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Ledermann K, von Känel R, Berna C, Sprott H, Burckhardt M, Jenewein J, Garland EL, Martin-Sölch C. Understanding and restoring dopaminergic function in fibromyalgia patients using a mindfulness-based psychological intervention: a [18F]-DOPA PET study. Study protocol for the FIBRODOPA study—a randomized controlled trial. Trials 2021; 22:864. [PMID: 35078536 PMCID: PMC8790842 DOI: 10.1186/s13063-021-05798-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 11/04/2021] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Fibromyalgia (FM) is a very prevalent and debilitating chronic pain disorder that is difficult to treat. Mindfulness-based techniques are regarded as a very promising approach for the treatment of chronic pain and in particular FM. The Mindfulness-Oriented Recovery Enhancement (MORE) intervention, a mindfulness-based group intervention, has shown beneficial effects in opioid-treated chronic pain patients, including reduced pain severity, functional interference, and opioid dosing, by restoring neurophysiological and behavioral responses to reward. The first evidence for a hypodopaminergic state and impaired reward processing in FM has been reported. However, little is known about its impact on dopamine (DA) function and in particular with regard to DA responses to monetary reward in FM. The aim of the present study protocol is to evaluate if MORE is able to restore the DA function in FM patients, in particular with regard to the DA responses to reward, and to reduce pain and mood complaints in FM.
Methods
The present study is a multi-center interventional RCT with 3 time points: before the intervention, after completion of the intervention, and 3 months after completion of the intervention. Sixty-four FM patients will be randomly assigned to either the MORE intervention (N = 32) or a non-intervention control group (N = 32). Additionally, a comparison group of healthy women (N = 20) for PET measures will be enrolled and another group of healthy women (N = 15) will do the ambulatory assessments only. The MORE intervention consists of eight 2-h-long group sessions administered weekly over a period of 8 weeks. Before and after the intervention, FM participants will undergo [18F] DOPA positron emission tomography (PET) and functional MR imaging while performing a reward task. The primary outcome will be endogeneous DA changes measured with [18F] DOPA PET at baseline, after the intervention (after 8 weeks for the non-intervention control group), and at 3 months’ follow-up. Secondary outcomes will be (1) clinical pain measures and FM symptoms using standardized clinical scales; (2) functional brain changes; (3) measures of negative and positive affect, stress, and reward experience in daily life using the ambulatory assessment method (AA); and (4) biological measures of stress including cortisol and alpha-amylase.
Discussion
If the findings of this study confirm the effectiveness of MORE in restoring DA function, reducing pain, and improving mood symptoms, MORE can be judged to be a promising means to improve the quality of life in FM patients. The findings of this trial may inform health care providers about the potential use of the MORE intervention as a possible non-pharmacological intervention for FM.
Trial registration
ClinicalTrials.govNCT 04451564. Registered on 3 July 2020. The trial was prospectively registered.
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Götz A, Kröner A, Jenewein J, Spirig R. Adherence to the distress screening through oncology nurses and integration of screening results into the nursing process to adapt psychosocial nursing care five years after implementation. Eur J Oncol Nurs 2020; 45:101725. [DOI: 10.1016/j.ejon.2020.101725] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Revised: 09/16/2019] [Accepted: 01/28/2020] [Indexed: 01/30/2023]
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Engeli L, Moergeli H, Binder M, Drabe N, Meier C, Buechi S, Dummer R, Jenewein J. Resilience in patients and spouses faced with malignant melanoma. A qualitative longitudinal study. Eur J Cancer Care (Engl) 2014; 25:122-31. [PMID: 25070508 DOI: 10.1111/ecc.12220] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/15/2014] [Indexed: 11/28/2022]
Abstract
Life-threatening diseases like malignant tumours are associated with considerable existential distress. Little is known about the factors that promote resilience within these individuals. This longitudinal qualitative partner study aimed to analyse resilience as per Antonovsky's sense of coherence. Eight patients with malignant melanoma and their partners were interviewed. They were asked about their coping strategies, attitudes towards the meaning of life and their cancer, and comprehension of what is happening to them. The questions were asked shortly after their diagnosis was made and 6 months later. All interviews were audio-taped and later transcribed and analysed according to the method of qualitative content analysis described by P. Mayring. At baseline, the majority of statements made (261; patients = 141/spouses = 120) related to coping/manageability of disease, with only 26 statements (patients = 15/spouses = 11) related to meaning and 127 (patients = 64/spouses = 63) to comprehension. There were no significant differences between the responses of patients and their partners and no significant changes in the number of statements during the 6-month interview. The most significant theme that emerged was manageability of disease, with distraction the most commonly utilised coping skill. The comprehension and meaning themes were far less prevalent. Hence, support should focus on disease and situational manageability.
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Affiliation(s)
- L Engeli
- Psychiatric Hospital of the University of Basel, Basel, Switzerland
| | - H Moergeli
- Department of Psychiatry and Psychotherapy, University Hospital Zurich, Zurich, Switzerland
| | - M Binder
- Department of Psychiatry and Psychotherapy, University Hospital Zurich, Zurich, Switzerland
| | - N Drabe
- Department of Psychiatry and Psychotherapy, University Hospital Zurich, Zurich, Switzerland
| | - C Meier
- Department of Psychiatry and Psychotherapy, University Hospital Zurich, Zurich, Switzerland
| | - S Buechi
- Private Clinic for Psychotherapy and Psychosomatics 'Hohenegg', Meilen, Switzerland
| | - R Dummer
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
| | - J Jenewein
- Department of Psychiatry and Psychotherapy, University Hospital Zurich, Zurich, Switzerland
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Jenewein J, Moergeli H, Sprott H, Honegger D, Brunner L, Ettlin D, Grillon C, Bloch K, Brügger M, Schwegler K, Schumacher S, Hasler G. Fear-learning deficits in subjects with fibromyalgia syndrome? Eur J Pain 2013; 17:1374-84. [PMID: 23468076 DOI: 10.1002/j.1532-2149.2013.00300.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2013] [Indexed: 11/06/2022]
Abstract
BACKGROUND Fibromyalgia syndrome (FMS) is frequently associated with psychiatric conditions, particularly anxiety. Deficits in contingency learning during fear conditioning have been hypothesized to increase anxiety and, consequently, pain sensation in susceptible individuals. The goal of this study was to examine the relationship between contingency learning and pain experience in subjects with FMS and rheumatoid arthritis (RA). METHODS Fourteen female FMS subjects, 14 age-matched female RA subjects and 14 age-matched female healthy controls (HCs) were included in a fear-conditioning experiment. The conditioned stimulus (CS) consisted of visual signs, the unconditioned stimulus (US) of thermal stimuli. CS- predicted low-temperature exposure (US), while CS+ was followed by low or high temperature. RESULTS In the FMS group, only 50% of the subjects were aware of the US-CS contingency, whereas 86% of the RA subjects and all of the HCs were aware of the contingency. CS+ induced more anxiety than CS- in RA subjects and HCs. As expected, low-temperature exposure was experienced as less painful after CS- than after CS+ in these subjects. FMS subjects did not show such adaptive conditioning. The effects of the type of CS on heart rate changes were significant in the HCs and the aware FMS subjects, but not in the unaware FMS subjects. CONCLUSIONS Contingency learning deficits represent a potentially promising and specific, but largely unstudied, psychopathological factor in FMS. Deficits in contingency learning may increase anxiety and, consequently, pain sensation. These findings have the potential to contribute to the development of novel therapeutic approaches for FMS.
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Affiliation(s)
- J Jenewein
- Department of Psychiatry and Psychotherapy, University Hospital Zurich, Zurich, Switzerland.
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Meier C, Mörgeli H, Büchi S, Bodenmann G, Witzemann L, Jenewein J. [Psychological distress and quality of life in COPD-patients and their spouses]. Praxis (Bern 1994) 2011; 100:407-415. [PMID: 21452127 DOI: 10.1024/1661-8157/a000482] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
OBJECTIVE To investigate psychological distress, quality of life, and satisfaction with medical support of patients with COPD and their spouses. METHOD Questionnaires concerning psychological distress and quality of life were sent by mail to 97 patients and 54 spouses (43 couples). RESULTS We found increased scores of anxiety and depression. In terms of quality of life the patients reported significantly lower scores than their spouses. Patients as well as their spouses reported a high satisfaction about the given medical support. CONCLUSION Spouses of COPD patients are at increased risk for psychiatric morbidity und should therefore be included regularly in care programs.
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Affiliation(s)
- C Meier
- Klinik für Psychiatrie und Psychotherapie, Universitätsspital Zürich
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Jenewein J, Ettlin D, Moergeli H, Hasler G, Sprott H. PW01-174 - Impaired fear conditioning to thermal pain stimuli in fibromyalgia patients - an experimental study. Eur Psychiatry 2010. [DOI: 10.1016/s0924-9338(10)71581-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Jenewein J, Wittmann L, Moergeli H, Creutzig J, Schnyder U. Mutual influence of posttraumatic stress disorder symptoms and chronic pain among injured accident survivors: a longitudinal study. J Trauma Stress 2009; 22:540-8. [PMID: 19924822 DOI: 10.1002/jts.20453] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The relationship between acute stress disorder (ASD), posttraumatic stress disorder symptoms (PTSD), and chronic pain was investigated in a longitudinal study of injured accident victims (N = 323, 64.7% men). Assessments took place 5 days (T1), 6 (T2) months, and 12 (T3) months postaccident. Relations between pain and posttraumatic stress symptoms were tested by structural equation modeling. Subjects diagnosed with full or subsyndromal PTSD at T2 and at T3 (14 and 19%) reported significantly higher pain intensity. Cross-lagged panel analysis yielded a mutual maintenance of pain intensity and ASD or PTSD symptoms across T2. Across the second half year, PTSD symptoms impacted significantly on pain but not vice versa. Clinicians need to pay careful attention to PTSD symptoms in accident survivors suffering from chronic pain.
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Affiliation(s)
- J Jenewein
- Department of Psychiatry, University Hospital, Zurich, Switzerland
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Lüddeckens T, Mörgeli H, Zwahlen D, Jenewein J, Büchi S. [Supportive needs and satisfaction in cancer outpatients and their spouses]. Praxis (Bern 1994) 2008; 97:1223-1230. [PMID: 19016421 DOI: 10.1024/1661-8157.97.23.1223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
OBJECTIVE To assess the satisfaction of outpatients treated for cancer and their spouses as regards to medical and psychosocial care. A second focus of interest included the understanding the extend of support needs not yet covered by the existing system. METHOD 224 outpatients with different cancer types and different stages as well and their 224 spouses were assessed by questionnaires. RESULTS The needs of the patients were significantly better covered in all areas investigated than those of their spouses. A high level of satisfaction was revealed in the aspect of understanding and confidence with doctors and other medical stuff as well as the information on the disease. Also regarding on the various ways of treatment and how a patient could keep his own mental balance were considered satisfactory. By patients, spouses and doctors were considered by far as the most important support. A significant number of patients and spouses reported a lack of assistance or advice in relevant social support aspects. CONCLUSION The wishes and needs of the spouses are considerably less taken into account within the exististing outpatient oncological medical treatment than those of the patients. As the spouses are heavily impacted by a psychological stress due their partners disease and the support duties, we require to ameliorate the assessment of the needs of relatives and to communicate better existing support programmes.
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Zwahlen R, Dannemann C, Graetz K, Studer G, Zwahlen D, Moergeli H, Drabe N, Buechi S, Jenewein J. O.160 QoL and dyadic adjustment related to psychiatric morbidity in oral cancer patients and wives. J Craniomaxillofac Surg 2008. [DOI: 10.1016/s1010-5182(08)71284-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Jenewein J, Moergeli H, Fauchère JC, Bucher HU, Kraemer B, Wittmann L, Schnyder U, Büchi S. Parents' mental health after the birth of an extremely preterm child: a comparison between bereaved and non-bereaved parents. J Psychosom Obstet Gynaecol 2008; 29:53-60. [PMID: 18266165 DOI: 10.1080/01674820701640181] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVE To assess the impact of extremely preterm birth (24-26 weeks of gestation) on the mental health of parents two to six years after delivery, and to examine potential differences in post-traumatic growth between parents whose newborn infant died and those whose child survived. METHOD A total of 54 parents who had lost their newborn and 38 parents whose preterm child survived were assessed by questionnaires with regard to depression and anxiety (HADS) and post-traumatic growth (PTGI). RESULTS Neither group of parents had clinically relevant levels of depression and anxiety. Mothers showed higher levels of anxiety than fathers. Bereaved parents with no other, living child reported higher levels of depression than bereaved parents with one or more children. Mothers reported higher post-traumatic growth compared to fathers. In particular, bereaved mothers experienced the value and quality of their close social relationships more positively compared to the non-bereaved parents. CONCLUSION In the long term, bereaved and non-bereaved parents cope reasonably well with an extremely preterm birth of a child. Post-traumatic growth appears to be positively related to bereavement, particularly in mothers.
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Affiliation(s)
- J Jenewein
- Department of Psychiatry, University Hospital, Zurich, Switzerland.
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Schweizer R, Büchi S, Fauchère J, Mörgeli H, Jenewein J. Was hilft Eltern bei der Bewältigung des Todes ihres extrem frühgeborenen Kindes? Eine qualitative Untersuchung. Geburtshilfe Frauenheilkd 2007. [DOI: 10.1055/s-2007-989310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Krähenbühl A, Zwahlen D, Knuth A, Schnyder U, Jenewein J, Kuhn C, Büchi S. [Prevalence of anxiety and depression in cancer outpatients and their spouses]. Praxis (Bern 1994) 2007; 96:973-9. [PMID: 17616035 DOI: 10.1024/1661-8157.96.24.973] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
OBJECTIVE To assess prevalence rates of anxiety disorder and depression in patients and their spouses treated in a cancer outpatient clinic of a university hospital. Also the distress-thermometer (DT) was tested as a screening instrument for anxiety disorders and depression. METHOD 109 patients with different cancer types of different stages as well as their 109 spouses were assessed by questionnaires. RESULTS In the patient sample anxiety levels were increased in 24.7% and in 20.2% for depression. In spouses anxiety levels were increased in 41.0% and in 21.6% for depression. Female spouses had higher anxiety levels than male spouses (p < 0.01); increased anxiety levels were found in 48% of the female spouses. In the patients sample the distress-thermometer has good values for sensitivity [0.93 (anxiety); 0.82 (depression)] and satisfying measures of specifity [0.68 (anxiety); 0.62 (depression)]. CONCLUSION Female spouses of cancer patients are at increased risk for psychiatric morbidity, a fact that should be considered in future oncological care. The distress-thermometer is a simple, time saving and sensitive screening instrument to assess psychiatric morbidity in cancer patients, which can be recommended for clinical use.
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Affiliation(s)
- A Krähenbühl
- Psychiatrische Poliklinik, Universitätsspital Zürich
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Jenewein J, Fauchère J, Glaser A, Mörgeli H, Büchi S. Was belastet Eltern nach dem Tod ihres extrem frühgeborenen Kindes? Eine qualitative Studie. Geburtshilfe Frauenheilkd 2006. [DOI: 10.1055/s-2005-872980] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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