• Zvia Rudich, Sheera F Lerman, Boris Gurevich, and Golan Shahar.
• Division of Anesthesia and Intensive Care, Soroka University Medical Center, Beer-Sheva, Israel. rudich@bgu.ac.il
• Pain Med. 2010 Mar 1; 11 (3): 446-52.

ObjectiveTo examine the predictive value of physician's prognosis after patient's first visit to a pain specialty clinic.DesignThis is a prospective-longitudinal study in which patients completed questionnaires regarding their pain and psychological constructs before their first visit to a pain specialist and again after an average of 5 months. Physicians rated patient's prognosis immediately after the first visit.SettingThis study was conducted at the outpatient specialty pain clinic at Soroka University Medical Center.PatientsForty-five chronic pain patients suffering from a range of nonmalignant pain conditions.Outcome MeasuresSensory and affective pain measured by the Short-Form McGill Pain Questionnaire and depressive symptoms measured by the Center for Epidemiological Studies-Depression Scale.ResultsMultiple regression analysis revealed that physician's rating of patient prognosis at Time 1 uniquely predicted subsequent depressive symptoms and affective pain but not sensory pain at Time 2 even after controlling for Time 1 levels of these variables.ConclusionPhysician's pessimistic evaluation of patient's prognosis after the first visit was longitudinally associated with an increase in depression and in the affective dimension of pain over time, but not with changes in the sensory component of pain. Referring to physician pessimism as a marker for pre-depressed patient may lead to early preventive interventions.

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