Methods: Long-term outcome in terms of well-being, depression and ability to cope was evaluated by means of a mailed questionnaire up to 5 years after participation in an integrated group treatment program for chronic musculoskeletal pain (mostly back pain). Sixty-one completed questionnaires were available for analysis, representing 69% of all 89 participants.
Results: Comparison of responders and non-responders yielded no important differences. On the basis of their further need for treatment, their working ability and global rating of outcome, patients were divided into three groups: In 18 cases the situation had further improved, 33 were unchanged and 10 had worsened. Sociodemographic data and pain history did not differ among the three groups. Patients with a favorable outcome scored significantly lower than the rest of the patients on a symptom check list and showed the greatest decrease from pretreatment values (if available). They rated themselves significantly higher on the two-dimensional health locus of control scale and were aware of significantly more factors influencing their pain than were the unimproved (unchanged or worsened) patients. Cognitive-behavioral strategies had been continued long-term by 83.6% of the patients and were rated most helpful. Physical training and at least one relaxation technique were continued in 80.3% of the patients, with a slightly lower rating of helpfulness. Improved patients gave generally higher ratings for helpfulness and applied these strategies also to problems other than pain (e.g. anxiety).
Conclusions: The majority of patients maintained at least two of the self-help strategies over many years and seem to profit from their use. Positive long-term effects on well-being were visible in 30% of all participants, and these were clearly more orientated towards self-control than the unimproved subgroups.