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Krahé C, Brown C, Twiddy H, Frank B, Brian E, Nurmikko T, Stancak A, Fallon N. Effects of Lockdown Restrictions and Impact of Anxiety and Depression Symptoms in People With Chronic Pain During the Covid-19 Pandemic: A 13-Wave Longitudinal Study. THE JOURNAL OF PAIN 2024; 25:104437. [PMID: 38029948 DOI: 10.1016/j.jpain.2023.11.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 11/17/2023] [Accepted: 11/19/2023] [Indexed: 12/01/2023]
Abstract
In early 2020, countries across the world imposed lockdown restrictions to curb the spread of the Covid-19 coronavirus. Lockdown conditions, including social and physical distancing measures and recommended self-isolation for clinically vulnerable groups, were proposed to disproportionately affect those living with chronic pain, who already report reduced access to social support and increased isolation. Yet, empirical evidence from longitudinal studies tracking the effects of prolonged and fluctuating lockdown conditions, and potential psychological factors mediating the effects of such restrictions on outcomes in chronic pain populations, is lacking. Accordingly, in the present 13-wave longitudinal study, we surveyed pain intensity, pain interference, and tiredness in people with chronic pain over the course of 11 months of the Covid-19 pandemic (April 2020-March 2021). Of N = 431 participants at baseline, average completion rate was ∼50% of time points, and all available data points were included in linear mixed models. We examined the impact of varying levels of lockdown restrictions on these outcomes and investigated whether psychological distress levels mediated effects. We found that a full national lockdown was related to greater pain intensity, and these effects were partially mediated by depressive symptoms. No effects of lockdown level were found for pain interference and tiredness, which were instead predicted by higher levels of depression, anxiety, pain catastrophising, and reduced exercise. Our findings are relevant for improving patient care in current and future crises. Offering remote management options for low mood could be particularly beneficial for this vulnerable population in the event of future implementation of lockdown restrictions. PERSPECTIVE: This longitudinal study demonstrates the impact of Covid-19 lockdown restrictions on people with chronic pain. Findings suggest a complex interaction of psychosocial factors that impacted various aspects of pain experience in patients, which offer the potential to inform clinical strategies for remote medicine and future crises.
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Affiliation(s)
- Charlotte Krahé
- Department of Primary Care and Mental Health, Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Christopher Brown
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Hannah Twiddy
- Department of Primary Care and Mental Health, Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Bernhard Frank
- Department of Pain Medicine, The Walton Centre NHS Foundation Trust, Liverpool, UK
| | - Eleanor Brian
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Turo Nurmikko
- Department of Pain Medicine, The Walton Centre NHS Foundation Trust, Liverpool, UK
| | - Andrej Stancak
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Nicholas Fallon
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, UK
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2
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Rovira-Remisa MM, Moreira M, Ventura PS, Gonzalez-Alvarez P, Mestres N, Graterol Torres F, Joaquín C, Seuma ARP, Del Mar Martínez-Colls M, Roche A, Ibáñez-Micó S, López-Laso E, Méndez-Hernández MJ, Murillo M, Monlleó-Neila L, Maqueda-Castellote E, Del Toro Riera M, Felipe-Rucián A, Giralt-López M, Cortès-Saladelafont E. Impact of COVID19 pandemic on patients with rare diseases in Spain, with a special focus on inherited metabolic diseases. Mol Genet Metab Rep 2023; 35:100962. [PMID: 36909454 PMCID: PMC9986135 DOI: 10.1016/j.ymgmr.2023.100962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 02/27/2023] [Indexed: 03/08/2023] Open
Abstract
Introduction The Covid-19 pandemic soon became an international health emergency raising concern about its impact not only on physical health but also on quality of life and mental health. Rare diseases are chronically debilitating conditions with challenging patient care needs. We aimed to assess the quality of life and mental health of patients with rare diseases in Spain, with a special focus on inherited metabolic disorders (IMD). Methods A prospective case-control study was designed, comparing 459 patients suffering from a rare disease (including 53 patients with IMD) and 446 healthy controls. Quality of life (QoL) and mental health were assessed using validated scales according to age: KINDL-R and the Pediatric Symptom Checklist (PSC) for children and the WhoQoL-Bref questionnaire, GAD and PHQ-9 in adults. Results First, children and adults (but not adolescents) with IMD showed greater psychological effects than controls (p = 0.022, p = 0.026 respectively). Second, when comparing QoL, only adult patients with IMD showed worse score than controls (66/100 vs 74,6/100 respectively, p = 0.017). Finally, IMD had better quality of life than other rare neurological and genetic diseases (p = 0.008) or other rare diseases (p < 0.001 respectively) but similar alteration of the mental status. Conclusions Our data show that the pandemic had a negative impact on mental health that is more evident in the group of patients with IMD. Young age would behave as a protective factor on the perception of QoL. Furthermore, patients with IMD show a better QoL than other rare diseases.
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Affiliation(s)
- M Mar Rovira-Remisa
- Unit of Inherited Metabolic Disorders and Pediatric Neurology, Department of Pediatrics, Hospital Universitari Germans Trias i Pujol, Badalona., Spain
| | - Mónica Moreira
- Department of Psychiatry, Hospital Universitari Germans Trias i Pujol, Badalona, Spain.,Universitat Autònoma de Barcelona, Campus Can Ruti, Badalona, Spain
| | - Paula Sol Ventura
- Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Spain.,Department of Pediatrics, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | | | - Núria Mestres
- Unit of Inherited Metabolic Disorders and Pediatric Neurology, Department of Pediatrics, Hospital Universitari Germans Trias i Pujol, Badalona., Spain
| | | | - Clara Joaquín
- Unit of Adults Inherited Metabolic Disorders, Department of Endocrinology, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Agustí Rodríguez-Palmero Seuma
- Unit of Inherited Metabolic Disorders and Pediatric Neurology, Department of Pediatrics, Hospital Universitari Germans Trias i Pujol, Badalona., Spain
| | - Maria Del Mar Martínez-Colls
- Unit of Pediatric Pneumology, Department of Pediatrics, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Ana Roche
- Unit of Pediatric Neurology, Department of Pediatrics, Hospital Universitari Parc Taulí, Sabadell, Spain
| | - Salvador Ibáñez-Micó
- Unit of Pediatric Neurology, Department of Pediatrics, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain
| | - Eduardo López-Laso
- Pediatric Neurology Unit, Department of Pediatrics, University Hospital Reina Sofía, IMIBIC, CIBERER, Córdoba, Spain
| | - María Jesús Méndez-Hernández
- Unit of Pediatric Infectious Diseases and Immunological Disorders, Department of Pediatrics, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Marta Murillo
- Unit of Pediatric Endocrinology, Department of Pediatrics, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Laura Monlleó-Neila
- Unit of Inherited Metabolic Disorders and Pediatric Neurology, Department of Pediatrics, Hospital Universitari Germans Trias i Pujol, Badalona., Spain
| | - Elena Maqueda-Castellote
- Unit of Inherited Metabolic Disorders and Pediatric Neurology, Department of Pediatrics, Hospital Universitari Germans Trias i Pujol, Badalona., Spain
| | | | - Ana Felipe-Rucián
- Pediatric Neurology Department, Hospital Vall d'Hebron, Barcelona, Barcelona, Spain
| | - Maria Giralt-López
- Department of Psychiatry, Hospital Universitari Germans Trias i Pujol, Badalona, Spain.,Universitat Autònoma de Barcelona, Campus Can Ruti, Badalona, Spain
| | - Elisenda Cortès-Saladelafont
- Unit of Inherited Metabolic Disorders and Pediatric Neurology, Department of Pediatrics, Hospital Universitari Germans Trias i Pujol, Badalona., Spain.,Universitat Autònoma de Barcelona, Campus Can Ruti, Badalona, Spain
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3
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Chronic pain experience through COVID-19: a comparison of reports prior and during the early stages of the pandemic. Pain 2023; 164:435-442. [PMID: 36095051 DOI: 10.1097/j.pain.0000000000002724] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 06/29/2022] [Indexed: 02/06/2023]
Abstract
ABSTRACT The impacts of COVID-19 and imposed restrictions on individuals with chronic noncancer pain continue to emerge, varying across countries. More recent research (including with longitudinal designs) suggests that the pandemic may not have such a disproportionate effect on chronic noncancer pain and its management as first thought. This longitudinal study, with assessments before the pandemic (2019) and early during the pandemic (May-July 2020), examined changes in validated measures of pain severity, pain interference, prescription opioid misuse, and mental health symptoms. Patients (N = 236) self-reported significant improvements in pain severity, pain interference, pain self-efficacy, pain catastrophizing, prescription opioid misuse, depression, and anxiety symptoms over time. Approximately 30% and 33% of patients achieved minimally important reductions (10% change) in pain severity and pain interference, respectively. In follow-up exploratory analyses, prepandemic sociodemographic and psychological factors predictive of 10% improved (vs 10% worse) pain severity and interference were investigated in logistic regressions. Reduction in pain interference was predicted by current employment, older age, and higher pain self-efficacy. There were no significant predictors of reduction in pain severity. The impact of COVID-19 on patients' pain experience and mental health was negligible in the early stages of the pandemic, and findings suggest improvements through the period. Targeted interventions that promote the protective factor of pain self-efficacy and build resilience may buffer patients' future response to the pandemic because it evolves as a part of our new normal. Targeted social determinants of health interventions that direct resources toward maintaining employment could also be important.
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Kersebaum D, Sendel M, Fabig SC, Sachau J, Lassen J, Rehm S, Forstenpointner J, Rümenapp J, Vollert J, Hüllemann P, Baron R, Gierthmühlen J. The pandemic's effect on a patient cohort with painful polyneuropathy in 2020: A longitudinal study on pain, mood, and everyday life. Medicine (Baltimore) 2022; 101:e32054. [PMID: 36550857 PMCID: PMC9771215 DOI: 10.1097/md.0000000000032054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
In the early phase of the COVID pandemic 2020, we demonstrated how patients with painful polyneuropathy, against our expectations, did not experience a deterioration of their neuropathic pain. We hypothesized that our assessed measures, that is, pain intensity and characteristics, emotional wellbeing, and everyday life, would deteriorate in the further course of the pandemic according to the phases of disaster management. Thus, the aim of our study was to investigate patients repeatedly under varying pandemic conditions from March until December 2020. Sixty-three patients were investigated with validated questionnaires (brief pain inventory [BPI], neuropathic pain symptom inventory [NPSI], pain catastrophizing scale [PCS], patient-reported outcomes measurement information system [PROMIS] pain interference/sleep disturbance/fatigue/ depression/anxiety, EuroQol 5 dimensions 5 level version [EQ-5D-5L]) and a pandemic-specific, self-designed questionnaire. The data from the beginning of the pandemic with severe restrictions, during summer with loosened regulations and from December 2020 with reinstalled, severe restrictions were compared with an observational design. Patients reported higher pain severity when restrictions were lower. Sleep, mood, and quality of life did not change in the course of the pandemic in the validated measures. Pain interference significantly decreased during the study independent from restrictions. Patients who reported medical disadvantages had a lower quality of life upon EuroQol 5 dimension (EQ-5D) and were significantly more worried about their health. The perception of pain intensity was dependent on pandemic severity. Sleep, mood, and quality of life did not change significantly in validated measures. Continued medical care seems decisive to prevent worsening of pain and quality of life.
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Affiliation(s)
- Dilara Kersebaum
- Division of Neurological Pain Research and Therapy, Department of Neurology, University Hospital of Schleswig-Holstein, Campus Kiel, Germany
- Imland Clinic Rendsburg, Department of Psychiatry, Psychotherapy and Psychosomatics, Rendsburg, Germany
- * Correspondence: Dilara Kersebaum, Division of Neurological Pain Research and Therapy, Department of Neurology, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, Haus D, Kiel 24105, Germany (e-mail: )
| | - Manon Sendel
- Division of Neurological Pain Research and Therapy, Department of Neurology, University Hospital of Schleswig-Holstein, Campus Kiel, Germany
| | - Sophie-Charlotte Fabig
- Division of Neurological Pain Research and Therapy, Department of Neurology, University Hospital of Schleswig-Holstein, Campus Kiel, Germany
| | - Juliane Sachau
- Division of Neurological Pain Research and Therapy, Department of Neurology, University Hospital of Schleswig-Holstein, Campus Kiel, Germany
| | - Josephine Lassen
- Division of Neurological Pain Research and Therapy, Department of Neurology, University Hospital of Schleswig-Holstein, Campus Kiel, Germany
| | - Stefanie Rehm
- Division of Neurological Pain Research and Therapy, Department of Neurology, University Hospital of Schleswig-Holstein, Campus Kiel, Germany
| | - Julia Forstenpointner
- Division of Neurological Pain Research and Therapy, Department of Neurology, University Hospital of Schleswig-Holstein, Campus Kiel, Germany
| | - Johanna Rümenapp
- Division of Neurological Pain Research and Therapy, Department of Neurology, University Hospital of Schleswig-Holstein, Campus Kiel, Germany
| | - Jan Vollert
- Division of Neurological Pain Research and Therapy, Department of Neurology, University Hospital of Schleswig-Holstein, Campus Kiel, Germany
| | - Philipp Hüllemann
- Division of Neurological Pain Research and Therapy, Department of Neurology, University Hospital of Schleswig-Holstein, Campus Kiel, Germany
| | - Ralf Baron
- Division of Neurological Pain Research and Therapy, Department of Neurology, University Hospital of Schleswig-Holstein, Campus Kiel, Germany
| | - Janne Gierthmühlen
- Interdisciplinary Pain and Palliative Care Division, Department of Anesthesiology and Intensive Care Medicine, Campus Kiel, Germany
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5
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Amanzio M, Cipriani GE, Mitsikostas DD. The nocebo phenomenon in the COVID-19 pandemic: a nocebodemic effect. Expert Rev Clin Pharmacol 2022; 15:1377-1382. [DOI: 10.1080/17512433.2022.2142115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
| | | | - Dimos D. Mitsikostas
- First Department of Neurology, Aeginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
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6
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Shanthanna H, Nelson AM, Kissoon N, Narouze S. The COVID-19 pandemic and its consequences for chronic pain: a narrative review. Anaesthesia 2022; 77:1039-1050. [PMID: 35848380 PMCID: PMC9350079 DOI: 10.1111/anae.15801] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2022] [Indexed: 11/30/2022]
Abstract
The COVID-19 pandemic transformed everyday life, but the implications were most impactful for vulnerable populations, including patients with chronic pain. Moreover, persistent pain is increasingly recognised as a key manifestation of long COVID. This narrative review explores the consequences of the COVID-19 pandemic for chronic pain. Publications were identified related to the COVID-19 pandemic influence on the burden of chronic pain, development of new-onset pain because of long COVID with proposed mechanisms and COVID-19 vaccines and pain interventions. Broadly, mechanisms underlying pain due to SARS-CoV-2 infection could be caused by 'systemic inflammatory-immune mechanisms', 'direct neuropathic mechanisms' or 'secondary mechanisms due to the viral infection or treatment'. Existing chronic pain populations were variably impacted and social determinants of health appeared to influence the degree of effect. SARS-CoV-2 infection increased the absolute numbers of patients with pain and headache. In the acute phase, headache as a presenting symptom predicted a milder course. New-onset chronic pain was reportedly common and likely involves multiple mechanisms; however, its prevalence decreases over time and symptoms appear to fluctuate. Patients requiring intensive support were particularly susceptible to long COVID symptoms. Some evidence suggests steroid exposure (often used for pain interventions) may affect vaccine efficacy, but there is no evidence of clinical repercussions to date. Although existing chronic pain management could help with symptomatic relief, there is a need to advance research focusing on mechanism-based treatments within the domain of multidisciplinary care.
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Affiliation(s)
- H Shanthanna
- Department of Anesthesia, McMaster University, Hamilton, ON, Canada
| | - A M Nelson
- Department of Anesthesiology and Perioperative Care, University of California Irvine, Orange, CA, USA
| | - N Kissoon
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - S Narouze
- Center for Pain Medicine, Western Reserve Hospital, Cuyahoga Falls, OH, USA
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7
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Balestra AM, Chalk K, Spies C, Denke C, Krampe H, Tafelski S. Living with Chronic Pain During the COVID-19 Pandemic: A Qualitative Analysis. J Pain Res 2022; 15:969-981. [PMID: 35411185 PMCID: PMC8994632 DOI: 10.2147/jpr.s351846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 02/18/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose COVID-19 pandemic containment measures have led to changes in various areas of life, including restrictions on health care. Patients with chronic pain may have faced an increased burden during pandemic and the resources of this vulnerable population are unknown. Therefore, a qualitative study was conducted to understand how people with chronic pain have experienced the course of the pandemic. Patients and Methods Twenty semi-structured telephone interviews were conducted six months after the initial lockdown in Germany. The participants were patients with chronic pain who exhibited varying changes in their pain during the first German lockdown, recruited from a German outpatient pain clinic at a Department of Anesthesiology and Intensive Care. The semi-structured interview guidelines were designed to explore how patients with chronic pain experienced their pain during the pandemic, how they coped, and how they experienced pain management during this time. The interview recordings were transcribed verbatim and coded using the qualitative content analysis method. Results Four themes emerged from the results: differential impact on pain experience, difficulty coping with pain, supportive pain management, and endurance. Conclusion During this uncertain time, it was particularly important to maintain pain treatment in order to establish a sense of safety and stability. This underscores the special role of maintaining therapeutic contact during a pandemic and the potentially special role of telemedicine.
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Affiliation(s)
- Anna Marie Balestra
- Department of Anesthesiology and Intensive Care Medicine, Charité – Universitätsmedizin Berlin, Berlin, Germany
- Correspondence: Anna Marie Balestra, Department of Anesthesiology and Intensive Care Medicine, Charité – Universitätsmedizin Berlin, Berlin, Germany, Tel +49 30 450 631 014, Fax +49 30 450 531 904, Email
| | - Katharina Chalk
- Department of Anesthesiology and Intensive Care Medicine, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Claudia Spies
- Department of Anesthesiology and Intensive Care Medicine, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Claudia Denke
- Department of Anesthesiology and Intensive Care Medicine, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Henning Krampe
- Department of Anesthesiology and Intensive Care Medicine, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Sascha Tafelski
- Department of Anesthesiology and Intensive Care Medicine, Charité – Universitätsmedizin Berlin, Berlin, Germany
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8
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Tanaka S. What changes occurred in patients with chronic pain in the early phase of the COVID-19 pandemic? J Anesth 2022; 36:332-334. [PMID: 35107662 PMCID: PMC8809068 DOI: 10.1007/s00540-022-03042-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 01/21/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Satoshi Tanaka
- Department of Anesthesiology and Resuscitology, Shinshu University School of Medicine, Matsumoto, Nagano, Japan.
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9
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Pakniyat-Jahromi S, Sher L. Pain management and prevention of suicide in the COVID-19 era. Eur Arch Psychiatry Clin Neurosci 2022; 272:169-170. [PMID: 33666693 PMCID: PMC7933382 DOI: 10.1007/s00406-021-01247-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Accepted: 02/24/2021] [Indexed: 12/02/2022]
Affiliation(s)
| | - Leo Sher
- grid.274295.f0000 0004 0420 1184James J. Peters Veterans’ Administration Medical Center, Bronx, NY USA ,grid.59734.3c0000 0001 0670 2351Icahn School of Medicine at Mount Sinai, New York, NY USA
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10
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Masselin-Dubois A, Enert-Barbero N, Gazagne A. Adaptation des pratiques psychologiques en clinique de la douleur durant la pandémie de la COVID-19. PRAT PSYCHOL 2022. [PMCID: PMC8784648 DOI: 10.1016/j.prps.2022.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Introduction La pratique clinique auprès de patients douloureux chroniques, ébranlée par la réorganisation du champ sanitaire, a nécessité de repenser la prise en charge psychologique de la douleur. Afin de poursuivre l’accompagnement psychologique des patients, des consultations individuelles ou des ateliers de groupes à distance se sont développés. Un groupe d’échange de pratiques rassemblant des psychologues et psychothérapeutes a partagé ses expériences cliniques et son vécu de la crise. Objectifs Les objectifs de cette étude sont d’explorer l’adaptation des pratiques cliniques pour les sujets douloureux chroniques, le vécu des professionnels, et de proposer des recommandations issues des réflexions collectives. Méthode La méthodologie de recherche clinique a suivi celle d’un focus group. Trois réunions en visioconférence de deux heures ont eu lieu de septembre 2020 à mai 2021. Une analyse thématique des retranscriptions a été réalisée avec le logiciel d’analyse qualitative NVivo. Résultats Au total, 9 psychologues et psychothérapeutes ont participé au focus group. L’analyse thématique a révélé trois grands thèmes, à savoir : (1) impact de la crise sanitaire liée à la COVID-19 ; (2) adaptation des pratiques ; (3) processus de changement des pratiques cliniques. Conclusion Les professionnels rapportent que l’usage des outils numériques a permis de limiter l’impact psychologique de la crise sanitaire sur les patients et de maintenir le lien. Des recommandations issues des réflexions collectives suggèrent de maintenir les soins en distanciel et de s’appuyer sur le soutien des équipes, de la hiérarchie, et des groupes d’échanges entre pairs.
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Pagé MG, Dassieu L, Develay É, Roy M, Vachon-Presseau É, Lupien S, Rainville P. Stress and Pain Before, During and After the First Wave of the COVID-19 Pandemic: An Exploratory Longitudinal Mixed Methods Study. FRONTIERS IN PAIN RESEARCH 2021; 2:725893. [PMID: 35295411 PMCID: PMC8915720 DOI: 10.3389/fpain.2021.725893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 10/22/2021] [Indexed: 11/13/2022] Open
Abstract
Aims: This study explores the association between subjective feeling of stress and pain experience in the context of the COVID-19 pandemic with a focus on characteristics known to trigger a physiological stress response [sense of low control, threat to ego, unpredictability and novelty (STUN)].Methods: This exploratory longitudinal convergent mixed methods design consisted of online questionnaires over three time points (before, during and after the 1st wave of the COVID-19 pandemic) (N = 49) and qualitative interviews (N = 27) during the 1st wave of the pandemic on distinct samples of individuals living with chronic pain (CP). Both types of data sources were mixed upon integration using joint display.Results: Mean pain intensity scores remained stable across time points, while pain unpleasantness and pain interference scores significantly improved. Global impression of change scores measured during the first wave of the pandemic do not entirely concord with pain scores evolution. Two thirds of participants reported a global deterioration of their pain condition at the beginning of the pandemic. Stress and pain catastrophizing before the pandemic were associated with pain scores throughout the pandemic; while most specific measures of stress due to the novel, uncontrollable, unpredictable and threatening nature of the pandemic were not. Qualitative data demonstrated that the deterioration reported in pain status reflected additional dimensions, including spatial expansion of the painful area, reduced access to treatments and challenges in adapting pain management strategies.Conclusions: Helping individuals to negotiate stressful aspects of the pandemic might help offset the negative impacts of stress on pain status in this context or other important life events.
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Affiliation(s)
- M. Gabrielle Pagé
- Department of Anesthesiology and Pain Medicine, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
- Department of Psychology, Faculty of Arts and Science, Université de Montréal, Montreal, QC, Canada
- Research Center of the Centre hospitalier de l'Université de Montréal (CRCHUM), Montreal, QC, Canada
- *Correspondence: M. Gabrielle Pagé
| | - Lise Dassieu
- Research Center of the Centre hospitalier de l'Université de Montréal (CRCHUM), Montreal, QC, Canada
| | - Élise Develay
- Research Center of the Centre hospitalier de l'Université de Montréal (CRCHUM), Montreal, QC, Canada
| | - Mathieu Roy
- Department of Psychology, Faculty of Science, McGill University, Montreal, QC, Canada
- Alan Edwards Centre for Research on Pain, McGill University, Montreal, QC, Canada
| | - Étienne Vachon-Presseau
- Alan Edwards Centre for Research on Pain, McGill University, Montreal, QC, Canada
- Faculty of Dentistry, McGill University, Montreal, QC, Canada
- Department of Anesthesia, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Sonia Lupien
- Centre for Studies on Human Stress, Montreal Mental Health University Institute, Montreal, QC, Canada
- Department of Psychiatry, Faculty of Medicine, University of Montreal, Montreal, QC, Canada
| | - Pierre Rainville
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, CIUSSS Centre-sud-de l'île de Montréal, Montreal, QC, Canada
- Department of Stomatology, Université de Montréal, Montreal, QC, Canada
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12
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Schwab R, Anić K, Stewen K, Schmidt MW, Kalb SR, Kottmann T, Brenner W, Domidian JS, Krajnak S, Battista MJ, Hasenburg A. Pain experience and social support of endometriosis patients during the COVID-19 pandemic in Germany - results of a web-based cross-sectional survey. PLoS One 2021; 16:e0256433. [PMID: 34432847 PMCID: PMC8386836 DOI: 10.1371/journal.pone.0256433] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 08/08/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Endometriosis is a chronic pain condition in premenopausal women. Pain is mainly characterized by pain intensity and may induce disability in all areas of daily life. Nevertheless, pain is influenced by emotional and social factors as well. Social distancing measures or quarantine, as reaction to rapidly rising infections with the COVID-19 virus due to the SARS-CoV-2 pandemic, were implemented across Europe to prevent the spread of the virus and social distancing measures were imposed by the German government by beginning of March 2020 with initiation of the lockdown by the end of March 2020. The objective of this study was to assess, how social distancing measures during the lockdown impacted the various aspects of pain perception in a group of chronic pain patients, such as women suffering from endometriosis. METHODS Between 6th to 27th April 2020, an online questionnaire was activated at internet platforms of endometriosis patients support groups. Participants were asked retrospectively at one time point about their visual pain intensity measured by the visual analogue scale (VAS) and pain disability via pain disability index (PDI) prior to initiation of social distancing measures in Germany (VASP, PDIP), as well as the pain intensity and pain disability since implementation of social distancing measures (VASI, PDII). Differences of VAS and PDI previous and after implementation of social distancing measures were displayed as ΔVAS and ΔPDI. Pain experience and social support were assessed by a 5-point Likert scale. RESULTS 285 participants completed at least one question regarding pain intensity, disability, pain experience or social support. Dysmenorrhea, the symptom with the highest level of pain assessed by VAS, decreased significantly during the SARS-CoV-2 pandemic compared to the time period prior to social isolation (45.30% respondents experienced improvemenet vs 40.50% who experienced worsening; p = 0.025). The global physical impairment improved significantly (improvement of pain induced disability in 48.20% vs 40.90% with worsening of pain symptoms; p = 0.032) after the implementation of social distancing measures. Pain experience was negatively affected by social distancing measures, since frequency of pain awareness increased in 43.6% (p<0.001) of participants and 30.0% (p<0.001) more participants experienced pain as a threat. Verbalization of pain experience was reduced in 36.6% (p = 0.001) of participants and 14.6% (p = 0.91), 21.9% (p<0.001) and 31.5% (p<0.001) of participants reported less social support from their partner, family and friends. CONCLUSIONS Physical pain and disability on one hand and emotional and social pain experience on the other were differentially affected by the emerged emotional, social and health care constraints related to the SARS-CoV-2 pandemic.
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Affiliation(s)
- Roxana Schwab
- Department of Obstetrics and Gynecology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Katharina Anić
- Department of Obstetrics and Gynecology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Kathrin Stewen
- Department of Obstetrics and Gynecology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Mona W. Schmidt
- Department of Obstetrics and Gynecology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Stefanie R. Kalb
- Department of Obstetrics and Gynecology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | | | - Walburgis Brenner
- Department of Obstetrics and Gynecology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Jana-Sophie Domidian
- Department of Obstetrics and Gynecology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Slavomir Krajnak
- Department of Obstetrics and Gynecology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Marco J. Battista
- Department of Obstetrics and Gynecology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Annette Hasenburg
- Department of Obstetrics and Gynecology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
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13
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Yu L, Kioskli K, McCracken LM. The Psychological Functioning in the COVID-19 Pandemic and Its Association With Psychological Flexibility and Broader Functioning in People With Chronic Pain. THE JOURNAL OF PAIN 2021; 22:926-939. [PMID: 33677112 PMCID: PMC7930808 DOI: 10.1016/j.jpain.2021.02.011] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 02/08/2021] [Accepted: 02/18/2021] [Indexed: 12/30/2022]
Abstract
AIMS People with chronic pain may be particularly vulnerable to the impact of the pandemic COVID-19, and psychological flexibility may protect them. This study investigates psychological functioning in the context of COVID-19, including fear and avoidance in the context of COVID-19, specifically its association with daily functioning, and the role of psychological flexibility, among people with chronic pain. METHODS Responses from 555 adults with chronic pain were collected through a cross-sectional online survey and analyzed. RESULTS Eight out of 10 participants reported significant depression and nearly 9 out of 10 reported significant functional impairment. COVID-19-related fear and avoidance significantly correlated with pain, pain-related disability, depression, and work and social adjustment (r = 18-.32), as well as psychological flexibility processes, including pain acceptance, self-as-context, and committed action, |r|=.13-.30. COVID-19-related fear and avoidance and COVID-19-related interference were significant predictors of some measures of daily functioning beyond demographics and pain, β = .09-.14. However, these associations weakened when psychological flexibility processes were factored into the models, with fear of COVID-19 no longer being a significant predictor of pain-related disability or depression, and COVID-19 avoidance no longer a significant predictor of depression. CONCLUSIONS The psychological functioning in the context of COVID-19 appears to be negatively associated with daily functioning in people with chronic pain, and is statistically significant in this regard. Psychological flexibility may have a role in these associations for people with chronic pain in the pandemic. PERSPECTIVE This article demonstrates the psychological implication of COVID-19 and its association with broader emotional and daily functioning in people with chronic pain. It also demonstrates that Psychological flexibility may have a role in these associations for people with chronic pain in the pandemic.
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Affiliation(s)
- Lin Yu
- Middlesex University, Department of Psychology, UK.
| | - Kitty Kioskli
- City, University of London, Department of Computer Science, UK; Maggioli S.p.A, Research and Development Lab, Greece
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14
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Law EF, Zhou C, Seung F, Perry F, Palermo TM. Longitudinal study of early adaptation to the coronavirus disease pandemic among youth with chronic pain and their parents: effects of direct exposures and economic stress. Pain 2021; 162:2132-2144. [PMID: 34050112 PMCID: PMC8205975 DOI: 10.1097/j.pain.0000000000002290] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 03/29/2021] [Indexed: 12/12/2022]
Abstract
ABSTRACT The novel coronavirus disease (COVID-19) has caused prolonged disruptions in daily life for many communities. Little is known about the impact of the COVID-19 pandemic on the health and well-being of youth with chronic pain and their families. We conducted a longitudinal, mixed-methods study to characterize early adaptation to the COVID-19 pandemic among 250 families of youth (ages 12-21 years) diagnosed with chronic headache (64%) or other chronic pain conditions (36%) and to determine whether direct exposures to COVID-19 and secondary economic stress modified symptom trajectories. Youth and parents reported on pain interference, anxiety, depression, and insomnia symptoms at 4 waves of data collection from April 2020 to July 2020. We also collected qualitative data on the impact of the pandemic on the youth's pain problem. Nearly half of our sample (49.6%) experienced direct exposures to COVID-19. Secondary economic stress was also common, affecting 44.4% of families. Symptom trajectories for pain, insomnia, depression, and anxiety remained stable or improved for most participants, indicating adaptive adjustment. However, overall symptom burden was high with persistent and clinically elevated depression, anxiety, and insomnia symptoms common among youth and parents. Direct exposures to COVID-19 did not modify symptom trajectories. However, youth pain interference and parent insomnia worsened in families who experienced secondary economic stress. Qualitative data revealed perceived benefits and harms from school closures on the youth's pain problem. Our findings of high symptom burden suggest that pediatric pain clinicians should offer distance assessment and treatment (eg, through telemedicine) to avoid pandemic-related disruptions in pain care.
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Affiliation(s)
- Emily F. Law
- Center for Child Health, Behavior & Development, Seattle Children’s Research Institute
- Department of Anesthesiology & Pain Medicine, University of Washington School of Medicine
| | - Chuan Zhou
- Center for Child Health, Behavior & Development, Seattle Children’s Research Institute
- Department of Pediatrics, University of Washington School of Medicine
| | - Fiona Seung
- Center for Child Health, Behavior & Development, Seattle Children’s Research Institute
| | - Frankie Perry
- Center for Child Health, Behavior & Development, Seattle Children’s Research Institute
| | - Tonya M. Palermo
- Center for Child Health, Behavior & Development, Seattle Children’s Research Institute
- Department of Anesthesiology & Pain Medicine, University of Washington School of Medicine
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15
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Rassu FS, McFadden M, Aaron RV, Wegener ST, Ephraim PL, Lane E, Brennan G, Minick KI, Fritz JM, Skolasky RL. The Relationship between Neighborhood Deprivation and Perceived Changes for Pain-Related Experiences among U.S. Patients with Chronic Low Back Pain during the COVID-19 Pandemic. PAIN MEDICINE 2021; 22:2550-2565. [PMID: 34181008 DOI: 10.1093/pm/pnab179] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Disruptions caused by the COVID-19 pandemic could disproportionately affect the health of vulnerable populations, including patients experiencing persistent health conditions (i.e., chronic pain), along with populations living within deprived, lower socioeconomic areas. The current cross-sectional study characterized relationships between neighborhood deprivation and perceived changes in pain-related experiences during the COVID-19 pandemic (early-September to mid-October 2020) for adult patients (N = 97) with nonspecific chronic low back pain. METHODS We collected self-report perceived experiences from participants enrolled in an ongoing pragmatic randomized trial across medical centers within the Salt Lake City, Utah and Baltimore, Maryland metropolitans. The Area Deprivation Index (composite of 17 U.S. Census deprivation metrics) reflected neighborhood deprivation based on participants' zip codes. RESULTS Although those living in the neighborhoods with greater deprivation endorsed significantly poorer physical (pain severity, pain interference, physical functioning), mental (depression, anxiety), and social health during the pandemic, there were no significant differences for perceived changes in pain-related experiences (pain severity, pain interference, sleep quality) between levels of neighborhood deprivation since the onset of the pandemic. However, those in neighborhoods with greater deprivation endorsed disproportionately worse perceived changes in pain coping, social support, and mood since the pandemic. CONCLUSIONS The current findings offer evidence that changes in pain coping during the pandemic may be disproportionately worse for those living in deprived areas. Considering poorer pain coping may contribute to long-term consequences, the current findings suggest the need for further attention and intervention to reduce the negative affect of the pandemic for such vulnerable populations.
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Affiliation(s)
- Fenan S Rassu
- Department of Physical Medicine and Rehabilitation, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Molly McFadden
- Division of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | - Rachel V Aaron
- Department of Physical Medicine and Rehabilitation, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Stephen T Wegener
- Department of Physical Medicine and Rehabilitation, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Patti L Ephraim
- Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Elizabeth Lane
- Department of Physical Therapy and Athletic Training, University of Utah, Salt Lake City, UT, USA
| | - Gerard Brennan
- Rehabilitation Services, Intermountain Healthcare, Salt Lake City, UT, USA
| | - Kate I Minick
- Rehabilitation Services, Intermountain Healthcare, Salt Lake City, UT, USA
| | - Julie M Fritz
- Department of Physical Therapy and Athletic Training, University of Utah, Salt Lake City, UT, USA
| | - Richard L Skolasky
- Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
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16
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Perra N. Non-pharmaceutical interventions during the COVID-19 pandemic: A review. PHYSICS REPORTS 2021; 913:1-52. [PMID: 33612922 PMCID: PMC7881715 DOI: 10.1016/j.physrep.2021.02.001] [Citation(s) in RCA: 214] [Impact Index Per Article: 71.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 02/08/2021] [Indexed: 05/06/2023]
Abstract
Infectious diseases and human behavior are intertwined. On one side, our movements and interactions are the engines of transmission. On the other, the unfolding of viruses might induce changes to our daily activities. While intuitive, our understanding of such feedback loop is still limited. Before COVID-19 the literature on the subject was mainly theoretical and largely missed validation. The main issue was the lack of empirical data capturing behavioral change induced by diseases. Things have dramatically changed in 2020. Non-pharmaceutical interventions (NPIs) have been the key weapon against the SARS-CoV-2 virus and affected virtually any societal process. Travel bans, events cancellation, social distancing, curfews, and lockdowns have become unfortunately very familiar. The scale of the emergency, the ease of survey as well as crowdsourcing deployment guaranteed by the latest technology, several Data for Good programs developed by tech giants, major mobile phone providers, and other companies have allowed unprecedented access to data describing behavioral changes induced by the pandemic. Here, I review some of the vast literature written on the subject of NPIs during the COVID-19 pandemic. In doing so, I analyze 348 articles written by more than 2518 authors in the first 12 months of the emergency. While the large majority of the sample was obtained by querying PubMed, it includes also a hand-curated list. Considering the focus, and methodology I have classified the sample into seven main categories: epidemic models, surveys, comments/perspectives, papers aiming to quantify the effects of NPIs, reviews, articles using data proxies to measure NPIs, and publicly available datasets describing NPIs. I summarize the methodology, data used, findings of the articles in each category and provide an outlook highlighting future challenges as well as opportunities.
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Affiliation(s)
- Nicola Perra
- Networks and Urban Systems Centre, University of Greenwich, London, UK
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17
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Rowbotham MC, Arendt-Nielsen L. A year like no other: introduction to a special issue on COVID-19 and pain. Pain Rep 2021; 6:e915. [PMID: 33997584 PMCID: PMC8116039 DOI: 10.1097/pr9.0000000000000915] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 02/12/2021] [Indexed: 12/23/2022] Open
Affiliation(s)
- Michael C. Rowbotham
- Pain Management Center, University of California School of Medicine, San Francisco, CA, USA
- Treasurer, International Association for the Study of Pain (IASP), Washington, DC, USA
| | - Lars Arendt-Nielsen
- Center for Neuroplasticity and Pain (CNAP), School of Medicine, Aalborg University, Aalborg, Denmark
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18
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Kiani P, Merlo A, Saeed HM, Benson S, Bruce G, Hoorn R, Kraneveld AD, van de Loo AJAE, Severeijns NR, Sips ASM, Scholey A, Garssen J, Verster JC. Immune Fitness and the Psychosocial and Health Consequences of the COVID-19 Pandemic Lockdown in The Netherlands: Methodology and Design of the CLOFIT Study. Eur J Investig Health Psychol Educ 2021; 11:199-218. [PMID: 34542459 PMCID: PMC8314332 DOI: 10.3390/ejihpe11010016] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 02/02/2021] [Accepted: 02/19/2021] [Indexed: 01/07/2023] Open
Abstract
This article provides an overview of the design and methodology of the "Corona lockdown: how fit are you?" (CLOFIT) study, including the questionnaires and scales that were included in the online survey. The aim of the CLOFIT study was to investigate the psychosocial and health consequences of the coronavirus disease 2019 (COVID-19) pandemic in the Netherlands. The survey was conducted among the Dutch population to collect data on immune fitness and the psychological and health consequences of the 2019 coronavirus disease (COVID-19) pandemic lockdown in the Netherlands. The CLOFIT dataset contains measures from N = 1910 participants and is broadly representative of the Dutch general population. The dataset represents both sexes, a range of ages including the elderly, different education levels, and ethnic backgrounds. The cohort also includes people with a diverse health status and range of medication use.
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Affiliation(s)
- Pantea Kiani
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, 3584CG Utrecht, The Netherlands; (P.K.); (A.M.); (H.M.S.); (R.H.); (A.D.K.); (A.J.A.E.v.d.L.); (N.R.S.); (A.S.M.S.); (J.G.)
| | - Agnese Merlo
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, 3584CG Utrecht, The Netherlands; (P.K.); (A.M.); (H.M.S.); (R.H.); (A.D.K.); (A.J.A.E.v.d.L.); (N.R.S.); (A.S.M.S.); (J.G.)
| | - Hama M. Saeed
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, 3584CG Utrecht, The Netherlands; (P.K.); (A.M.); (H.M.S.); (R.H.); (A.D.K.); (A.J.A.E.v.d.L.); (N.R.S.); (A.S.M.S.); (J.G.)
| | - Sarah Benson
- Centre for Human Psychopharmacology, Swinburne University, Melbourne, VIC 3122, Australia; (S.B.); (A.S.)
| | - Gillian Bruce
- Division of Psychology and Social Work, School of Education and Social Sciences, University of the West of Scotland, Paisley PA1 2BE, UK;
| | - Rosalie Hoorn
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, 3584CG Utrecht, The Netherlands; (P.K.); (A.M.); (H.M.S.); (R.H.); (A.D.K.); (A.J.A.E.v.d.L.); (N.R.S.); (A.S.M.S.); (J.G.)
- Clinical Psychology, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, 1081BT Amsterdam, The Netherlands
| | - Aletta D. Kraneveld
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, 3584CG Utrecht, The Netherlands; (P.K.); (A.M.); (H.M.S.); (R.H.); (A.D.K.); (A.J.A.E.v.d.L.); (N.R.S.); (A.S.M.S.); (J.G.)
| | - Aurora J. A. E. van de Loo
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, 3584CG Utrecht, The Netherlands; (P.K.); (A.M.); (H.M.S.); (R.H.); (A.D.K.); (A.J.A.E.v.d.L.); (N.R.S.); (A.S.M.S.); (J.G.)
| | - Noortje R. Severeijns
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, 3584CG Utrecht, The Netherlands; (P.K.); (A.M.); (H.M.S.); (R.H.); (A.D.K.); (A.J.A.E.v.d.L.); (N.R.S.); (A.S.M.S.); (J.G.)
| | - Annabel S. M. Sips
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, 3584CG Utrecht, The Netherlands; (P.K.); (A.M.); (H.M.S.); (R.H.); (A.D.K.); (A.J.A.E.v.d.L.); (N.R.S.); (A.S.M.S.); (J.G.)
| | - Andrew Scholey
- Centre for Human Psychopharmacology, Swinburne University, Melbourne, VIC 3122, Australia; (S.B.); (A.S.)
| | - Johan Garssen
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, 3584CG Utrecht, The Netherlands; (P.K.); (A.M.); (H.M.S.); (R.H.); (A.D.K.); (A.J.A.E.v.d.L.); (N.R.S.); (A.S.M.S.); (J.G.)
- Global Centre of Excellence Immunology, Nutricia Danone Research, 3584CT Utrecht, The Netherlands
| | - Joris C. Verster
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, 3584CG Utrecht, The Netherlands; (P.K.); (A.M.); (H.M.S.); (R.H.); (A.D.K.); (A.J.A.E.v.d.L.); (N.R.S.); (A.S.M.S.); (J.G.)
- Centre for Human Psychopharmacology, Swinburne University, Melbourne, VIC 3122, Australia; (S.B.); (A.S.)
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Pain during and after COVID-19 in Germany and worldwide: a narrative review of current knowledge. Pain Rep 2021; 6:e893. [PMID: 33490851 PMCID: PMC7819701 DOI: 10.1097/pr9.0000000000000893] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 12/08/2020] [Accepted: 12/11/2020] [Indexed: 01/08/2023] Open
Abstract
COVID-19 may potentially increase the incidence of persisting pain syndromes and worsen symptoms of preexisting chronic pain. Pain is a common symptom accompanying the coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Nonspecific discomfort such as sore throat and body ache are frequent. Parainfectious pain such as headache, myalgia, or neuropathic pain has also been reported. The latter seems to be associated with an autoimmune response or an affection of the peripheral neuromuscular system or the central nervous system because of the viral infection. Furthermore, chronic pain can be a complication of intensive care unit treatment due to COVID-19 itself (such as intensive care–acquired weakness) or of secondary diseases associated with the SARS-CoV-2 infection, including Guillain–Barré syndrome, polyneuritis, critical illness polyneuropathy, or central pain following cerebrovascular events. Data on long-lasting painful symptoms after clinically manifest COVID-19 and their consequences are lacking. In addition, preexisting chronic pain may be exacerbated by limited and disrupted health care and the psychological burden of the COVID-19 pandemic. Medical providers should be vigilant on pain during and after COVID-19.
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