuto Tsuchiya, Geundong Kim, Takuma Otagiri, Tomohito Mukaihata, Takahisa Hishiya, Seiji Ohtori
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Publicado: Nature Portfolio 2021
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spelling oai:doaj.org-article:af2eef468a0c4b339c70a9968efce4cf2021-12-02T18:03:07ZBackground factors for chronic low back pain resistant to cognitive behavioral therapy10.1038/s41598-021-87239-22045-2322https://doaj.org/article/af2eef468a0c4b339c70a9968efce4cf2021-04-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-87239-2https://doaj.org/toc/2045-2322Abstract This study examined the factors that inhibit the therapeutic effects of cognitive behavioral therapy (CBT) and clarify the adaptation judgment criteria of CBT. We included patients with chronic low back pain and allocated them to the adaptation (with visual analog scale [VAS] improvement) or non-adaptation group (without VAS improvement). The patients were analyzed using various psychological tests. CBT improved depressive symptoms and catastrophic thinking; however, they were not correlated with the VAS and did not directly affect low back pain improvement. The non-adaptation group showed an unexplainable/vague sense of anxiety; an excessive focus on searching for pain; a strong intimacy desire; a strong tendency of medical dependency; and fantasy or distortion of the actual experience, especially self-image. Moreover, the patients showed a low ability to objectively express or attribute meaning to pain due to poor language skills, attention-deficit hyperactivity disorder, and emotional value judgment. Individuals with the aforementioned characteristics of pre-CBT psychological tests should select a different treatment approach given the high poor-adaption possibility. Even patients with depressive or anxious symptoms are not necessarily adaptable for CBT. Therefore, pre-CBT tests for treatment suitability are necessary. Future studies should establish a protocol for psychotherapy suitable for the non-adaptation group.Keisuke ShimizuKazuhide InageSumihisa OritaYawara EguchiYasuhiro ShigaMasao KodaYasuchika AokiToshiaki KotaniTsutomu AkazawaTakeo FuruyaJunichi NakamuraHiroshi TakahashiMiyako Suzuki-NaritaSatoshi MakiShigeo HagiwaraMasahiro InoueMasaki NorimotoHideyuki KinoshitaTakashi SatoMasashi SatoKeigo EnomotoHiromitsu TakaokaNorichika MizukiTakashi HozumiRyuto TsuchiyaGeundong KimTakuma OtagiriTomohito MukaihataTakahisa HishiyaSeiji OhtoriNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-10 (2021)
institution DOAJ
collection DOAJ
language EN
topic Medicine
R
Science
Q
spellingShingle Medicine
R
Science
Q
Keisuke Shimizu
Kazuhide Inage
Sumihisa Orita
Yawara Eguchi
Yasuhiro Shiga
Masao Koda
Yasuchika Aoki
Toshiaki Kotani
Tsutomu Akazawa
Takeo Furuya
Junichi Nakamura
Hiroshi Takahashi
Miyako Suzuki-Narita
Satoshi Maki
Shigeo Hagiwara
Masahiro Inoue
Masaki Norimoto
Hideyuki Kinoshita
Takashi Sato
Masashi Sato
Keigo Enomoto
Hiromitsu Takaoka
Norichika Mizuki
Takashi Hozumi
Ryuto Tsuchiya
Geundong Kim
Takuma Otagiri
Tomohito Mukaihata
Takahisa Hishiya
Seiji Ohtori
Background factors for chronic low back pain resistant to cognitive behavioral therapy
description Abstract This study examined the factors that inhibit the therapeutic effects of cognitive behavioral therapy (CBT) and clarify the adaptation judgment criteria of CBT. We included patients with chronic low back pain and allocated them to the adaptation (with visual analog scale [VAS] improvement) or non-adaptation group (without VAS improvement). The patients were analyzed using various psychological tests. CBT improved depressive symptoms and catastrophic thinking; however, they were not correlated with the VAS and did not directly affect low back pain improvement. The non-adaptation group showed an unexplainable/vague sense of anxiety; an excessive focus on searching for pain; a strong intimacy desire; a strong tendency of medical dependency; and fantasy or distortion of the actual experience, especially self-image. Moreover, the patients showed a low ability to objectively express or attribute meaning to pain due to poor language skills, attention-deficit hyperactivity disorder, and emotional value judgment. Individuals with the aforementioned characteristics of pre-CBT psychological tests should select a different treatment approach given the high poor-adaption possibility. Even patients with depressive or anxious symptoms are not necessarily adaptable for CBT. Therefore, pre-CBT tests for treatment suitability are necessary. Future studies should establish a protocol for psychotherapy suitable for the non-adaptation group.
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author Keisuke Shimizu
Kazuhide Inage
Sumihisa Orita
Yawara Eguchi
Yasuhiro Shiga
Masao Koda
Yasuchika Aoki
Toshiaki Kotani
Tsutomu Akazawa
Takeo Furuya
Junichi Nakamura
Hiroshi Takahashi
Miyako Suzuki-Narita
Satoshi Maki
Shigeo Hagiwara
Masahiro Inoue
Masaki Norimoto
Hideyuki Kinoshita
Takashi Sato
Masashi Sato
Keigo Enomoto
Hiromitsu Takaoka
Norichika Mizuki
Takashi Hozumi
Ryuto Tsuchiya
Geundong Kim
Takuma Otagiri
Tomohito Mukaihata
Takahisa Hishiya
Seiji Ohtori
author_facet Keisuke Shimizu
Kazuhide Inage
Sumihisa Orita
Yawara Eguchi
Yasuhiro Shiga
Masao Koda
Yasuchika Aoki
Toshiaki Kotani
Tsutomu Akazawa
Takeo Furuya
Junichi Nakamura
Hiroshi Takahashi
Miyako Suzuki-Narita
Satoshi Maki
Shigeo Hagiwara
Masahiro Inoue
Masaki Norimoto
Hideyuki Kinoshita
Takashi Sato
Masashi Sato
Keigo Enomoto
Hiromitsu Takaoka
Norichika Mizuki
Takashi Hozumi
Ryuto Tsuchiya
Geundong Kim
Takuma Otagiri
Tomohito Mukaihata
Takahisa Hishiya
Seiji Ohtori
author_sort Keisuke Shimizu
title Background factors for chronic low back pain resistant to cognitive behavioral therapy
title_short Background factors for chronic low back pain resistant to cognitive behavioral therapy
title_full Background factors for chronic low back pain resistant to cognitive behavioral therapy
title_fullStr Background factors for chronic low back pain resistant to cognitive behavioral therapy
title_full_unstemmed Background factors for chronic low back pain resistant to cognitive behavioral therapy
title_sort background factors for chronic low back pain resistant to cognitive behavioral therapy
publisher Nature Portfolio
publishDate 2021
url https://doaj.org/article/af2eef468a0c4b339c70a9968efce4cf
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