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Huang Y, Xu J, Liu Q, Zeng Z, Zhang Y. Stellate ganglion block successfully relieved medically unexplained chronic pain: a case report. J Int Med Res 2022; 50:3000605221086735. [PMID: 35301893 PMCID: PMC8935417 DOI: 10.1177/03000605221086735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Medically unexplained symptoms refers to a clinical syndrome characterized by somatic symptoms that cannot be reasonably explained by any organic disease. Chronic pain can be a type of medically unexplained symptom. The current treatment modalities for chronic pain mainly include drugs and psychotherapy. The use of stellate ganglion block for treatment of chronic pain has rarely been reported. Herein, we report a patient whose chronic pain was completely relieved after receiving a stellate ganglion block.
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Affiliation(s)
- Yiting Huang
- Department of Surgery and Anesthesia, The Third Affiliated Hospital of Sun Yat-sen University Yuedong Hospital, Guangdong, China
| | - Jian Xu
- Department of Surgery and Anesthesia, The Third Affiliated Hospital of Sun Yat-sen University Yuedong Hospital, Guangdong, China
| | - Qingyan Liu
- Department of Surgery and Anesthesia, The Third Affiliated Hospital of Sun Yat-sen University Yuedong Hospital, Guangdong, China
| | - Zhimin Zeng
- Department of Surgery and Anesthesia, The Third Affiliated Hospital of Sun Yat-sen University Yuedong Hospital, Guangdong, China
| | - Yuenong Zhang
- Department of Surgery and Anesthesia, The Third Affiliated Hospital of Sun Yat-sen University Yuedong Hospital, Guangdong, China
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Dueñas M, Ojeda B, Salazar A, Fernández-Palacín F, Micó JA, Torres LM, Failde I. Use and satisfaction with the Healthcare System of the chronic pain patients in Spain: results from a nationwide study. Curr Med Res Opin 2016; 32:1813-1820. [PMID: 27400416 DOI: 10.1080/03007995.2016.1211519] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To analyze the use of healthcare resources by chronic pain (CP) patients in Spain and their satisfaction with them. RESEARCH DESIGN AND METHODS A nationwide, cross-sectional study was carried out on a representative sample of 1957 Spanish adults. A telephone survey was conducted with the aim of analyzing the prevalence of CP, the characteristics and consequences of pain, the use of healthcare resources and patients' satisfaction with them. Descriptive, bivariate and multivariate analyses were performed. RESULTS Of the 1957 subjects interviewed, 325 suffered CP. The mean duration of CP was 10 years (SD: 11.3) and 48.9% of the CP sufferers reported severe/unbearable pain. Moreover, about 30% felt sad/very sad or anxious/very anxious, 24.4% had been on sick leave, 12% had left/lost their jobs and 47.2% considered their pain affected their families. Likewise, 92.9% had consulted a healthcare professional due to their CP, on average 3.49 times (SD: 3.9), and 69.2% took medication. In addition, 67.3% and 63.8% were satisfied/very satisfied with the care and the healthcare information they received, respectively. Individuals who reported headache (OR = 0.34) and feeling sad (OR =0.38) were least satisfied with the care they received. In addition, CP sufferers who made greater use of consultations were those who had left/lost their jobs (β = 1.44), those who took medication (β = 1.67), those who considered their pain affected their families (β = 0.97) and those with a shorter duration of pain (β = -0.003). CONCLUSIONS CP produces relevant demands on healthcare resources, conditioned by the consequences within the family and the effects on their employment. To achieve greater patient satisfaction, professionals need to pay particular attention to certain sites of pain and to patients' mental health.
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Affiliation(s)
- María Dueñas
- a Salus Infirmorum Faculty of Nursing , University of Cádiz , Cádiz , Spain
| | - Begoña Ojeda
- b Preventive Medicine and Public Health Area, Faculty of Nursing and Physiotherapy , University of Cádiz , Cádiz , Spain
| | - Alejandro Salazar
- b Preventive Medicine and Public Health Area, Faculty of Nursing and Physiotherapy , University of Cádiz , Cádiz , Spain
| | - Fernando Fernández-Palacín
- c Department of Statistics and Operations Research, Faculty of Sciences , University of Cádiz , Cádiz , Spain
| | - Juan Antonio Micó
- d Department of Neuroscience, Pharmacology and Psychiatry , University of Cádiz, CIBER of Mental Health, CIBERSAM, Instituto de Salud Carlos III , Cádiz , Spain
| | - Luis Miguel Torres
- e Department of Anesthesiology - Critical Care and Pain Management , University Hospital "Puerta del Mar" , Cádiz , Spain
| | - Inmaculada Failde
- b Preventive Medicine and Public Health Area, Faculty of Nursing and Physiotherapy , University of Cádiz , Cádiz , Spain
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Psyche at the end of life: Psychiatric symptoms are prevalent in patients admitted to a palliative care unit. Palliat Support Care 2015; 14:250-8. [PMID: 26447347 DOI: 10.1017/s1478951515000899] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Our aim was to evaluate the frequency and treatment of psychiatric symptoms in patients at palliative care units (PCUs). METHOD Patients admitted to one of five participating PCUs in Austria were included. The short version of the Patient Health Questionnaire (PHQ-D) was used to evaluate their mental health status. Pain intensity was rated on a numeric rating scale (NRS) from 0 to 10 by patients and physicians. Patients with a previously diagnosed psychiatric disorder were compared to those without or with newly diagnosed psychiatric symptoms, based on PHQ-D results. Pain and psychopharmacological medication were assessed. Opioid doses were converted into oral morphine equivalents (OMEs). RESULTS Some 68 patients were included. Previously undetected psychiatric symptoms were identified in 38% (26 of 68), preexisting psychiatric comorbidities were evident in 25% (17), and no psychiatric symptoms were observed in 37% (25). Patients with a preexisting psychiatric comorbidity received antidepressants and benzodiazepines significantly more often than patients without or with previously undetected psychiatric symptoms (p < 0.001). Patient and physician median NRS ratings of pain intensity correlated significantly (p = 0.001). Median NRS rating showed no significant difference between patients with preexisting, previously undetected, or without psychiatric symptoms. OMEs did not differ significantly between preexisting, without, or previously undetected psychiatric symptoms. Patients with undetected and preexisting psychiatric comorbidities had a greater impairment in their activities of daily living than patients without psychiatric symptoms (p = 0.003). SIGNIFICANCE OF RESULTS Undetected psychiatric comorbidities are common in patients receiving palliative care. Screening for psychiatric symptoms should be integrated into standard palliative care to optimize treatment and reduce the psychosocial burden of the disease.
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Abstract
This retrospective study investigated the influence of psychiatric comorbidity on pain perception and coping with pain in tertiary pain clinic patients, 427 treated for chronic low back pain (CLBP) and 629 for other forms of chronic pain (CG). No differences in psychosomatic dimensions were found between the two groups, but Italian Pain Questionnaire dimensions and intensity scores (t = 7.35; p < 0.0001) were higher in CLBP than in CG subjects. According to the Mini-International Neuropsychiatric Interview, CLBP patients also had a higher prevalence of lifetime major depressive episodes (χ2 = 4.96; p < 0.05), dysthymic disorder (χ2 = 4.64; p < 0.05), suicide risk (χ2 = 10.43; p < 0.01), and agoraphobia (χ2 = 6.31; p < 0.05) than CG patients did. The Multidimensional Pain Inventory showed a close association between CLBP and both agoraphobia (χ2 = 3.74; p < 0.05) and dysfunctional coping style (χ2 = 8.25; p < 0.01), which increased disability. Both agoraphobia and lifetime depression were associated with an overall increase in dimensions and pain intensity in CLBP, but not in CG.
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Salazar A, Dueñas M, Mico JA, Ojeda B, Agüera-Ortiz L, Cervilla JA, Failde I. Undiagnosed mood disorders and sleep disturbances in primary care patients with chronic musculoskeletal pain. PAIN MEDICINE 2013; 14:1416-25. [PMID: 23742219 DOI: 10.1111/pme.12165] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The study aims to determine the prevalence of undiagnosed comorbid mood disorders in patients suffering chronic musculoskeletal pain in a primary care setting and to identify sleep disturbances and other associated factors in these patients, and to compare the use of health services by chronic musculoskeletal pain patients with and without comorbid mood disorders. DESIGN Cross-sectional study. SUBJECTS A total of 1,006 patients with chronic musculoskeletal pain from a representative sample of primary care centers were evaluated. OUTCOME MEASURES Pain was measured using a visual analog scale and the Primary Care Evaluation of Mental Disorders questionnaire was used to measure mood disorders. RESULTS We observed a high prevalence of undiagnosed mood disorders in chronic musculoskeletal pain patients (74.7%, 95% confidence interval [CI] 71.9-77.4%), with greater comorbidity in women (adjusted odds ratio [OR] = 1.91, 95% CI 1.37-2.66%) and widow(er)s (adjusted OR = 1.87, 95% CI 1.19-2.91%). Both sleep disturbances (adjusted OR = 1.60, 95% CI 1.17-2.19%) and pain intensity (adjusted OR = 1.02, 95% CI 1.01-1.02%) displayed a direct relationship with mood disorders. Moreover, we found that chronic musculoskeletal pain patients with comorbid mood disorders availed of health care services more frequently than those without (P < 0.001). CONCLUSIONS The prevalence of undiagnosed mood disorders in patients with chronic musculoskeletal pain is very high in primary care settings. Our findings suggest that greater attention should be paid to this condition in general practice and that sleep disorders should be evaluated in greater detail to achieve accurate diagnoses and select the most appropriate treatment.
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Affiliation(s)
- Alejandro Salazar
- Preventive Medicine and Public Health Department, University of Cádiz, Cádiz, Spain
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Biopsychosocial aspects of atypical odontalgia. ISRN NEUROSCIENCE 2013; 2013:413515. [PMID: 24959561 PMCID: PMC4045532 DOI: 10.1155/2013/413515] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2012] [Accepted: 01/25/2013] [Indexed: 11/22/2022]
Abstract
Background. A few studies have found somatosensory abnormalities in atypical odontalgia (AO) patients. The aim of the study is to explore the presence of specific abnormalities in facial pain patients that can be considered as psychophysical factors predisposing to AO. Materials and Methods. The AO subjects (n = 18) have been compared to pain-free (n = 14), trigeminal neuralgia (n = 16), migraine (n = 17), and temporomandibular disorder (n = 14). The neurometer current perception threshold (CPT) was used to investigate somatosensory perception. Structured clinical interviews based on the DSM-IV axis I and DSM III-R axis II criteria for psychiatric disorders and self-assessment questionnaires were used to evaluate psychopathology and aggressive behavior among subjects. Results. Subjects with AO showed a lower Aβ, Aδ, and C trigeminal fiber pain perception threshold when compared to a pain-free control group. Resentment was determined to be inversely related to Aβ (rho: 0.62, P < 0.05), Aδ (rho: 0.53, P < 0.05) and C fibers (rho: 0.54, P < 0.05), and depression was inversely related with C fiber (rho: 0.52, P < 0.05) perception threshold only in AO subjects. Conclusion. High levels of depression and resentment can be considered predictive psychophysical factors for the development of AO after dental extraction.
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Olaya-Contreras P, Styf J. Biopsychosocial function analyses changes the assessment of the ability to work in patients on long-term sick-leave due to chronic musculoskeletal pain: the role of undiagnosed mental health comorbidity. Scand J Public Health 2013; 41:247-55. [PMID: 23361388 DOI: 10.1177/1403494812473380] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
AIMS To study the prevalence of somatic and mental health comorbidity and the use of opioid medication among patients on long-term sick-leave due to chronic musculoskeletal pain (CMP); to compare an orthopaedic-based assessment of ability to work with a team assessment; to investigate the relationship between intensity of pain and psychosocial characteristics in this group. METHODS A cross-sectional study was carried out with 174 consecutive patients on sick-leave for a mean of 21 months. All were referred from the Social Insurance Office for orthopaedic evaluation and assessment of the ability to work. Of them, only 83/174 patients were referred by the Office for psychiatric evaluation. RESULTS Neck pain was the main cause of disability. Patients with neck pain often suffered pain in more than two sites, and greater intensity of pain. Thirty-four percent of all participants had been prescribed opioid medication before consultation. Degrees of disability, unemployment, low degree of education and to be an immigrant were related to intensity of pain. Unrecognized psychiatric disorders changed the main cause of inability to work in 69% of patients who underwent both orthopaedic and psychiatric evaluation. CONCLUSIONS An evaluation based on biopsychosocial function is valuable in reaching an accurate assessment of the patient's diagnosis, and ability to work in CMP. Ability to work and degree of sick-leave in patients on long-term sick-leave is determined to a large extent by undiagnosed mental health comorbidities, and not solely somatic complaints.
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Agüera-Ortiz L, Failde I, Cervilla JA, Mico JA. Unexplained pain complaints and depression in older people in primary care. J Nutr Health Aging 2013; 17:574-7. [PMID: 23732555 DOI: 10.1007/s12603-013-0012-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Chronic pain and depression are frequent conditions in primary care patients. Depression is frequently overlooked in the presence of pain of uncertain origin. The aim is to measure the prevalence and clinical correlates of unrecognized comorbid mood disorders and chronic pain of uncertain origin in older primary care patients, and to elucidate the differences with younger adults with the same conditions. DESIGN Cross-sectional study. SETTING Primary care centres in Spain. PARTICIPANTS Patients (n= 2720) with persistent pain of uncertain origin. MEASUREMENTS Pain characteristics, sites and intensity (Visual Analogical Scales), depression (PRIME-MD interview), clinical characteristics and health services use. RESULTS We observed a similarly high (80.5%) prevalence of undiagnosed mood disorders (especially major depressive disorders) among older and younger adult patients with comorbid chronic pain complaints of uncertain origin. Older patients suffered pain that was more intense, longer lasting and located in a higher number of different areas, when compared to younger patients. Pain intensity was a factor associated with suffering from mood disorders among patients above 65 years, whilst the number of pain sites was a more important factor among younger patients. CONCLUSIONS Depression is highly associated with pain of uncertain origin in older patients with differences in pain characteristics when compared to younger patients. The robust comorbid relationship between both conditions should alert clinicians to specifically look for depression in the presence of poorly explained painful symptoms.
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Affiliation(s)
- L Agüera-Ortiz
- Psychiatry department. University Hospital 12 de Octubre. Complutense University, Centro de investigación Biomédica en Red de Salud Mental, CiBerSAM. Madrid
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Castro MMC, Daltro C, Kraychete DC, Lopes J. The cognitive behavioral therapy causes an improvement in quality of life in patients with chronic musculoskeletal pain. ARQUIVOS DE NEURO-PSIQUIATRIA 2012; 70:864-8. [DOI: 10.1590/s0004-282x2012001100008] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2012] [Accepted: 07/26/2012] [Indexed: 11/22/2022]
Abstract
Chronic pain causes functional incapacity and compromises an individual's affective, social, and economic life. OBJECTIVE: To study the cognitive behavioral therapy (CBT) effectiveness in a group of patients with chronic pain. METHODS: A randomized clinical trial with two parallel groups comprising 93 patients with chronic pain was carried out. Forty-eight patients were submitted to CBT and 45 continued the standard treatment. The visual analogue, hospital anxiety and depression, and quality of life SF-36 scales were applied. Patients were evaluated before and after ten weeks of treatment. RESULTS: When the Control Group and CBT were compared, the latter presented reduction of depressive symptoms (p=0.031) and improvement in the domains 'physical limitations' (p=0.012), 'general state of health' (p=0.045), and 'limitations by emotional aspects' (p=0.025). CONCLUSIONS: The CBT was effective and it has caused an improvement in more domains of quality of life when compared to the Control Group, after ten weeks of treatment.
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Affiliation(s)
- Martha M. C. Castro
- Universidade Federal da Bahia (UFBA), Brazil; Universidade Federal da Bahia (UFBA), Brazil
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Lou HY, Kong JF. The effects of prenatal maternal depressive symptoms on pain scores in the early postpartum period. J OBSTET GYNAECOL 2012; 32:764-6. [DOI: 10.3109/01443615.2012.702152] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Park S, Cho MJ, Seong S, Shin SY, Sohn J, Hahm BJ, Hong JP. Psychiatric morbidities, sleep disturbances, suicidality, and quality-of-life in a community population with medically unexplained pain in Korea. Psychiatry Res 2012; 198:509-15. [PMID: 22424895 DOI: 10.1016/j.psychres.2012.01.028] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2011] [Revised: 11/16/2011] [Accepted: 01/26/2012] [Indexed: 11/26/2022]
Abstract
We examined the psychiatric morbidities, sleep disturbances, suicidality, quality-of-life, and psychological distress of community-dwelling subjects in Korea who had medically unexplained pain. A total of 6510 subjects (age 18-65 years) participated in this study. A medically unexplained pain symptom (MUS-pain) was defined as pain lasting for 6 months or longer that was sufficiently severe to cause significant distress or to materially interfere with normal activities in the previous year, and that could not be explained by a medical condition or substance use/abuse. Diagnostic assessments were based on responses to the Composite International Diagnostic Interview, which was administered by lay colleagues. The presence of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) disorders, sleep disturbances, suicidal tendency, quality-of-life issues, and psychological distress was determined in subjects with and without MUS-pain. There were significant positive associations between MUS-pain and nicotine dependence and withdrawal, alcohol dependence, major depressive disorder, dysthymic disorder, bipolar disorder, post-traumatic stress disorder, social phobia, generalized anxiety disorder, and psychotic disorder. In addition, subjects with MUS-pain reported more sleep disturbances, suicidality, psychological distress, and a poorer quality-of-life than did subjects without MUS-pain. The results of this study suggest that clinicians should carefully evaluate and treat comorbid psychiatric problems in individuals with MUS-pain.
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Affiliation(s)
- Subin Park
- Department of Psychiatry, Asan Medical Center, Ulsan University College of Medicine, Seoul, South Korea
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Ciaramella A, Spiegel D. Psychiatric disorders among cancer patients. HANDBOOK OF CLINICAL NEUROLOGY 2012; 106:557-72. [PMID: 22608644 DOI: 10.1016/b978-0-444-52002-9.00033-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Poli P, Ciaramella A. Psychiatric Predisposition to Autonomic and Abnormal Perception Side-Effects of Ziconotide: A Case Series Study. Neuromodulation 2011; 14:219-24; discussion 224. [DOI: 10.1111/j.1525-1403.2011.00334.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Abstract
OBJECTIVES In this work, we propose a model, designed to understand mental symptoms and adapted for the analysis of psychosomatic symptoms, to be used as a tool to represent group phenomena, named the 'group mind'. DESIGN A revision of the relevant literature on the concept of 'group mind' and psychosomatics, and the presentation of the Cambridge model. METHODS We describe how unformatted experiences can appear as somatization, and how this process can be corrected via mental representations. Group dynamics can function creating these representations and thus contribute to solving psychosomatic symptoms. We refer to W. R. Bion's concepts, mainly the ones on proto-thoughts and the proto-mental system, comparing them to the proposed model and giving a foundation to this conceptual representation. We illustrate with four cases of clinical interaction. CONCLUSIONS Psychotherapeutic groups are privileged places to comprehend and transform psychosomatic symptoms. The Cambridge model allows a representation of these processes. Further studies are necessary to assess its validity, test its adequacy, and expand its possibilities.
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Affiliation(s)
- Lazslo Antonio Avila
- Psychiatry and Medical Psychology, Medicine School of Sao Jose do Rio Preto, Sao Jose Rio Preto, Sao Paulo, Brazil.
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Agüera L, Failde I, Cervilla JA, Díaz-Fernández P, Mico JA. Medically unexplained pain complaints are associated with underlying unrecognized mood disorders in primary care. BMC FAMILY PRACTICE 2010; 11:17. [PMID: 20199657 PMCID: PMC2837858 DOI: 10.1186/1471-2296-11-17] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/11/2009] [Accepted: 03/03/2010] [Indexed: 11/25/2022]
Abstract
BACKGROUND Patients with chronic pain frequently display comorbid depression, but the impact of this concurrence is often underestimated and mistreated. The aim of this study was to determine the prevalence of unrecognized major depression and other mood disorders and comorbid unexplained chronic pain in primary care settings and to explore the associated factors.Also, to compare the use of health services by patients with unexplained chronic pain, both with and without mood disorder comorbidity. METHODS A cross-sectional study was carried out in a sample of primary care centers. 3189 patients consulting for "unexplained chronic pain" were assessed by the Visual Analogue Scales (VAS) and the Primary Care Evaluation of Mental Disorders (PRIME-MD) questionnaire. RESULTS We report: a) a high prevalence of unrecognized mood disorders in patients suffering from unexplained chronic pain complaints (80.4%: CI 95%: 79.0%; 81.8%); b) a greater susceptibility of women to mood disorders (OR adjusted = 1.48; CI 95%:1.22; 1.81); c) a direct relationship between the prevalence of mood disorders and the duration of pain (OR adjusted = 1.01; CI 95%: 1.01; 1.02) d) a higher comorbidity with depression if the pain etiology was unknown (OR adjusted = 1.74; CI 95%: 1.45; 2.10) and, e) an increased use of health care services in patients with such a comorbidity (p < 0.0001). CONCLUSIONS The prevalence of undiagnosed mood disorders in patients with unexplained chronic pain in primary care is very high, leading to dissatisfaction with treatment processes and poorer outcomes. Consequently, it seems necessary to explore this condition more regularly in general practice in order to reach accurate diagnoses and to select the appropriate treatment.
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Affiliation(s)
- Luis Agüera
- Psychiatry Department, University Hospital 12 de Octubre, Complutense University, Madrid, Spain
| | - Inmaculada Failde
- Preventive Medicine and Public Health Department, University of Cádiz, Spain
| | - Jorge A Cervilla
- Department of Psychiatry, University of Granada, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Granada, Spain
| | | | - Juan Antonio Mico
- Department of Neuroscience, Pharmacology and Psychiatry, School of Medicine, University of Cádiz, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Cádiz, Spain
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Castro MMC, Daltro C. Sleep patterns and symptoms of anxiety and depression in patients with chronic pain. ARQUIVOS DE NEURO-PSIQUIATRIA 2010; 67:25-8. [PMID: 19330205 DOI: 10.1590/s0004-282x2009000100007] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2008] [Accepted: 12/06/2008] [Indexed: 11/22/2022]
Abstract
BACKGROUND Sleep disturbances and symptoms of anxiety and depression have been shown to be involved in the genesis and perpetuation of chronic pain. OBJECTIVE To evaluate sleep patterns and the prevalence of symptoms of anxiety and depression in patients with chronic pain. METHOD Four hundred consecutive patients referred to a chronic pain outpatient clinic were investigated using patient charts, the numerical Visual Analogue Scale for the evaluation of pain, the Hospital Anxiety and Depression scale and the Mini-Sleep Questionnaire. RESULTS The mean age of patients was 45.6+/-11.4 years. The most frequent medical diagnosis was myofascial pain followed by neuropathic pain. The prevalence of symptoms of anxiety was 72.8%, depression 93% and altered sleep patterns 93%. CONCLUSION This study revealed a high prevalence of symptoms of depression and anxiety and alterations in sleep patterns in patients with chronic pain, justifying investigation into these disturbances in this group of patients.
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Affiliation(s)
- Martha M C Castro
- Professor Edgard Santos University Hospital, Federal University of Bahia, Salvador, BA, Brazil.
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Castro M, Kraychete D, Daltro C, Lopes J, Menezes R, Oliveira I. Comorbid anxiety and depression disorders in patients with chronic pain. ARQUIVOS DE NEURO-PSIQUIATRIA 2009; 67:982-5. [DOI: 10.1590/s0004-282x2009000600004] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2009] [Accepted: 08/03/2009] [Indexed: 11/22/2022]
Abstract
OBJECTIVE: To evaluate the frequency of anxiety and depression disorders in patients with chronic pain. METHOD: Patients receiving care at the pain clinic of the Federal University of Bahia between February 2003 and November 2006. The MINI PLUS - Mini International Neuropsychiatric Interview was used to evaluate the patients and establish psychiatric diagnoses. RESULTS: 400 patients were evaluated mean age was 45.6±11.37 years; 82.8% were female, 17.3% male; 48.5% were married; 55.1% were Catholics; and 40.5% had only high school education. Of these 29.9% reported intense pain and 70.8% reported suffering pain daily. The most frequent medical diagnosis was herniated disc (24.5%), and 48.5% of patients had been undergoing treatment at the pain clinic for less than 3 months. Comorbidities found were depressive episodes (42%), dysthymia (54%), social phobia (36.5%), agoraphobia (8.5%) and panic disorder (7.3%). CONCLUSION: Psychiatric comorbidities are prevalent in patients suffering chronic pain.
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Affiliation(s)
- Martha Castro
- Federal University of Bahia, Brazil; Bahiana School of Medicine and Public Health, Brazil
| | | | - Carla Daltro
- Bahiana School of Medicine and Public Health, Brazil
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Menezes Costa LDC, Maher CG, McAuley JH, Costa LOP. Systematic review of cross-cultural adaptations of McGill Pain Questionnaire reveals a paucity of clinimetric testing. J Clin Epidemiol 2009; 62:934-43. [DOI: 10.1016/j.jclinepi.2009.03.019] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2008] [Revised: 03/09/2009] [Accepted: 03/24/2009] [Indexed: 10/20/2022]
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Evaluation of a multi-disciplinary back pain rehabilitation programme--individual and group perspectives. Qual Life Res 2008; 17:357-66. [PMID: 18278566 DOI: 10.1007/s11136-008-9315-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2007] [Accepted: 01/22/2008] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To evaluate the impact of a multi-disciplinary back pain rehabilitation programme using a combination of individual and group change data. METHODS A total of 261 consecutive patients attending an assessment session for the back pain rehabilitation programme completed the SF-36 health survey questionnaire. The patients were requested to complete the questionnaires again at programme completion and at the 6-month follow-up. The Reliable Change Index was used to define 'clinical significance' in terms of the assessment of individual change. RESULTS Half of those patients considered to be suitable for the programme subsequently completed it. In group terms, non-completers scored lower than completers on all SF-36 scales. Statistically significant improvements were evident for those completing the programme (all scales at P < 0.000), with improvement maintained at follow-up. In individual terms, 'clinical significance' was exceeded most frequently in the Physical Functioning and Role Physical scales. Whilst some participants lost previous improvements between completion and follow-up, others improved over this same time period. The majority of those completing the programme showed improvement in at least one scale. CONCLUSIONS Adding assessment of individual change to traditional group change measures provides greater insight into the impact a rehabilitation programme has upon participants' quality of life. Whilst the programme is clearly effective for those who complete it, work is required to limit post-programme deterioration and improve uptake.
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Ye Z, Honda S, Abe Y, Kusano Y, Takamura N, Imamura Y, Eida K, Takemoto TI, Aoyagi K. Influence of work duration or physical symptoms on mental health among Japanese visual display terminal users. INDUSTRIAL HEALTH 2007; 45:328-33. [PMID: 17485878 DOI: 10.2486/indhealth.45.328] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
The present study examined the relationship of work duration or physical symptoms to the mental health of visual display terminal (VDT) workers in Japan. The mental health status of 2,327 VDT users at an administrative office was investigated using the 12-item General Health Questionnaire (GHQ-12). Subjects were asked about their age, sex, hours of daily VDT use, rest and breaks during VDT work, eyestrain, and musculoskeletal pain. Logistic regression analysis was used to evaluate the associations with mental health status (GHQ-12 scores). The mean age of subjects was 39.5 yr (SD=10.3). Among all subjects, 36.7% could rest during VDT work and 66.9% received breaks during VDT work. The proportion of subjects who reported eyestrain and musculoskeletal pain were 19.6% and 25.7%, respectively. Eighteen percent of subjects were classified into a GHQ-12 high score group. Logistic regression analysis showed that age less than 40 yr, not receiving breaks during VDT work, and the presence of eyestrain and musculoskeletal pain were significantly associated with poor mental health status (high GHQ-12 scores). Using a VDT for more than 5 h/d and being female were also marginally associated with high GHQ scores (p<0.1). In conclusion, the management of physical health as well as work duration is important for good mental health status among VDT users.
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Affiliation(s)
- Zhaojia Ye
- Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto, Nagasaki, Japan
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Guez M, Hildingsson C, Nasic S, Toolanen G. Chronic low back pain in individuals with chronic neck pain of traumatic and non-traumatic origin: a population-based study. Acta Orthop 2006; 77:132-7. [PMID: 16534713 DOI: 10.1080/17453670610045812] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND It is unclear whether the prevalence of chronic low back pain is higher in chronic whiplash patients than in the general population. In a population-based study, we evaluated the prevalence of chronic low back pain in individuals with chronic neck pain of traumatic and non-traumatic origin, with special emphasis on whiplash injury. SUBJECTS AND METHODS Additional questions concerning the patient's experience of neck and low back pain were added to the questionnaire of the MONICA health survey. 4,415 subjects aged 25-64 years were randomly selected from a geographically well-defined area in northern Sweden. RESULTS The prevalences of chronic low back pain and chronic neck pain were 16% and 17%, respectively. 51% of subjects had both back and neck pain. Of the patients with neck pain, one quarter had a history of neck injury, which was related to whiplash injury in almost one-half of the cases. The prevalence of chronic low back pain in individuals with chronic non-traumatic neck pain was 53%, and it was 48% in those with chronic neck pain and a history of neck trauma. There was no difference in the prevalence of chronic low back pain between whiplash injury and other types of neck trauma. Confounding factors such as sex, age, marital status, BMI, smoking status and level of education were not significantly different between traumatic and non-traumatic groups. INTERPRETATION Independently of traumatic or non-traumatic origin of the symptoms, the prevalence of chronic low back pain is 3 times higher in individuals with chronic neck pain than in the general population. Causes other than a history of neck trauma, such as chronic muskuloskeletal pain syndromes, may be important in evaluation of these cases.
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Affiliation(s)
- Michel Guez
- Department of Orthopedics, University Hospital, SE-901 85 Umeå, Sweden.
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