Dr. James Wade

It wouldn't be surprising if someone suffering from "dementia secondary to hypoxic brain injury" was out and about in the community, says James Wade, professor of psychiatry, neurology and anesthesiology at VCU Medical Center. Wade evaluated Fuller earlier this summer and declined to discuss his diagnosis, citing patient confidentiality.
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As for the broader question - can psychiatrists be duped by their patients, if, say, they're trying to avoid prosecution - Wade says it would be extremely difficult to do so.

The conclusions were based on what appears to be the first study to systematically evaluate the impact of intelligence on the stages of pain processing, according to James Wade, PhD, Associate Professor of Psychiatry and Anesthesiology, Medical College of Virginia, Richmond.

"It is possible that people of higher intelligence are better able at coping and finding satisfaction in life, in the face of chronic pain compared to those who are limited intellectually," Dr. Wade suggested in an interview with Anesthesiology News."Unfortunately, even though they may desperately need help, people of lower intellect may not have the ability to navigate the healthcare system to get authorization for the treatment they need for their pain."

Although psychologic/behavioral factors have previously been shown to mediate the association between low back pain and the development of chronic disability, Dr. Wade's study provides empirical evidence that verbal intelligence is predictive of pain intensity, suffering and illness behavior.In particular, he found, individuals of lower intelligence are at greater risk for disruptive symptomatology.

The investigation included 795 patients with chronic pain of a persistent and continuous nature, excluding head pain or cancer-related pain.
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Previously, Dr. Wade proposed a four-stage model of pain processing consisting of pain sensation intensity, pain-related emotional unpleasantness (stage 1 affect), suffering (stage 2 affect) and pain behavior.The model was used in the study.

Patients were administered the MCV Pain Questionnaire, developed by Dr. Wade and his colleagues in 1996, which consists of Visual Analogue Scale (VAS) scores assessing pain sensation intensity, immediate pain-related unpleasantness and emotional as well as cognitive suffering.Elements of the Psychosocial Pain Inventory, a structured interview, were used to assess illness behavior.The Satz-Mogel short form of the Wechsler Adult Intelligence Scale–Revised (WAIS-R) was used to determine the relationship between an individual's Verbal Intelligence Quotient (VIQ) and the four stages of pain processing.

Describing the study results in a poster presentation at the 2000 annual scientific meeting of the American Pain Society, Dr. Wade reported that he found significant correlations with measured verbal intelligence (P Based on a poster presentation at the 2000 annual scientific meeting of the American Pain Society and an interview with James Wade, PhD.

This article is derived from the McMahon Archives.This information may be time sensitive and was archived on 4/9/2001

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