Measuring Mental Stress

Even whilst the structured, pain-based patient history is being taken, exercising a little empathy and understanding will normally reveal any mental stress in the patient. This should be recorded within the context of a standard diagnosis by using a short questionnaire – the GCS-D (Grading of Chronic Pain, German version). This consists simply of seven innocuous questions and can easily be carried out in the dental practice. The GCS-D makes it possible to classify the patients’ pain into two groups – functional and dysfunctional. Dysfunctional means that the pain has already brought about changes in the patient’s professional and social life and these must be taken into account during any course of treatment.

If, during the course of an anamnesis, the GCS-D reveals any mental stress, there are a number of additional questionnaires available, e.g. the HADS-D (Hospital Anxiety and Depression Scale, German version) and many others. One thing that all these questionnaires have in common is that their conclusions are scientifically verified. Any severe mental stress or problems must be taken into account within the treatment plan. Unfortunately, this is not always the case, even with so-called CMD specialists who often believe that dealing with the somatic or physical side of the problem is enough. This blatant ignorance of the mental aspects of pain is one of the reasons that CMD treatment is often lacking so it just costs more effort and money rather than bringing any real help.