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Shaygan M, Tehranineshat B, Teshnizi SH, Mohammadi A. The predicting factors of chronic pain among nursing students: a national study in Iran. BMC Psychol 2024; 12:297. [PMID: 38802966 PMCID: PMC11129415 DOI: 10.1186/s40359-024-01803-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 05/21/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND Nursing students are faced with a variety of challenges that demand effective cognitive and emotional resources. The physical and psychological well-being of the students plays a key part in the public health of the community. Despite the special lifestyle of nursing students, few studies have addressed chronic pain in this population. Accordingly, the present study aims to identify the predictors of chronic pain among nursing students. METHODS This cross-sectional study was conducted on 1,719 nursing students aged 18-42 years, between February and November 2019. Sampling was carried out in several stages. Data were collected using seven instruments, namely a demographics survey, the characteristics of chronic pain form, Spielberger State-Trait Anxiety Inventory (STAI), the Patient Health Questionnaire-9 (PHQ-9), the Bar-on Emotional Quotient Inventory, Academic Satisfaction Scale, and Procidano and Heller Social Support Scale. Descriptive statistics, multinomial logistic regression, and regression models were used to describe the characteristics of the pain and its predictive factors. RESULTS The average age of the participants was 22.4 ± 2.96 years. The results of univariate analysis showed that gender (P = 0.506), mother's education (P = 0.056, P = 0.278, P = 0.278), father's education (P = 0.817, P = 0.597, P = 0.41), place of residence (P = 0.215), depression (P = 0.501), grade point average (P = 0.488), academic satisfaction (P = 0.183) and chronic pain weren't significantly correlated with chronic pain in nursing students. The results of the multiple logistic regression models showed that chronic pain was positively correlated with age, social support, state anxiety, and trait anxiety (OR = 1.07, 95% CI: 1.02-1.12; OR = 0.95, 95% CI: 0.93-0.97; OR = 1.03, 95% CI: 1.02-1.05; and OR = 1.97, 95% CI: 0.95-1.99; respectively). CONCLUSION The prevalence of chronic pain was relatively high in these students. In addition, age, social support, and anxiety could be important factors in the development or persistence of chronic pain in nursing students. The results also provided basic and essential information about the contributing factors in this area. However, consideration of factors such as referral for treatment, home medications for pain relief, and outcomes of chronic pain are suggested in future longitudinal studies.
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Affiliation(s)
- Maryam Shaygan
- Community Based Psychiatric Care Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Banafsheh Tehranineshat
- Department of Nursing, Faculty of Nursing and Midwifery, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
| | - Saeed Hosseini Teshnizi
- Department of Community Medicine, School of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Agrin Mohammadi
- Student Research Committee, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
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Overmann L, Schleip R, Michalak J. Exploring fascial properties in patients with depression and chronic neck pain: An observational study. Acta Psychol (Amst) 2024; 244:104214. [PMID: 38461580 DOI: 10.1016/j.actpsy.2024.104214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 02/29/2024] [Accepted: 03/07/2024] [Indexed: 03/12/2024] Open
Abstract
BACKGROUND Depressive disorder and chronic pain are prevalent conditions that often co-occur. The myofascial fascial continuum has been hypothesized to contribute to both conditions. However, limited research exists on the specific association between fascial properties and chronic pain and depression. OBJECTIVE This study aims to investigate the properties of the deep fascia of the M. trapezius and their relationship with depression, chronic neck pain, and cervical spine mobility. METHOD This study compared fascial properties between two groups: individuals with depression and chronic neck pain, and healthy individuals. Fascial thickness, elasticity, and stiffness were measured as primary outcomes using standardized techniques such as ultrasound imaging and compliance meter. Statistical analyses were conducted to identify potential differences and correlations in fascial properties between the two groups. RESULT Significant differences emerge in stiffness, tone, and fascia thickness in the deep fascia, alongside identified correlations between depression, chronic pain, and these variables. CONCLUSION The study highlights the impact of depression and chronic pain on fascial properties, emphasizing the need for further research in this domain to unravel the intricate connections and potential implications for treatment strategies.
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Affiliation(s)
- Lea Overmann
- Department of Psychology, University of Witten-Herdecke, Germany
| | - Robert Schleip
- Department of Sport and Health Sciences, Technical University Munich, Germany
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Oloruntoba O, Bergeron CD, Zhong L, Merianos AL, Sherman LD, Kew CL, Goidel RK, Smith ML. Pharmacological Prescribing and Satisfaction with Pain Treatment Among Non-Hispanic Black Men with Chronic Pain. Patient Prefer Adherence 2024; 18:187-195. [PMID: 38264322 PMCID: PMC10804868 DOI: 10.2147/ppa.s435652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 12/15/2023] [Indexed: 01/25/2024] Open
Abstract
Introduction Pharmacological strategies are often central to chronic pain management; however, pain treatment among non-Hispanic Black men may differ because of their disease profiles and healthcare interactions. However, less is known about pain medication prescribing and patients' satisfaction with pain treatment and management among non-Hispanic Black men with self-reported chronic pain. Purpose This study assessed factors associated with non-Hispanic Black men being prescribed/recommended narcotics/opioids for chronic pain and their satisfaction with pain treatment/management. Methods Data were analyzed from 286 non-Hispanic Black men with chronic pain who completed an internet-delivered questionnaire. Participants were recruited nationwide using a Qualtrics web-based panel. Logistic regression was used to identify factors associated with being prescribed/recommended narcotics/opioids for pain management treatment. Then, ordinary least squares regression was used to identify factors associated with their satisfaction level with the pain treatment/management received. Results On average, participants were 56.2 years old and 48.3% were prescribed/recommended narcotics/opioids for chronic pain. Men with more chronic conditions (Odds Ratio [OR] = 0.57, P = 0.043) and depression/anxiety disorders (OR = 0.53, P = 0.029) were less likely to be prescribed/recommended narcotics/opioids. Men who were more educated (OR = 2.09, P = 0.044), reported more frequent chronic pain (OR = 1.28, P = 0.007), and were allowed to participate more in decisions about their pain treatment/management (OR = 1.11, P = 0.029) were more likely to be prescribed/recommended narcotics/opioids. On average, men with more frequent chronic pain (B = -0.25, P = 0.015) and pain problems (B = -0.16, P = 0.009) were less satisfied with their pain treatment/management. Men who were allowed to participate more in decisions about their pain treatment/management reported higher satisfaction with their pain treatment/management (B = 0.55, P < 0.001). Conclusion Playing an active role in pain management can improve non-Hispanic Black men's satisfaction with pain treatment/management. This study illustrates the importance of patient-centered approaches and inclusive patient-provider interactions to improve chronic pain management.
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Affiliation(s)
- Oluyomi Oloruntoba
- Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, TX, USA
| | | | - Lixian Zhong
- Department of Pharmaceutical Sciences, Rangel School of Pharmacy, Texas A&M University, College Station, TX, USA
| | - Ashley L Merianos
- School of Human Services, University of Cincinnati, Cincinnati, OH, USA
| | - Ledric D Sherman
- Department of Health Behavior, School of Public Health, Texas A&M University, College Station, TX, USA
- Center for Health Equity and Evaluation Research, Texas A&M University, College Station, TX, USA
| | - Chung Lin Kew
- Department of Health Behavior, School of Public Health, Texas A&M University, College Station, TX, USA
| | - R Kirby Goidel
- Public Policy Research Institute, Texas A&M University, College Station, TX, USA
| | - Matthew Lee Smith
- Department of Health Behavior, School of Public Health, Texas A&M University, College Station, TX, USA
- Center for Health Equity and Evaluation Research, Texas A&M University, College Station, TX, USA
- Center for Community Health and Aging, Texas A&M University, College Station, TX, USA
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Wang F, Cheung CW, Wong SSC. Use of pain-related gene features to predict depression by support vector machine model in patients with fibromyalgia. Front Genet 2023; 14:1026672. [PMID: 37065490 PMCID: PMC10090498 DOI: 10.3389/fgene.2023.1026672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 03/20/2023] [Indexed: 03/31/2023] Open
Abstract
The prevalence rate of depression is higher in patients with fibromyalgia syndrome, but this is often unrecognized in patients with chronic pain. Given that depression is a common major barrier in the management of patients with fibromyalgia syndrome, an objective tool that reliably predicts depression in patients with fibromyalgia syndrome could significantly enhance the diagnostic accuracy. Since pain and depression can cause each other and worsen each other, we wonder if pain-related genes can be used to differentiate between those with major depression from those without. This study developed a support vector machine model combined with principal component analysis to differentiate major depression in fibromyalgia syndrome patients using a microarray dataset, including 25 fibromyalgia syndrome patients with major depression, and 36 patients without major depression. Gene co-expression analysis was used to select gene features to construct support vector machine model. The principal component analysis can help reduce the number of data dimensions without much loss of information, and identify patterns in data easily. The 61 samples available in the database were not enough for learning based methods and cannot represent every possible variation of each patient. To address this issue, we adopted Gaussian noise to generate a large amount of simulated data for training and testing of the model. The ability of support vector machine model to differentiate major depression using microarray data was measured as accuracy. Different structural co-expression patterns were identified for 114 genes involved in pain signaling pathway by two-sample KS test (p < 0.001 for the maximum deviation D = 0.11 > Dcritical = 0.05), indicating the aberrant co-expression patterns in fibromyalgia syndrome patients. Twenty hub gene features were further selected based on co-expression analysis to construct the model. The principal component analysis reduced the dimension of the training samples from 20 to 16, since 16 components were needed to retain more than 90% of the original variance. The support vector machine model was able to differentiate between those with major depression from those without in fibromyalgia syndrome patients with an average accuracy of 93.22% based on the expression levels of the selected hub gene features. These findings would contribute key information that can be used to develop a clinical decision-making tool for the data-driven, personalized optimization of diagnosing depression in patients with fibromyalgia syndrome.
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Yalew ES, Melese AZ, Guadie YG, Abich Y, Kassa T, Gashaw M. Magnitude of depression and associated risk factors among patients with musculoskeletal disorder treated in physiotherapy outpatient department in Amhara region comprehensive specialized hospital in Ethiopia: a prospective cross-sectional study. BMC Psychiatry 2023; 23:189. [PMID: 36949431 PMCID: PMC10035282 DOI: 10.1186/s12888-023-04658-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 03/06/2023] [Indexed: 03/24/2023] Open
Abstract
BACKGROUND The state of depression that can lead to substance and drug abuse, as well as an increased risk of suicide. Without a doubt, the link between musculoskeletal pain and depression compromises a person's health and drastically lowers their quality of life, resulting in increased incapacity. Depression and musculoskeletal discomfort are two well-known risk factors for long-term sickness absence, which is defined as a period of sickness lasting more than a week, which means chronic musculoskeletal pains, particularly multiple pains, are linked to depression. And early diagnosis and care of depression in musculoskeletal disorder are critical to patients' physical, functional, and occupational results. This study aimed to assess the magnitude of depression and associated risk factors among patients with musculoskeletal disorder. METHOD Multi-institution cross-sectional study conducted in Amhara region Comprehensive specialized Hospitals from April 1st to May 30th, 2021. The data was collected from 217 participants through interview administrative questioner and patient medical record review. Binary logistic regression was used to identify associated risk factors of depression. The strength of the association was detected by the adjusted odds ratio. RESULT A total of 217 participate in this study with the age range of 18-80 years. Among the study participants, 57.1% (n = 124) (AOR: 95% CI: 50.7-63.6) were had depression. Treatment duration, and social support were significantly association with depression among patient with musculoskeletal disorder with P < 0.05. CONCLUSION The magnitude of depression was relatively high among musculoskeletal disorder patients treated in physiotherapy out-patient department. The length of treatment duration (hospital stay) and the status of social support from families and friends were significantly associated with depression among patients with musculoskeletal disorders. A multidisciplinary strategy is required for diagnosing and treating depression in patients with musculoskeletal disorder.
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Affiliation(s)
- Ermias Solomon Yalew
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, University of Gondar Comprehensive Specialized Hospital, P.O. Box: 196, Gondar, Ethiopia.
| | - Ashenafi Zemed Melese
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, University of Gondar Comprehensive Specialized Hospital, P.O. Box: 196, Gondar, Ethiopia
| | - Yisak Girma Guadie
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, University of Gondar Comprehensive Specialized Hospital, P.O. Box: 196, Gondar, Ethiopia
| | - Yohannes Abich
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, University of Gondar Comprehensive Specialized Hospital, P.O. Box: 196, Gondar, Ethiopia
| | - Tesfa Kassa
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, University of Gondar Comprehensive Specialized Hospital, P.O. Box: 196, Gondar, Ethiopia
| | - Moges Gashaw
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, University of Gondar Comprehensive Specialized Hospital, P.O. Box: 196, Gondar, Ethiopia
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Mullins PM, Yong RJ, Bhattacharyya N. Associations between chronic pain, anxiety, and depression among adults in the United States. Pain Pract 2023. [PMID: 36881021 DOI: 10.1111/papr.13220] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 02/10/2023] [Accepted: 02/24/2023] [Indexed: 03/08/2023]
Abstract
OBJECTIVE The objective of the study was to determine the associations of depression and anxiety with chronic pain among U.S. adults. SETTING Nationally representative cross-sectional survey analysis. METHODS The National Health Interview Survey for 2019 was analyzed with respect to the chronic pain module and embedded depression and anxiety scales (PHQ-8 and GAD-7). Univariate associations between the presence of chronic pain and depression and anxiety scores were determined. Similarly, associations between the presence of chronic pain and the adults' treating with medications for depression and anxiety were also determined. Odds ratios, adjusted for age and sex, were computed for these associations. RESULTS Among 244.6 million sampled U.S. adults, 50.2 million (95% confidence interval, 48.2-52.2 million) reported chronic pain (20.5%, [19.9%-21.2%] of the population). Adults with chronic pain had elevated severity of depressive symptoms (PHQ-8 categories: none/minimal: 57.6%, mild: 22.3%, moderate: 11.4%, and severe: 8.7%) versus those without chronic pain (87.6%, 8.8%, 2.3%, and 1.2%; p < 0.001). Adults with chronic pain had elevated severity of anxiety symptoms (GAD-7 categories: none/minimal: 66.4%, mild: 17.1%, moderate: 8.5%, severe: 8.0%) versus those without chronic pain (89.0%, 7.5%, 2.1%, and 1.4%; p < 0.001). 22.4% and 24.5% of chronic pain sufferers were taking medication for depression and anxiety versus 6.6% and 8.5% of those without chronic pain, respectively (both p < 0.001). Adjusted odds ratios for the association of chronic pain with increasing severity of depression or anxiety and taking a depression or anxiety medication were 6.32 (5.82-6.85), 5.63 (5.15-6.15), 3.98 (3.63-4.37), and 3.42 (3.12-3.75), respectively. CONCLUSIONS The presence of chronic pain in adults associated with significantly higher severity scores for both anxiety and depression as measured by validated surveys in a nationally representative sample. The same is true for the association between chronic pain and an adult taking medication for depression and/or anxiety. These data highlight the impact of chronic pain has on psychological well-being within the general population.
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Affiliation(s)
- Peter M Mullins
- Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Women's Hospital, Harvard University, Boston, Massachusetts, USA
| | - Robert Jason Yong
- Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Women's Hospital, Harvard University, Boston, Massachusetts, USA
| | - Neil Bhattacharyya
- Department of Otolaryngology, Massachusetts Eye and Ear & Harvard Medical School, Boston, Massachusetts, USA
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Puto G, Repka I, Muszalik M. Factors Correlating with Functional Capacity in Older People with Chronic Pain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2748. [PMID: 36768110 PMCID: PMC9915534 DOI: 10.3390/ijerph20032748] [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: 12/14/2022] [Revised: 01/26/2023] [Accepted: 02/01/2023] [Indexed: 06/18/2023]
Abstract
INTRODUCTION Chronic pain in older people is a global health problem not only in terms of a negative subjective feeling, but also as a social and economic factor. Deterioration of functional capacity is one of the main symptoms of chronic pain; therefore, it should be assessed as a basic parameter in the life of older people. The aim of the study was to analyze the factors which have an impact on the functional capacity of older people with chronic pain. MATERIAL AND METHODS The study was conducted among 181 people over 65 suffering from chronic pain lasting more than 6 months. The study used a questionnaire that included questions about demographic and social characteristics and the following scales: Abbreviated Mental Score (AMTS), Personal Activities of Daily Living (PADL) by Katz, Instrumental Activities of Daily Living (IADL) by Lawton, Geriatric Pain Measure-24 (GPM-24). RESULTS In the study group, a positive correlation was found between: coexisting diseases and withdrawal due to pain, pain intensity, pain resulting from walking or from the effort from other activities, and in terms of the total GPM-24 score. A positive correlation was also found between the Geriatric Depression Scale (GDS) and withdrawal due to pain, pain intensity, pain resulting from walking or from the effort from other activities, and in terms of the total GPM-24 score. A significantly negative correlation was found between: AMTS, ADL, IADL performance and: withdrawal due to pain, pain intensity, pain resulting from walking or from the effort from other activities, and in terms of total GPM-24 score. CONCLUSIONS Chronic pain is more common in people with disabilities in basic and complex activities of daily living, with limited efficiency in cognitive functions and an increased sense of depression. The standard in everyday practice and clinical trials should be taking a history of chronic pain in every older person, monitoring the pain's intensity and accompanying characteristics by using a multidimensional scale for assessing pain in older people.
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Affiliation(s)
- Grażyna Puto
- Institute of Nursing and Midwifery, Faculty of Health Sciences, Jagiellonian University Medical College, Kopernika 25 Street, 31-501 Krakow, Poland
| | - Iwona Repka
- Institute of Nursing and Midwifery, Faculty of Health Sciences, Jagiellonian University Medical College, Kopernika 25 Street, 31-501 Krakow, Poland
| | - Marta Muszalik
- Department of Geriatrics, Faculty of Health Sciences, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz, 85-094 Bydgoszcz, Poland
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Dai J, Kim H, You Z, McCabe MF, Zhang S, Wang S, Lim G, Chen L, Mao J. Role of 5-HT1A-mediated upregulation of brain indoleamine 2,3 dioxygenase 1 in the reduced antidepressant and antihyperalgesic effects of fluoxetine during maintenance treatment. Front Pharmacol 2022; 13:1084108. [PMID: 36588734 PMCID: PMC9800882 DOI: 10.3389/fphar.2022.1084108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Accepted: 12/09/2022] [Indexed: 12/23/2022] Open
Abstract
The reduced antidepressant and antihyperalgesic effects of selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine during maintenance treatment has been reported, but little is known about the molecular mechanism of this phenomenon. In three comorbid pain and depression animal models (genetic predisposition, chronic social stress, arthritis), we showed that the fluoxetine's antidepressant and antihyperalgesic effects were reduced during the maintenance treatment. Fluoxetine exposure induced upregulation of the 5-hydroxytryptamine 1A (5-HT1A) auto-receptor and indoleamine 2,3 dioxygenase 1 (IDO1, a rate-limiting enzyme of tryptophan metabolism) in the brainstem dorsal raphe nucleus (DRN), which shifted the tryptophan metabolism away from the 5-HT biosynthesis. Mechanistically, IDO1 upregulation was downstream to fluoxetine-induced 5-HT1A receptor expression because 1) antagonism of the 5-HT1A receptor with WAY100635 or 5-HT1A receptor knockout blocked the IDO1 upregulation, and 2) inhibition of IDO1 activity did not block the 5-HT1A receptor upregulation following fluoxetine exposure. Importantly, inhibition of either the 5-HT1A receptor or IDO1 activity sustained the fluoxetine's antidepressant and antihyperalgesic effects, indicating that 5-HT1A-mediated IDO1 upregulation in the brainstem DRN contributed to the reduced antidepressant and antihyperalgesic effects of fluoxetine. These results suggest a new strategy to improving the therapeutic efficacy of SSRI during maintenance treatment.
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Affiliation(s)
- Jiajia Dai
- MGH Center for Translational Pain Research, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States,Department of Anesthesiology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Hyangin Kim
- MGH Center for Translational Pain Research, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States,*Correspondence: Jianren Mao, ; Hyangin Kim,
| | - Zerong You
- MGH Center for Translational Pain Research, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Michael F. McCabe
- MGH Center for Translational Pain Research, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Shuzhuo Zhang
- MGH Center for Translational Pain Research, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Shiyu Wang
- MGH Center for Translational Pain Research, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Grewo Lim
- MGH Center for Translational Pain Research, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Lucy Chen
- MGH Center for Translational Pain Research, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Jianren Mao
- MGH Center for Translational Pain Research, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States,*Correspondence: Jianren Mao, ; Hyangin Kim,
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John H, Lim YH, Hong SJ, Jeong JH, Choi HR, Park SK, Kim JE, Kim BS, Kim JH. Impact of coronavirus disease 2019 on patients with chronic pain: multicenter study in Korea. Korean J Pain 2022; 35:209-223. [PMID: 35354684 PMCID: PMC8977200 DOI: 10.3344/kjp.2022.35.2.209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 12/27/2021] [Accepted: 12/31/2021] [Indexed: 11/23/2022] Open
Abstract
Background The coronavirus disease 2019 (COVID-19) pandemic has caused significant changes. This study aimed to investigate the impact of COVID-19 on patients with chronic pain. Methods Patients with chronic pain from 23 university hospitals in South Korea participated in this study. The anonymous survey questionnaire consisted of 25 questions regarding the following demographic data, diagnosis, hospital visit frequency, exercise duration, time outside, sleep duration, weight change, nervousness and anxiety, depression, interest or pleasure, fatigue, daily life difficulties, and self-harm thoughts. Depression severity was evaluated using the Patient Health Questionnaire-9 (PHQ-9). Logistic regression analysis was used to investigate the relationship between increased pain and patient factors. Results A total of 914 patients completed the survey, 35.9% of whom had decreased their number of visits to the hospital, mostly due to COVID-19. The pain level of 200 patients has worsened since the COVID-19 outbreak, which was more prominent in complex regional pain syndrome (CRPS). Noticeable post-COVID-19 changes such as exercise duration, time spent outside, sleep patterns, mood, and weight affected patients with chronic pain. Depression severity was more significant in patients with CRPS. The total PHQ-9 average score of patients with CRPS was 15.5, corresponding to major depressive orders. The patients’ decreased exercise duration, decreased sleep duration, and increased depression were significantly associated with increased pain. Conclusions COVID-19 has caused several changes in patients with chronic pain. During the pandemic, decreased exercise and sleep duration and increased depression were associated with patients’ increasing pain.
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Affiliation(s)
- Hyunji John
- Department of Anesthesiology and Pain Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Yun Hee Lim
- Department of Anesthesiology and Pain Medicine, Inje University Sanggye Paik Hospital, Seoul, Korea
| | - Sung Jun Hong
- Department of Anesthesiology and Pain Medicine, Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea
| | - Jae Hun Jeong
- Department of Anesthesiology and Pain Medicine, Jeong-clinic, Seoul, Korea
| | - Hey Ran Choi
- Department of Anesthesiology and Pain Medicine, Inje University Seoul Paik Hospital, Seoul, Korea
| | - Sun Kyung Park
- Department of Anesthesiology and Pain Medicine, Jeju National University School of Medicine, Jeju, Korea
| | - Jung Eun Kim
- Department of Anesthesiology and Pain Medicine, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea
| | - Byung-Soo Kim
- Department of Anesthesiology and Pain Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Jae Hun Kim
- Department of Anesthesiology and Pain Medicine, Konkuk University School of Medicine, Seoul, Korea
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Roldán-Majewski C, Broedel E, von Korff M, Rammelsberg P, Schindler HJ, Giannakopoulos NN. Diagnostic accuracy of the Pain (P), Enjoyment (E), and General activity (G) scale, a three-item questionnaire, for grading the impact of orofacial pain-related dysfunction. Pain 2022; 163:e540-e546. [PMID: 34261977 DOI: 10.1097/j.pain.0000000000002406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Accepted: 06/23/2021] [Indexed: 11/25/2022]
Abstract
ABSTRACT Purpose of this study was to examine the discriminative properties of the 3-item Pain (P), Enjoyment (E), and General activity (G) (PEG) questionnaire for grading impact of nondental orofacial pain. Two hundred eighty-six consecutive patients with orofacial pain of nondental origin filled out the PEG questionnaire and Graded Chronic Pain Scale (GCPS, version 2). Correlation between the PEG and GCPS scores, internal consistency of the PEG, and differences between groups were examined statistically (level of significance: P ≤ 0.05). The mean (±SD) age of the 213 patients (158 female) who were included in the analysis was 43.1 (±16.7) years. Of the sample, 48.8% (n = 104) had some degree of orofacial pain-related disability (mean overall characteristic pain intensity: 51.2 ± 23.2, average overall PEG score: 4.3 ± 2.7, and average PHQ-9 score: 8.2 ± 6.5). No significant differences were found between the sexes for any score. The number of disability points (GCPS) and overall PEG score showed a strong and positive correlation (Spearman ρ = 0.77, P < 0.001). The internal consistency of the PEG questionnaire was high (Cronbach α = 0.86). Assuming 3 different levels of orofacial pain-related disability (mild, moderate, and severe), we obtained overall accuracy of 69.01%, with high specificity for mild and severe cases. The 3 PEG groups (mild, moderate, or severe) differed from each other significantly regarding their clinical grading according to the GCPS (Kruskal-Wallis, P < 0.001). Analysis of the receiver operating characteristic curve showed that a single cutoff value of 3.8 points in the PEG score yields adequate validity (sensitivity = 0.91 and specificity = 0.78). The proposed 2 cutoff points (upper = 7 and lower = 4) yield low sensitivity for the upper threshold. The 3-item PEG questionnaire is suitable for grading impact of nondental orofacial pain.
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Affiliation(s)
| | - Elias Broedel
- Private dental office of Dr. Szabo & Partners, Offenbach am Main, Germany
| | - Michael von Korff
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, United States
| | - Peter Rammelsberg
- Department of Prosthodontics, Heidelberg University Hospital, Heidelberg, Germany
| | | | - Nikolaos Nikitas Giannakopoulos
- Department of Prosthodontics, Würzburg University Hospital, Würzburg, Germany
- Department of Prosthodontics, National and Kapodistrian University, Athens, Greece
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Gupta M, Malik T, Sinha C. Delivery of a Mental Health Intervention for Chronic Pain Through an Artificial Intelligence-Enabled App (Wysa): Protocol for a Prospective Pilot Study. JMIR Res Protoc 2022; 11:e36910. [PMID: 35314423 PMCID: PMC9015778 DOI: 10.2196/36910] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 03/07/2022] [Accepted: 03/21/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Patients with chronic pain often suffer from coexisting, long-term and debilitating mental health comorbidities such as depression and anxiety. Artificial Intelligence Supported Cognitive Behavioral Therapy or AI-CBT interventions could offer cost-effective, accessible, and potentially effective resources to tackle this problem. However, there is not enough research conducted about the efficacy of AI-CBT interventions for chronic pain. OBJECTIVE This prospective cohort study aims to examine the efficacy and usage of an AI-CBT intervention for chronic pain (Wysa for Chronic Pain app), using a conversational agent (with no human intervention). To the best of our knowledge, this is the first such study for chronic pain using a fully-automated, free-text-based conversational agent (CA). METHODS Participants with self-reported chronic pain (N = 500) will be recruited online on a rolling basis from April 2022 through posts on US-based internet communities within this prospective cohort. Informed consent is taken from the participants within the app and the Wysa intervention is delivered remotely for 8 weeks. Outcome measures including NPRS (Numeric Pain Rating Scale), PROMIS PI (Patient-Reported Outcomes Measurement Information System Pain Interference), GAD-7 (Generalized Anxiety Disorder), and PHQ-9 (Patient Health Questionnaire) questionnaires will be administered to test the effectiveness of the intervention on reducing levels of pain interference, depression, and anxiety. The therapeutic alliance created with the conversational agent will be assessed through the WAI-SR (Working Alliance Inventory-Short Revised). Retention and usage statistics will be observed for adherence and engagement. RESULTS The study will open for recruitment in April 2022 and data collection is expected to be completed by August 2022. The results for the primary outcomes are expected to be published by late-2022. CONCLUSIONS Mental health conversational agents driven by artificial intelligence (AI) could be effective in helping patients with chronic pain learn to self-manage their pain and deal with common comorbidities like depression and anxiety. The Wysa for Chronic Pain app is one such digital intervention that can potentially serve as a solution to the problems of affordability and scalability associated with interventions with a human therapist in loop. This prospective study examines the efficacy of the app as a treatment solution for chronic pain. It aims to inform future practices and digital mental health interventions for individuals with chronic pain. CLINICALTRIAL
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Shaygan M, Jaberi A, Firozian R, Yazdani Z, Zarifsanaiey N. Effect of a multimedia training programme for pain management on pain intensity and depression in patients with non-specific chronic back pain. INVESTIGACION Y EDUCACION EN ENFERMERIA 2022; 40:e13. [PMID: 35485626 PMCID: PMC9052722 DOI: 10.17533/udea.iee.v40n1e13] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 03/03/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVES To determine the effect of multimedia training on pain intensity and depression in patients with chronic low back pain. METHODS In this randomized controlled trial study, the intervention group was trained about pain management consisted of communication skills, assertiveness, stress management, lifestyle enhancement skills and physical activity prepared in seven CDs using multimedia method and the control group received routine training included physician's visits, medication prescriptions and receiving the recommendations of the physician and healthcare providers. Beck Depression Inventory and Jensen Pain Questionnaire were completed for the two groups in three stages: pre-training, post-training and 2 months thereafter. RESULTS The results showed that there were no significant statistical difference between two groups in terms of demographic variables indicated homogeneity of research groups. Repeated measure ANOVA showed that the mean scores of pain intensity and depression changed significantly over time in both control and intervention groups (p<0.001); however, the effect of the group was not significant (p=0.565, p=0.748, respectively). Hence, the results of time-group interaction showed that there was significant difference between the two groups in terms of pain intensity and depression (p<0.001, p=0.003, respectively). The effect size revealed that the difference between mean scores of depression before and after the intervention in the both group was high (1.04 and 1.45, respectively). CONCLUSIONS The study results indicated that multimedia training has the potential in relieving pain intensity and depression in patients with non-specific chronic low back pain.
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Alsalman M, Alhabrati A, Alkuwaiti A, Alramadhan N, AlMurayhil N, Althafar A, Alsaad A. Depression among patient with sickle cell disease: Prevalence and prediction. Niger J Clin Pract 2022; 25:1274-1278. [DOI: 10.4103/njcp.njcp_50_22] [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]
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14
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Roohafza H, Yavari N, Feizi A, Khani A, Saneian P, Bagherieh S, Sattar F, Sadeghi M. Determinants of depression in non-cardiac chest pain patients: a cross sectional study. Korean J Pain 2021; 34:417-426. [PMID: 34593659 PMCID: PMC8494964 DOI: 10.3344/kjp.2021.34.4.417] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 04/03/2021] [Accepted: 04/06/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Non-cardiac chest pain (NCCP) is a common patient complaint imposing great costs on the healthcare system. It is associated with psychological factors such as depression. The aim of the present study is determining depression predictors in NCCP patients. METHODS The participants of this cross-sectional study were 361 NCCP patients. Patients filled out questionnaires concerning their sociodemographic, lifestyle, and clinical factors (severity of pain, type D personality, somatization, cardiac anxiety, fear of body sensations, and depression). RESULTS Based on multiple ordinal logistic regression, lack of physical activity (odds ratio [OR], 1.78; 95% confidence interval [CI], 1.09-2.87), sleep quality (OR, 2.98; 95% CI, 1.15-7.69), being a smoker (OR, 1.33; 95% CI, 2.41-4.03), present pain intensity (OR, 1.08; 95% CI, 1.05-1.11), type D personality (OR, 2.43; 95% CI, 1.47- 4.03), and somatization (OR, 1.22; 95% CI, 1.15-1.3) were significant predictors of depression in NCCP patients. Additionally, multiple linear regression showed that being unmarried (β = 1.51, P = 0.008), lack of physical activity (β = 1.22, P = 0.015), sleep quality (β = 2.26, P = 0.022), present pain intensity (β = 0.07, P = 0.045), type D personality (β = 1.87, P < 0.001), somatization (β = 0.45, P < 0.001), and fear of bodily sensation (β = 0.04, P = 0.032) increased significantly depression scores in NCCP patients. CONCLUSIONS Physicians should consider the predictors of depression in NCCP patients which can lead to receiving effective psychological consultations and reducing the costs and ineffectual referrals to medical centers.
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Affiliation(s)
- Hamidreza Roohafza
- Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Niloufar Yavari
- Students’ Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Awat Feizi
- Department of Biostatistics and Epidemiology, School of Health and Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Azam Khani
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Parsa Saneian
- Students’ Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sara Bagherieh
- Students’ Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fereshteh Sattar
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Masoumeh Sadeghi
- Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
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Koç M, Bazancir Z, Apaydın H, Talu B, Bayar K. Cross-cultural adaptation and validation of the Turkish Yellow Flag Questionnaire in patients with chronic musculoskeletal pain. Korean J Pain 2021; 34:501-508. [PMID: 34593668 PMCID: PMC8494960 DOI: 10.3344/kjp.2021.34.4.501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 06/29/2021] [Accepted: 07/23/2021] [Indexed: 11/05/2022] Open
Abstract
Background Yellow flags are psychosocial factors shown to be indicative of longterm chronicity and disability. The purpose of the study was to evaluate the psychometric properties of the Turkish Yellow Flag Questionnaire (YFQ) in patients with chronic musculoskeletal pain (CMP). Methods The cross-cultural adaptation was conducted with translation and backtranslation of the original version. Reliability (internal consistency and test-retest) was examined for 231 patients with CMP. Construct validity was assessed by correlating the YFQ with the Hospital Anxiety and Depression Scale (HADS), Orebro Musculoskeletal Pain Questionnaire (OMPQ), and Tampa Kinesiophobia Scale (TKS). Factorial validity was examined with both exploratory and confirmatory factorial analysis. Results The YFQ showed excellent test/retest reliability with an Intraclass correlation coefficient of 0.82. The internal consistency was moderate (Cronbach's alpha of 0.797). As a result of the exploratory factor analysis, there were 7 domains compatible with the original version. As a result of confirmatory factor analysis, the seven-factor structure of YFQ was confirmed. There was a statistically significant correlation between YFQ-total score and OMPQ (r = 0.57, P < 0.001), HADS-anxiety (r = 0.32, P < 0.001), HADS-depression (r = 0.44, P < 0.001), and TKS (r = 0.37, P < 0.001). Conclusions This study's results provide considerable evidence that the Turkish version of the YFQ has appropriate psychometric properties, including test-retest reliability, internal consistency, construct validity and factorial validity. It can be used for evaluating psychosocial impact in patients with CMP.
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Affiliation(s)
- Meltem Koç
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Muğ la Sıtkı Koçman University, Muğ la, Turkey
| | - Zilan Bazancir
- Department of Physiotherapy and Rehabilitation, Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Hakan Apaydın
- Department of Rheumatology, Ankara City Hospital, Ankara, Turkey
| | - Burcu Talu
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Inonu University, Malatya, Turkey
| | - Kılıçhan Bayar
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Muğ la Sıtkı Koçman University, Muğ la, Turkey
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Pain, Sleep, and Health-Related Quality of Life after Multidisciplinary Intervention for Chronic Pain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910233. [PMID: 34639534 PMCID: PMC8508437 DOI: 10.3390/ijerph181910233] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 09/24/2021] [Accepted: 09/24/2021] [Indexed: 12/15/2022]
Abstract
Multidisciplinary pain-management programs have the potential to decrease pain intensity, improve health-related quality of life (HRQOL), and increase sleep quality. In this longitudinal prospective cohort study, the aim was to investigate the long-term effects of multidisciplinary pain rehabilitation interventions in Iceland. More precisely, we (a) explored and described how individuals with chronic pain evaluated their pain severity, sleep, and HRQOL at pre-treatment and at one-year follow-up and (b) examined what predicted the participants' one-year follow-up HRQOL. Seventy-nine patients aged 20-68 years, most of whom were women (85%), responded. The participants scored their pain lower at one-year follow-up (p < 0.001). According to their response, most of them had disrupted sleep, mainly because of pain. One year after the treatment, more participants slept through the night (p = 0.004), and their HRQOL increased. Higher pre-treatment mental component summary (MCS) scores and having pursued higher education predicted higher MCS scores at one-year follow-up, and higher pre-treatment physical component summary (PCS) scores predicted higher PCS scores at one-year follow-up. Sleep problems, being a woman, and having children younger than 18 years of age predicted lower MCS scores at one-year follow-up. These findings are suggestive that patients should be examined with respect to their mental status, and it could be beneficial if they received some professional support after completing the intervention.
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Abstract
BACKGROUND Psychological factors influence or are associated with physical function, pain, and health care costs among individuals with musculoskeletal pain conditions. Recent clinical practice guidelines recommend screening for psychological factors (also referred to as "yellow flags") in physical therapy practice to help understand prognosis and inform shared decision making for treatment. CLINICAL QUESTION Despite the urgings of clinical practice guidelines and evidence of the influence of psychological factors on clinical outcomes, screening for yellow flags is uncommon in clinical practice. Clinicians may feel uncertain about how to integrate screening tools into clinical practice, and how screening results might inform decision making and care coordination. KEY RESULTS We outline a 3-step framework for routine yellow flag screening in physical therapy practice: (1) establish a standard first-line screening instrument and process, (2) interpret the results to inform shared decision making, and (3) monitor treatment progress. Four case examples illustrate how yellow flag screening can help clinicians and patients decide whether the patient might benefit most from standard physical therapy, psychologically informed physical therapy, psychologically informed physical therapy with referral to another health care provider, or immediate referral. CLINICAL APPLICATION Consider incorporating a standard yellow flag screening process into usual musculoskeletal health care. We present a framework to guide yellow flag screening in practice (1) to help inform treatment pathway selection and (2) to enhance interdisciplinary communication. J Orthop Sports Phys Ther 2021;51(9):459-469. doi:10.2519/jospt.2021.10570.
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Smyrnioti ME, Lyrakos G, Meindani M, Matsota P, Kostopanagiotou G, Batistaki C. The Impact of the First Wave of the COVID-19 Pandemic on Patients' Perceptions of Chronic Pain. J Pain Res 2021; 14:2571-2581. [PMID: 34456587 PMCID: PMC8387638 DOI: 10.2147/jpr.s323568] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 08/05/2021] [Indexed: 12/23/2022] Open
Abstract
Purpose On 10 March 2020, Greece entered an increasingly restrictive 42-day lockdown, in order to contain the first wave of the COVID-19 pandemic. All scheduled appointments and activities of the pain clinics around the country were postponed indefinitely. The aim of this prospective study was to assess the perceived impact of the first wave of the pandemic on pain, quality of life, and access to treatment, during the first austere lockdown in Greece. Patients and Methods In this cross-sectional study, 101 patients suffering from chronic pain completed a structured questionnaire. Levels of depression, anxiety, stress, personal wellbeing, optimism and personality traits were also evaluated, using the Depression, Anxiety and Stress Scale (DASS42), the Ten Item Personality Index (TIPI), the Life Orientation Test-Revised (GrLOT-R) and the Personal Wellbeing Index (PWI). Results Despite the dramatic decrease in health care visitations before, during and after the imposed lockdown, most patients did not feel that access to pain physicians and medication was significantly affected. Higher levels of stress, anxiety, depression, neuroticism, openness to experience and general satisfaction with life seemed to be important determinant factors in how patients experienced their level, intensity and duration of pain, quality of life and response to medication. Conclusion The effects of the lockdown had a more severe impact on patients than the pandemic itself. For most, the level of their pain was not affected by the pandemic and was affected only slightly by the lockdown. Quality of life, however, was affected formost participants. Both the necessity and the complications of introducing the use of telemedicine to Greek chronic pain patients became evident during the study.
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Affiliation(s)
- Maria Eleni Smyrnioti
- 2nd Department of Anaesthesiology, School of Medicine, National and Kapodistrian University of Athens, Pain Management Unit, Attikon Hospital, Athens, Greece
| | - Georgios Lyrakos
- Psychiatric Ward and Thalassaemia Transfusion Unit, General Hospital of Nikaia, Piraeus, Greece
| | - Maria Meindani
- 2nd Department of Anaesthesiology, School of Medicine, National and Kapodistrian University of Athens, Pain Management Unit, Attikon Hospital, Athens, Greece
| | - Paraskevi Matsota
- 2nd Department of Anaesthesiology, School of Medicine, National and Kapodistrian University of Athens, Pain Management Unit, Attikon Hospital, Athens, Greece
| | - Georgia Kostopanagiotou
- 2nd Department of Anaesthesiology, School of Medicine, National and Kapodistrian University of Athens, Pain Management Unit, Attikon Hospital, Athens, Greece
| | - Chrysanthi Batistaki
- 2nd Department of Anaesthesiology, School of Medicine, National and Kapodistrian University of Athens, Pain Management Unit, Attikon Hospital, Athens, Greece
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Nguyen AT, Nguyen THT, Nguyen TTH, Nguyen HTT, Nguyen TX, Nguyen TN, Nguyen AL, Vu LG, Do HT, Doan LP, Vu GT, Nguyen HTT, Pham T, Vu HTT. Chronic Pain and Associated Factors Related to Depression among Older Patients in Hanoi, Vietnam. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179192. [PMID: 34501779 PMCID: PMC8431642 DOI: 10.3390/ijerph18179192] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 08/25/2021] [Accepted: 08/26/2021] [Indexed: 11/16/2022]
Abstract
The interaction of chronic pain and depression among older people has been studied for many years. This study aimed to investigate the frequency of chronic pain and depression among older patients and correlated factors. A cross-sectional study was conducted in 921 older patients at the National Geriatric Hospital from November 2019 to March 2020. We used the Charlson Comorbidity Index (CCI) to assess the comorbid condition, a numerical rating scale (NRS) to examine pain severity, and Geriatric Depression Scale-15 items (GDS-15) to measure depression among participants. A chi-square test and Tobit regression were used to analyze the relationships. A total of 921 older patients participated in the study. The proportion of depression accounted for 55.8%. The mean Charlson score and number of diseases were 1.2 and 4.7, respectively. A positive correlation was found between comorbidity and chronic pain and depression. Moreover, socio-demographic variables such as occupation, education, and income were associated with pain and depressive symptoms. This study highlights the issue of mental health in older people with chronic pain. The results indicate the necessity of frequent depression screening, pain management, and social activity programs for older people to enhance their health.
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Affiliation(s)
- Anh Trung Nguyen
- Department of Geriatrics, Hanoi Medical University, Hanoi 100000, Vietnam; (T.T.H.N.); (H.T.T.N.); (T.X.N.); (T.N.N.); (A.L.N.); (T.P.); (H.T.T.V.)
- Scientific Research Department, National Geriatric Hospital, Hanoi 100000, Vietnam
- Correspondence: ; Tel.: +84-090-348-0774
| | - Trang Huyen Thi Nguyen
- Institute for Global Health Innovations, Duy Tan University, Da Nang 550000, Vietnam; (T.H.T.N.); (L.G.V.)
- Faculty of Medicine, Duy Tan University, Da Nang 550000, Vietnam
| | - Thu Thi Hoai Nguyen
- Department of Geriatrics, Hanoi Medical University, Hanoi 100000, Vietnam; (T.T.H.N.); (H.T.T.N.); (T.X.N.); (T.N.N.); (A.L.N.); (T.P.); (H.T.T.V.)
- Scientific Research Department, National Geriatric Hospital, Hanoi 100000, Vietnam
| | - Huong Thi Thu Nguyen
- Department of Geriatrics, Hanoi Medical University, Hanoi 100000, Vietnam; (T.T.H.N.); (H.T.T.N.); (T.X.N.); (T.N.N.); (A.L.N.); (T.P.); (H.T.T.V.)
- Scientific Research Department, National Geriatric Hospital, Hanoi 100000, Vietnam
| | - Thanh Xuan Nguyen
- Department of Geriatrics, Hanoi Medical University, Hanoi 100000, Vietnam; (T.T.H.N.); (H.T.T.N.); (T.X.N.); (T.N.N.); (A.L.N.); (T.P.); (H.T.T.V.)
- Scientific Research Department, National Geriatric Hospital, Hanoi 100000, Vietnam
| | - Tam Ngoc Nguyen
- Department of Geriatrics, Hanoi Medical University, Hanoi 100000, Vietnam; (T.T.H.N.); (H.T.T.N.); (T.X.N.); (T.N.N.); (A.L.N.); (T.P.); (H.T.T.V.)
- Scientific Research Department, National Geriatric Hospital, Hanoi 100000, Vietnam
| | - Anh Lan Nguyen
- Department of Geriatrics, Hanoi Medical University, Hanoi 100000, Vietnam; (T.T.H.N.); (H.T.T.N.); (T.X.N.); (T.N.N.); (A.L.N.); (T.P.); (H.T.T.V.)
- Scientific Research Department, National Geriatric Hospital, Hanoi 100000, Vietnam
| | - Linh Gia Vu
- Institute for Global Health Innovations, Duy Tan University, Da Nang 550000, Vietnam; (T.H.T.N.); (L.G.V.)
- Faculty of Medicine, Duy Tan University, Da Nang 550000, Vietnam
| | - Hoa Thi Do
- Institute of Health Economics and Technology, Hanoi 100000, Vietnam; (H.T.D.); (L.P.D.)
| | - Linh Phuong Doan
- Institute of Health Economics and Technology, Hanoi 100000, Vietnam; (H.T.D.); (L.P.D.)
| | - Giang Thu Vu
- Center of Excellence in Evidence-Based Medicine, Nguyen Tat Thanh University, Ho Chi Minh City 700000, Vietnam;
| | - Huong Thi Thanh Nguyen
- Dinh Tien Hoang Institute of Medicine, Hanoi 100000, Vietnam;
- Physiology Department, Hanoi Medical University, Hanoi 100000, Vietnam
| | - Thang Pham
- Department of Geriatrics, Hanoi Medical University, Hanoi 100000, Vietnam; (T.T.H.N.); (H.T.T.N.); (T.X.N.); (T.N.N.); (A.L.N.); (T.P.); (H.T.T.V.)
- Scientific Research Department, National Geriatric Hospital, Hanoi 100000, Vietnam
| | - Huyen Thi Thanh Vu
- Department of Geriatrics, Hanoi Medical University, Hanoi 100000, Vietnam; (T.T.H.N.); (H.T.T.N.); (T.X.N.); (T.N.N.); (A.L.N.); (T.P.); (H.T.T.V.)
- Scientific Research Department, National Geriatric Hospital, Hanoi 100000, Vietnam
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Abstract
BACKGROUND Pain and depression have a high impact on caring for the people who need palliative care, but both of these are neglected compared with the approach for other symptoms encountered by these patients. AREAS OF UNCERTAINTY There are few studies in humans that support the existence of common neural circuits between depression and pain that also explore the use of drugs with effects in both conditions. More knowledge is needed about the relationship of these clinical entities that will lead to the optimization of the treatment and improvement of quality of life. DATA SOURCES We conducted a search in PubMed to identify relevant articles and reviews that have been published in the last 5 years, concerning the topic of common pathways between depression and pain (2014-April 2019). THERAPEUTIC ADVANCES The connections between the 2 clinical entities start at the level of the cortical regions. The hippocampus is the main site of neural changes, modification of the immune system, neuromodulators, neurotransmitters, and signaling pathways implicated in both conditions. Increased levels of peripheral proinflammatory cytokines and neuroinflammatory changes are related to the physiopathology of these entities. Inflammation links depression and pain by altering neural circuits and changes in their common cortical regions. Antidepressants are used to treat depression and chronic, pain but more experimental studies are needed to determine which antidepressant drugs are the most effective in treating the 2 entities. CONCLUSIONS Pharmacological and nonpharmacological interventions targeting cortical changes in pain and depression are promising, but more clinical studies are needed to validate their usefulness.
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Tenti M, Raffaeli W, Gremigni P. A Narrative Review of the Assessment of Depression in Chronic Pain. Pain Manag Nurs 2021; 23:158-167. [PMID: 33962870 DOI: 10.1016/j.pmn.2021.03.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 03/02/2021] [Accepted: 03/29/2021] [Indexed: 12/21/2022]
Abstract
OBJECTIVES This narrative review sought to explore the main critical issues in the assessment of depression in chronic pain and to identify self-report tools that can be reliably used for measuring it. DESIGN Narrative review of the literature. METHODS Articles were obtained through a search of three databases and a hand search of the references of full-text papers. Key results within the retrieved articles were summarized and integrated to address the review objectives. RESULTS Criterion contamination, different ways to define and evaluate pain and depression across studies, variability in chronic pain samples and settings, pitfalls of diagnostic systems and self-reports, and reluctance to address (or difficulty of recognizing) depression in patients and healthcare providers emerged as main critical issues. The Beck Depression Inventory seems to be the more accurate tool to evaluate depression in chronic pain patients, while other instruments such as the Patient Health Questionnaire could be recommended for a rapid screening. CONCLUSIONS Assessment of depression comorbidity in chronic pain represents a challenge in both research and clinical practice; the choice and use of tests, as well as the score interpretation, require clinical reasoning. NURSING PRACTICE IMPLICATIONS Nurses play an important role in screening for depression. Cognitive contents of depression should be carefully evaluated since somatic symptoms may be confusing in the chronic pain context. Some self-reports may be useful for rapid screening. It is also advisable to consider other relevant patient information in evaluating depression.
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Affiliation(s)
- Michael Tenti
- Fondazione ISAL, Institute for Research on Pain, Torre Pedrera, Italy
| | - William Raffaeli
- Fondazione ISAL, Institute for Research on Pain, Torre Pedrera, Italy.
| | - Paola Gremigni
- Department of Psychology, University of Bologna, Bologna, Italy
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A pain-induced tonic hypodopaminergic state augments phasic dopamine release in the nucleus accumbens. Pain 2021; 161:2376-2384. [PMID: 32453137 DOI: 10.1097/j.pain.0000000000001925] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Diseases and disorders such as Parkinson disease, schizophrenia, and chronic pain are characterized by altered mesolimbic dopaminergic neurotransmission. Dopamine release in the nucleus accumbens influences behavior through both tonic and phasic signaling. Tonic dopamine levels are hypothesized to inversely regulate phasic signals through dopamine D2 receptor feedback inhibition. We tested this hypothesis directly in the context of ongoing pain. Tonic and phasic dopamine signals were measured using fast-scan controlled-adsorption voltammetry and fast-scan cyclic voltammetry, respectively, in the nucleus accumbens shell of male rats with standardized levels of anesthesia. Application of capsaicin to the cornea produced a transient decrease in tonic dopamine levels. During the pain-induced hypodopaminergic state, electrically evoked phasic dopamine release was significantly increased when compared to baseline, evoked phasic release. A second application of capsaicin to the same eye had a lessened effect on tonic dopamine suggesting desensitization of TRPV1 channels in that eye. Capsaicin treatment in the alternate cornea, however, again produced coincident decreased dopaminergic tone and increased phasic dopamine release. These findings occurred independently of stimulus lateralization relative to the hemisphere of dopamine measurement. Our data show that (1) the mesolimbic dopamine circuit reliably encodes acute noxious stimuli; (2) ongoing pain produces decreases in dopaminergic tone; and (3) pain-induced decreases in tonic dopamine correspond to augmented evoked phasic dopamine release. Enhanced phasic dopamine neurotransmission resulting from salient stimuli may contribute to increased impulsivity and cognitive deficits often observed in conditions associated with decreased dopaminergic tone, including Parkinson disease and chronic pain.
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Sculpting Dendritic Spines during Initiation and Maintenance of Neuropathic Pain. J Neurosci 2021; 40:7578-7589. [PMID: 32998955 DOI: 10.1523/jneurosci.1664-20.2020] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 07/31/2020] [Accepted: 08/21/2020] [Indexed: 12/21/2022] Open
Abstract
Accumulating evidence has established a firm role for synaptic plasticity in the pathogenesis of neuropathic pain. Recent advances have highlighted the importance of dendritic spine remodeling in driving synaptic plasticity within the CNS. Identifying the molecular players underlying neuropathic pain induced structural and functional maladaptation is therefore critical to understanding its pathophysiology. This process of dynamic reorganization happens in unique phases that have diverse pathologic underpinnings in the initiation and maintenance of neuropathic pain. Recent evidence suggests that pharmacological targeting of specific proteins during distinct phases of neuropathic pain development produces enhanced antinociception. These findings outline a potential new paradigm for targeted treatment and the development of novel therapies for neuropathic pain. We present a concise review of the role of dendritic spines in neuropathic pain and outline the potential for modulation of spine dynamics by targeting two proteins, srGAP3 and Rac1, critically involved in the regulation of the actin cytoskeleton.
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Sheriffdeen A, Millar JL, Martin C, Evans M, Tikellis G, Evans SM. (Dis)concordance of comorbidity data and cancer status across administrative datasets, medical charts, and self-reports. BMC Health Serv Res 2020; 20:858. [PMID: 32917193 PMCID: PMC7488579 DOI: 10.1186/s12913-020-05713-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 09/03/2020] [Indexed: 01/22/2023] Open
Abstract
Background Benchmarking outcomes across settings commonly requires risk-adjustment for co-morbidities that must be derived from extant sources that were designed for other purposes. A question arises as to the extent to which differing available sources for health data will be concordant when inferring the type and severity of co-morbidities, how close are these to the “truth”. We studied the level of concordance for same-patient comorbidity data extracted from administrative data (coded from International Classification of Diseases, Australian modification,10th edition [ICD-10 AM]), from the medical chart audit, and data self-reported by men with prostate cancer who had undergone a radical prostatectomy. Methods We included six hospitals (5 public and 1 private) contributing to the Prostate Cancer Outcomes Registry-Victoria (PCOR-Vic) in the study. Eligible patients from the PCOR-Vic underwent a radical prostatectomy between January 2017 and April 2018.Health Information Manager’s in each hospital, provided each patient’s associated administrative ICD-10 AM comorbidity codes. Medical charts were reviewed to extract comorbidity data. The self-reported comorbidity questionnaire (SCQ) was distributed through PCOR-Vic to eligible men. Results The percentage agreement between the administrative data, medical charts and self-reports ranged from 92 to 99% in the 122 patients from the 217 eligible participants who responded to the questionnaire. The presence of comorbidities showed a poor level of agreement between data sources. Conclusion Relying on a single data source to generate comorbidity indices for risk-modelling purposes may fail to capture the reality of a patient’s disease profile. There does not appear to be a ‘gold-standard’ data source for the collection of data on comorbidities.
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Affiliation(s)
- A Sheriffdeen
- Department of Epidemiology & Preventive Medicine, Monash University, Melbourne, Australia
| | - J L Millar
- Department of Epidemiology & Preventive Medicine, Monash University, Melbourne, Australia.,William Buckland Radiotherapy Centre, The Alfred, Melbourne, Australia
| | - C Martin
- Department of Epidemiology & Preventive Medicine, Monash University, Melbourne, Australia
| | - M Evans
- Department of Epidemiology & Preventive Medicine, Monash University, Melbourne, Australia
| | - G Tikellis
- Department of Epidemiology & Preventive Medicine, Monash University, Melbourne, Australia
| | - S M Evans
- Department of Epidemiology & Preventive Medicine, Monash University, Melbourne, Australia.
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Chan FH, Suen H, Jackson T, Vlaeyen JW, Barry TJ. Pain-related attentional processes: A systematic review of eye-tracking research. Clin Psychol Rev 2020; 80:101884. [DOI: 10.1016/j.cpr.2020.101884] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 05/03/2020] [Accepted: 06/11/2020] [Indexed: 02/01/2023]
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Amiri S, Behnezhad S, Azad E. Back pain and depressive symptoms: A systematic review and meta-analysis. Int J Psychiatry Med 2020:91217420913001. [PMID: 32220220 DOI: 10.1177/0091217420913001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Low back pain is a common disorder that has many consequences. This study is an attempt to meta-analyze the risk of depression symptoms in back pain. METHOD Four databases were selected for review, and this search was conducted using key words. Eleven eligible articles were selected for review and meta-analysis was conducted. Subgroup analyses were continued with study design and the method of measuring depression. Also, the heterogeneity and publication bias were examined. RESULTS Eleven cohort and cross-sectional articles are used in the meta-analysis between back pain and depressive symptoms. The odds ratio 2.07 was calculated for this relationship. In prospective-cohort studies, 1.71 (95% confidence interval = 1.24-2.36) results indicated that back pain is a risk factor for depression symptoms and in cross-sectional studies, pooled odds ratio (2.33; 95% confidence interval = 1.29-4.21) showed that back pain is associated with depression symptoms. Some degree of publication bias was not found in the study. CONCLUSIONS Back pain is an effective factor in increasing the likelihood of depression. Adoption of effective prevention and treatment approaches can play an important role in reducing the psychological consequences in these individuals.
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Affiliation(s)
- Sohrab Amiri
- Behavioral Sciences Research Center, Lifestyle Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | | | - Esfandiar Azad
- Behavioral Sciences Research Center, Lifestyle Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
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Camacho-Conde JA, Campos-Arillo VM. The phenomenology of pain in Parkinson's disease. Korean J Pain 2020; 33:90-96. [PMID: 31888323 PMCID: PMC6944372 DOI: 10.3344/kjp.2020.33.1.90] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 11/28/2019] [Accepted: 12/02/2019] [Indexed: 01/02/2023] Open
Abstract
Background Parkinson's disease (PD) is a neurodegenerative disorder that is the second most common disorder after Alzheimer's disease. PD includes both "motor" and "non-motor" symptoms, one of which is pain. The aim of this study was to investigate the clinical characteristics of pain in patients with PD. Methods This cross-sectional study included 250 patients diagnosed with PD, 70% of which had mild to moderate PD (stages 2/3 of Hoehn and Yahr scale). The average age was 67.4 years, and the average duration since PD diagnosis was 7.1 years. Relevant data collected from PD patients were obtained from their personal medical history. Results The prevalence of pain was found to be high (82%), with most patients (79.2%) relating their pain to PD. Disease duration was correlated with the frequency of intense pain (R: 0.393; P < 0.05). PD pain is most frequently perceived as an electrical current (64%), and two pain varieties were most prevalent (2.60 ± 0.63). Our findings confirm links between pain, its evolution over time, its multi-modal character, the wide variety of symptoms of PD, and the female sex. Conclusions Our results demonstrated that the pain felt by PD patients is mainly felt as an electrical current, which contrasts with other studies where the pain is described as burning and itching. Our classification is innovative because it is based on anatomy, whereas those of other authors were based on syndromes.
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Lee JH. The opioid epidemic and crisis in US: how about Korea? Korean J Pain 2019; 32:243-244. [PMID: 31569915 PMCID: PMC6813894 DOI: 10.3344/kjp.2019.32.4.243] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 09/09/2019] [Accepted: 09/10/2019] [Indexed: 01/03/2023] Open
Affiliation(s)
- Joon-Ho Lee
- Department of Anesthesiology and Pain Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
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Mills SEE, Nicolson KP, Smith BH. Chronic pain: a review of its epidemiology and associated factors in population-based studies. Br J Anaesth 2019; 123:e273-e283. [PMID: 31079836 PMCID: PMC6676152 DOI: 10.1016/j.bja.2019.03.023] [Citation(s) in RCA: 653] [Impact Index Per Article: 130.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 03/22/2019] [Indexed: 12/18/2022] Open
Abstract
Chronic pain is a common, complex, and distressing problem that has a profound impact on individuals and society. It frequently presents as a result of a disease or an injury; however, it is not merely an accompanying symptom, but rather a separate condition in its own right, with its own medical definition and taxonomy. Studying the distribution and determinants of chronic pain allows us to understand and manage the problem at the individual and population levels. Targeted and appropriate prevention and management strategies need to take into account the biological, psychological, socio-demographic, and lifestyle determinants and outcomes of pain. We present a narrative review of the current understanding of these factors.
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Affiliation(s)
- Sarah E E Mills
- Population Health and Genomics Division, University of Dundee School of Medicine, Ninewells Hospital and Medical School, Dundee, Scotland, UK.
| | - Karen P Nicolson
- Population Health and Genomics Division, University of Dundee School of Medicine, Ninewells Hospital and Medical School, Dundee, Scotland, UK
| | - Blair H Smith
- Population Health and Genomics Division, University of Dundee School of Medicine, Ninewells Hospital and Medical School, Dundee, Scotland, UK
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Akodu AK, Akindutire OM. The effect of stabilization exercise on pain-related disability, sleep disturbance, and psychological status of patients with non-specific chronic low back pain. Korean J Pain 2018; 31:199-205. [PMID: 30013734 PMCID: PMC6037811 DOI: 10.3344/kjp.2018.31.3.199] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 06/02/2018] [Accepted: 06/04/2018] [Indexed: 11/23/2022] Open
Abstract
Background Sleep disturbance and depression are becoming more recognized as important symptoms among individuals with chronic low back pain. This study evaluated the effect of stabilization exercise on pain-related disability, sleep disturbance and the psychological status of patients with non-specific chronic low back pain (NSCLBP). Methods A total of 26 patients (M/F = 17/9) with NSCLBP with a mean age of 50.0 ± 15.5 took part in this study. Participants were recruited from selected hospitals in Lagos state. Ethical approval was sought and obtained from the health research and ethics committee of Lagos University Teaching Hospital Idi-araba, Lagos, Nigeria. Participants performed stabilization exercise for eight weeks consecutively and were assessed for pain-related disability, anxiety, depression, and sleep disturbance using the pain-disability index, hospital anxiety and depression scale, and the insomnia severity index at baseline, the 4th week, and the 8th week, post-intervention. Results The participants studied recorded significant reduction in pain-related disability (P = 0.001). There was also improvement in the sleep quality (P = 0.001), depression level (P = 0.001), and anxiety level (P = 0.001), post intervention. Conclusions This study revealed that stabilization exercise is very useful in the management of sleep disturbance, pain-related disability, depression, and anxiety in NSCLBP patients.
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Affiliation(s)
- Ashiyat Kehinde Akodu
- Department of Physiotherapy, College of Medicine, University of Lagos, Lagos, Nigeria
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