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Biao D, Umoh K, Qiguang C, Xiaole W, Ting F, Yuqian Y, Jinchao Z, Fushui L. The Role of Mindfulness Therapy in the Treatment of Chronic Pain. Curr Pain Headache Rep 2024; 28:1155-1165. [PMID: 38951466 DOI: 10.1007/s11916-024-01284-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2024] [Indexed: 07/03/2024]
Abstract
PURPOSE OF REVIEW Mindfulness therapy is a widely used treatment for many diseases and has been shown to improve pain-related functions. There is growing support for the use of psychotherapy in the treatment of chronic pain. While studies have shown a positive effect of mindfulness therapy, it is important to consider psychosocial factors as there are still a small number of studies that question its effectiveness. RECENT FINDINGS Based on current studies, mindfulness therapy involves cognitive factors related to chronic pain, both in terms of cognitive production and its impact on cognitive control. Psychological and neurobasic studies were reviewed to provide a deeper understanding of these components, which include thought inhibition, attention deficit, pain catastrophizing, and self-efficacy. Mindfulness therapy has the potential to normalize psychology and nerves, and increase internal and external connectivity to work networks related to stress perception, cognition, and emotion. However, further research is needed to fully understand its effects. By exploring the relationship between mindfulness therapy and chronic pain. This review provides a new avenue for future research in psychotherapy for patients with chronic pain.
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Affiliation(s)
- Deng Biao
- School of Clinical Medicine, Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - KuyikAbasi Umoh
- School of Clinical Medicine, Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Cao Qiguang
- Apartment of Acupotomy and Chiropractic, Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Wang Xiaole
- Apartment of Acupotomy and Chiropractic, Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, China.
| | - Fang Ting
- Apartment of Acupotomy and Chiropractic, Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Yang Yuqian
- School of Clinical Medicine, Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Zhu Jinchao
- School of Clinical Medicine, Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Liu Fushui
- Apartment of Acupotomy and Chiropractic, Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, China.
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HARMANCI H, KUL B. Pain catastrophizing in migraine patients and associated factors. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2021. [DOI: 10.32322/jhsm.975669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Grazzi L, Andrasik F, Rizzoli P, Bernstein C, Sansone E, Raggi A. Acceptance and commitment therapy for high frequency episodic migraine without aura: Findings from a randomized pilot investigation. Headache 2021; 61:895-905. [PMID: 34115399 DOI: 10.1111/head.14139] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 02/22/2021] [Accepted: 03/25/2021] [Indexed: 12/14/2022]
Abstract
OBJECTIVE We compared the incremental effects of adding acceptance and commitment therapy (ACT) to pharmacological treatment as usual (TAU) in a sample of patients with high frequency episodic migraine without aura (HFEM), assessing impact on a spectrum of measures across multiple domains. BACKGROUND Patients with HFEM are at risk of developing chronic migraine and medication overuse headache. ACT has been shown to be effective for the treatment of various chronic pain conditions, but little attention has been given to its therapeutic value in the management of recurring headaches. METHODS In this single-blind (masking for outcome assessor), open-label, randomized clinical trial, 35 patients with HFEM, with a monthly headache frequency ranging from 9 to 14 days, were recruited at the headache center of C. Besta Neurological Institute and randomized to either TAU (patient education and pharmacological prophylaxis; n = 17) or TAU + ACT (n = 18). Patients assigned to the combined treatment arm additionally received six 90-min weekly group sessions of ACT therapy and two supplementary "booster" sessions. All patients were on a stable course of prophylactic medication in the 3 months prior to initiating either treatment. Monthly headache frequency served as the primary outcome measure, with all other data collected being considered as secondary measures (medication intake, disability, headache impact, anxiety and depression, catastrophizing, allodynia, cognitive inflexibility, pain acceptance, mindful attention and awareness). RESULTS A total of 35 patients were enrolled: 17 randomized to TAU, of whom three dropped out, and 18 to TAU + ACT (no dropouts in this group). Headache frequency and medication intake decreased in both groups over 12 months, with patients in the TAU + ACT group showing statistically significant reduction earlier, that is, by month 3. Headache frequency was reduced by 3.3 days (95% CI: 1.4 to 5.2) among those randomized to ACT + TAU, whereas it increased by 0.7 days (95% CI: -2.7 to 1.3) among those randomized to TAU only (p = 0.007, partial η2 = 0.21), the difference being 4 days (95% CI: 1.2 to 6.8). Medication intake was reduced by 4.1 intakes (95% CI: 2.0 to 6.3) among those randomized to ACT + TAU and by 0.4 intakes (95% CI: -1.8 to 2.5) among those randomized to TAU only (p = 0.016; partial η2 = 0.17), the difference being 3.8 intakes (95% CI: 0.7 to 6.8). At 6 and 12 months, the variations were not different between the two groups for headache frequency and medication intake. The opposite was found for measures of headache impact and pain acceptance, where the differences over time favored patients allocated to TAU. Both groups improved with regard to measures of disability, anxiety and depression, catastrophizing, and cognitive inflexibility, whereas measures of allodynia and pain acceptance were stable over time. CONCLUSIONS Our preliminary findings indicate that supplementing TAU with ACT can enhance the main clinical outcomes, namely headache frequency and medication intake of patients with HFEM.
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Affiliation(s)
- Licia Grazzi
- Dipartimento Neuroalgologia Centro Cefalee, Fondazione IRRCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - Frank Andrasik
- Department of Psychology, University of Memphis, Memphis, TN, USA
| | - Paul Rizzoli
- John Graham Headache Center, Brigham and Women's/Faulkner Hospital, Harvard Medical School, Boston, MA, USA
| | - Carolyn Bernstein
- John Graham Headache Center, Brigham and Women's/Faulkner Hospital, Harvard Medical School, Boston, MA, USA
| | - Emanuela Sansone
- UO Neurologia Salute Pubblica e Disabilità, Fondazione IRRCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - Alberto Raggi
- UO Neurologia Salute Pubblica e Disabilità, Fondazione IRRCS Istituto Neurologico Carlo Besta, Milano, Italy
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An exploratory investigation into the effects of mental defeat on pain threshold, pain rating, pain anticipation, and mood. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-01548-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AbstractIn chronic pain, mental defeat is considered as a disabling type of self-evaluation triggered by repeated episodes of debilitating pain. This exploratory study experimentally tested the effect of an activated sense of defeat, as well as its interaction with pain catastrophizing, on pain and mood. Participants (N = 71) were allocated to either high or low pain catastrophizing groups and then randomly assigned to receive either defeat or neutral manipulations. A cold pressor task administered before and after the thought manipulation measured pain threshold, alongside visual analogue scales for mental defeat, attention, pain intensity, pain anticipation as well as mood. Thought manipulation checks supported successful defeat activation. Defeat activation was associated with increased negative mood and attentional disengagement from the nociceptive stimuli, irrespective of pain catastrophizing tendency. There were no changes in pain threshold, pain or pain anticipation ratings. The results suggest that mental defeat can be experimentally activated using an autobiographical memory task and that an activated sense of defeat appears to operate independently from pain catastrophizing in influencing mood and attentional disengagement from the nociceptive stimuli. Future research can utilize our experimental approach to evaluate the effect of an activated sense of mental defeat in people with chronic pain, for whom the magnitude of pain, mood and attentional responses may be stronger and broader.
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Díaz-de-Terán J, Sastre-Real M, Lobato-Pérez L, Navarro-Fernández G, Elizagaray-García I, Gil-Martínez A. Cluster headache, beyond the pain: a comparative cross-sectional study. Neurol Sci 2021; 42:3673-3680. [PMID: 33439388 DOI: 10.1007/s10072-020-04996-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 12/12/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To compare the presence of allodynia, pain catastrophizing, and the impact of headaches on patients with cluster headache (CH) and healthy individuals. Our second aim was to analyze the relationship between catastrophism, psychological comorbidities, and the impact in CH. METHODS We designed this cross-sectional study to compare various factors among 47 patients diagnosed with CH and 40 healthy controls, and then focus on catastrophism, anxiety, depression, and impact in the CH group. RESULTS There were statistically significant differences between CH and the asymptomatic group in Allodynia Symptom Checklist (ASC) (p < 0.001), Pain Catastrophizing Scale (p < 0.001), and HIT-6 (p < 0.001) scores. We found a correlation among ASC, PCS, anxiety-depression, EuroQoL, and HIT-6 for the CH group. In this group, we observed a strong positive correlation between PCS and anxiety (rho = 0.69; p < 0.001), PCS and depression (rho = 0.62; p < 0.001) and depression and EuroQoL (rho = - 0.68; p < 0.001). The regression model showed that the combination of anxiety and HIT-6 was a significant predictor of PCS (adjusted R2 = 0.52). DISCUSSION Our findings reveal significant differences regarding allodynia, pain catastrophism, and impact in CH group compared with controls. We found a significant relationship between psychological comorbidity, pain catastrophism, and quality of life in CH patients. Anxiety and HIT-6 were a predictor (adjusted R2 = 52%) of pain catastrophism. Screening for these comorbidities should be implemented through a multidisciplinary approach.
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Affiliation(s)
- Javier Díaz-de-Terán
- Department of Neurology, La Paz University Hospital, Madrid, Spain
- La Paz University Hospital Institute for Health Research (IdiPAZ), Madrid, Spain
- CranioSPain Research Group, Centro Superior de Estudios Universitarios La Salle, Departamento de Fisioterapia, Universidad Autónoma de Madrid, Madrid, Spain
| | - María Sastre-Real
- Department of Neurology, La Paz University Hospital, Madrid, Spain
- La Paz University Hospital Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Luis Lobato-Pérez
- Department of Neurology, La Paz University Hospital, Madrid, Spain
- La Paz University Hospital Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Gonzalo Navarro-Fernández
- CranioSPain Research Group, Centro Superior de Estudios Universitarios La Salle, Departamento de Fisioterapia, Universidad Autónoma de Madrid, Madrid, Spain
- Centro Superior de Estudios Universitarios La Salle, Departamento de Fisioterapia, Universidad Autónoma de Madrid, C/La Salle, 10, Edificio C, 28036, Madrid, Spain
| | - Ignacio Elizagaray-García
- CranioSPain Research Group, Centro Superior de Estudios Universitarios La Salle, Departamento de Fisioterapia, Universidad Autónoma de Madrid, Madrid, Spain
- Centro Superior de Estudios Universitarios La Salle, Departamento de Fisioterapia, Universidad Autónoma de Madrid, C/La Salle, 10, Edificio C, 28036, Madrid, Spain
| | - Alfonso Gil-Martínez
- La Paz University Hospital Institute for Health Research (IdiPAZ), Madrid, Spain.
- CranioSPain Research Group, Centro Superior de Estudios Universitarios La Salle, Departamento de Fisioterapia, Universidad Autónoma de Madrid, Madrid, Spain.
- Centro Superior de Estudios Universitarios La Salle, Departamento de Fisioterapia, Universidad Autónoma de Madrid, C/La Salle, 10, Edificio C, 28036, Madrid, Spain.
- Unit of Physiotherapy, La Paz University Hospital, Madrid, Spain.
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Christidi F, Karavasilis E, Michels L, Riederer F, Velonakis G, Anagnostou E, Ferentinos P, Kollias S, Efstathopoulos E, Kelekis N, Kararizou E. Dimensions of pain catastrophising and specific structural and functional alterations in patients with chronic pain: Evidence in medication-overuse headache. World J Biol Psychiatry 2020; 21:726-738. [PMID: 31535584 DOI: 10.1080/15622975.2019.1669822] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVES We examined the neuroanatomical substrate of different pain catastrophising (PC) dimensions (i.e. rumination; magnification; helplessness) in patients with medication-overuse headache (MOH). METHODS We included 18 MOH patients who were administered the Pain Catastrophizing Scale (PCS) and scanned in a 3T-MRI. We conducted whole-brain volumetric and resting-state functional connectivity (FC) analysis to examine the association between grey matter (GM) density and FC strength and PCS dimensions controlling for depression and anxiety. RESULTS Higher total PCS score was associated with decreased GM density in precentral and inferior temporal gyrus, increased FC between middle temporal gyrus and cerebellum and reduced FC between precuneus and inferior temporal gyrus, as well as between frontal pole and temporal fusiform cortex. Regarding PCS dimensions, we mainly observed the involvement of (1) somatosensory cortex, supramarginal gyrus, basal ganglia, core default-mode network (DMN) in rumination; (2) somatosensory cortex, core DMN, dorsal medial prefrontal cortex (DMPFC)-DMN subsystem and cerebellum in magnification; and (3) temporal regions, DMN and basal ganglia in helplessness. CONCLUSIONS PC dimensions are associated with a specific structural and functional neuroanatomical pattern, which is different from the pattern observed when PC is considered as a single score. The involvement of basal ganglia and cerebellum needs further investigation.
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Affiliation(s)
- Foteini Christidi
- First Department of Neurology, Aeginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Efstratios Karavasilis
- Second Department of Radiology, Attikon General University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Lars Michels
- Department of Neuroradiology, University Hospital Zurich, Zurich, Switzerland
| | - Franz Riederer
- Neurological Center Rosenhuegel and Karl Landsteiner Institute for Epilepsy Research and Cognitive Neurology, Vienna, Austria
| | - Georgios Velonakis
- Second Department of Radiology, Attikon General University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Evangelos Anagnostou
- First Department of Neurology, Aeginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Panagiotis Ferentinos
- Second Department of Psychiatry, Attikon General University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Spyridon Kollias
- Neurological Center Rosenhuegel and Karl Landsteiner Institute for Epilepsy Research and Cognitive Neurology, Vienna, Austria
| | - Efstathios Efstathopoulos
- Second Department of Radiology, Attikon General University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Kelekis
- Second Department of Radiology, Attikon General University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Evangelia Kararizou
- First Department of Neurology, Aeginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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Dale PC, Thomas JC, Hazle CR. Physical therapist clinical reasoning and classification inconsistencies in headache disorders: a United States survey. J Man Manip Ther 2019; 28:28-40. [PMID: 31373539 DOI: 10.1080/10669817.2019.1645414] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Objective: The purpose of this study was to investigate the decision-making processes of physical therapists relating to evaluation and categorization of patients with headaches, including consistency with criteria proposed by the International Headache Society (IHS).Methods: A national online survey was distributed in cooperation with the Academy of Orthopaedic Physical Therapy of the American Physical Therapy Association. Three hypothetical patient case vignettes featuring headache disorders were used as assessment instruments. Additionally, data on physical therapist education, clinical experience, manual therapy training, self-efficacy, and familiarity & consistency with IHS criteria were collected. Physical therapist identification and valuation of clinical features of headache disorders were also examined in the decision-making processes.Results: Among the 384 respondents, 32.3% classified the tension-type headache case consistent with IHS criteria. The cervicogenic and migraine headache cases were classified at 54.8% and 41.7% consistent with IHS categories, respectively. Experienced clinicians and those with formal manual training categorized patient presentations with greater consistency. Clinician familiarity with IHS classification criteria was low with 73.6% collectively somewhat and not familiar, while 26.4% of physical therapists were self-described as very or moderately familiar.Discussion: Clinicians' headache categorization was significantly affected by symptom misattribution and weighting of individual examination findings. Weighting by practitioners of clinical features varied markedly with greatest emphasis being placed on detailed manual examination procedures, including passive intervertebral movements. Inconsistencies in valuation of clinical features in headache categorization suggest a need for further formal education in physical therapy educational curricula and in post-graduate education, including of IHS criteria and classification.Level of Evidence: 2a.
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Affiliation(s)
- Philip C Dale
- KORT-Bryan Station, Kentucky Orthopedic Rehab Team, Lexington, KY, USA
| | - Jacob C Thomas
- Orthopedics Plus Physical Therapy, Medical Center at Bowling Green, Bowling Green, KY, USA
| | - Charles R Hazle
- Division of Physical Therapy, University of Kentucky, Hazard, KY, USA
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Christensen JO, Nielsen MB, Finne LB, Knardahl S. Human resource primacy, dispositional optimism, and chest pain: A prospective, cross-lagged study of work, personality, and health. PLoS One 2019; 14:e0215719. [PMID: 31017947 PMCID: PMC6481920 DOI: 10.1371/journal.pone.0215719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 04/08/2019] [Indexed: 11/18/2022] Open
Abstract
Chest pain (CP) is common, frightening, and often medically unexplained. Occupational psychological factors are associated with somatic pain. Personality may influence both perceived working conditions and somatic health, thereby confounding associations of work with health. Despite this, very few studies have investigated the interplay between work factors, personality and pain. The current study assessed relationships of a relatively novel work factor, human resource primacy (HRP), and a personality factor known to be relevant to health, dispositional optimism (Opt), with CP across two years (N = 6714). A series of structural equation models (SEMs) were fitted, modeling "substantive" and "confounded" relationships of psychological factors with CP. A "common latent factor" (CLF) was included to account for bias by unmeasured factors that may have influenced all variables (e.g. reporting bias) and the role of optimism as a possible confounder of the relationship between HRP and CP was investigated specifically. Independent effects of HRP and Opt on CP were observed. No effects of HRP/CP on Opt were observed. Opt appeared to confound the relationship between HRP and CP to some extent. However, best fit was observed for a "reciprocal" model with independent lagged effects from HRP/Opt to CP as well as from CP/Opt to HRP. Thus, results suggested a mutual causal dynamic between HRP and CP along with an influence of Opt on both HRP and CP-implying that working conditions influence the experience of chest pain while the chest pain also influences the experience of working conditions. Optimistic dispositions may influence the experience of both work and pain, but not to an extent that fully explains their relationship. Hence, the notion that associations of HRP with CP are mere artifacts of optimistic/pessimistic reporting was not supported. More likely, complex reciprocal relationships exist between these factors, in which mutual reinforcements occur and both vicious and virtuous cycles may result.
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Affiliation(s)
- Jan Olav Christensen
- Department of Work Psychology and Physiology, National Institute of Occupational Health, Oslo, Norway
- * E-mail:
| | - Morten Birkeland Nielsen
- Department of Work Psychology and Physiology, National Institute of Occupational Health, Oslo, Norway
| | - Live Bakke Finne
- Department of Work Psychology and Physiology, National Institute of Occupational Health, Oslo, Norway
| | - Stein Knardahl
- Department of Work Psychology and Physiology, National Institute of Occupational Health, Oslo, Norway
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Gil-Martínez A, Navarro-Fernández G, Mangas-Guijarro MÁ, Lara-Lara M, López-López A, Fernández-Carnero J, La Touche R. Comparison Between Chronic Migraine and Temporomandibular Disorders in Pain-Related Disability and Fear-Avoidance Behaviors. PAIN MEDICINE 2018; 18:2214-2223. [PMID: 28575454 DOI: 10.1093/pm/pnx127] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Objective To compare patients with chronic migraine (CM) and chronic temporomandibular disorders (TMD) on disability, pain, and fear avoidance factors and to associate these variables within groups. Design Descriptive, cross-sectional study. Settings A neurology department and a temporomandibular disorders consult in a tertiary care center. Subjects A total of 50 patients with CM and 51 patients with chronic TMD, classified by international criteria classifications. Methods The variables evaluated included pain intensity (visual analog scale [VAS]), neck disability (NDI), craniofacial pain and disability (CF-PDI), headache impact (HIT-6), pain catastrophizing (PCS), and kinesiophobia (TSK-11). Results Statistically significant differences were found between the CM group and the chronic TMD group in CF-PDI (P < 0.001), PCS (P = 0.03), and HIT-6 (P < 0.001); however, there were no differences between the CM group and the VAS, NDI, and TSK-11 groups (P > 0.05). For the chronic TMD group, the combination of NDI and TSK-11 was a significant covariate model of CF-PDI (adjusted R2 = 0.34). In the CM group, the regression model showed that NDI was a significant predictive factor for HIT-6 (adjusted R2 = 0.19). Conclusions Differences between the CM group and the chronic TMD group were found in craniofacial pain and disability, pain catastrophizing, and headache impact, but they were similar for pain intensity, neck disability, and kinesiophobia. Neck disability and kinesiophobia were covariates of craniofacial pain and disability (34% of variance) for chronic TMD. In the CM group, neck disability was a predictive factor for headache impact (19.3% of variance).
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Affiliation(s)
- Alfonso Gil-Martínez
- Departamento de Fisioterapia.,Motion in Brains Research Group, Instituto de Neurociencias y Ciencias del Movimiento, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.,Hospital La Paz Institute for Health Research, Madrid, Spain
| | - Gonzalo Navarro-Fernández
- Motion in Brains Research Group, Instituto de Neurociencias y Ciencias del Movimiento, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
| | | | - Manuel Lara-Lara
- Hospital La Paz Institute for Health Research, Madrid, Spain.,Servicio de Neurología, Hospital Universitario La Paz, Madrid, Spain
| | - Almudena López-López
- Departamento de Medicina y Cirugía, Psicología, Medicina Preventiva y Salud Pública e Inmunología Microbiología Médica
| | - Josué Fernández-Carnero
- Motion in Brains Research Group, Instituto de Neurociencias y Ciencias del Movimiento, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.,Hospital La Paz Institute for Health Research, Madrid, Spain.,Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Spain
| | - Roy La Touche
- Departamento de Fisioterapia.,Motion in Brains Research Group, Instituto de Neurociencias y Ciencias del Movimiento, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.,Hospital La Paz Institute for Health Research, Madrid, Spain
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Lee J, Protsenko E, Lazaridou A, Franceschelli O, Ellingsen DM, Mawla I, Isenburg K, Berry MP, Galenkamp L, Loggia ML, Wasan AD, Edwards RR, Napadow V. Encoding of Self-Referential Pain Catastrophizing in the Posterior Cingulate Cortex in Fibromyalgia. Arthritis Rheumatol 2018; 70:1308-1318. [PMID: 29579370 DOI: 10.1002/art.40507] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Accepted: 03/20/2018] [Indexed: 01/02/2023]
Abstract
OBJECTIVE Pain catastrophizing is a common feature of chronic pain, including fibromyalgia (FM), and is strongly associated with amplified pain severity and disability. While previous neuroimaging studies have focused on evoked pain response modulation by catastrophizing, the brain mechanisms supporting pain catastrophizing itself are unknown. We designed a functional magnetic resonance imaging (fMRI)-based pain catastrophizing task whereby patients with chronic pain engaged in catastrophizing-related cognitions. We undertook this study to test our hypothesis that catastrophizing about clinical pain would be associated with amplified activation in nodes of the default mode network (DMN), which encode self-referential cognition and show altered functioning in chronic pain. METHODS During fMRI, 31 FM patients reflected on how catastrophizing (CAT) statements (drawn from the Pain Catastrophizing Scale) impact their typical FM pain experience. Response to CAT statements was compared to response to matched neutral (NEU) statements. RESULTS During statement reflection, higher fMRI signal during CAT statements than during NEU statements was found in several DMN brain areas, including the ventral (posterior) and dorsal (anterior) posterior cingulate cortex (vPCC and dPCC, respectively). Patients' ratings of CAT statement applicability were correlated solely with activity in the vPCC, a main DMN hub supporting self-referential cognition (r = 0.38, P < 0.05). Clinical pain severity was correlated solely with activity in the dPCC, a PCC subregion associated with cognitive control and sensorimotor processing (r = 0.38, P < 0.05). CONCLUSION These findings provide evidence that the PCC encodes pain catastrophizing in FM and suggest distinct roles for different PCC subregions. Understanding the brain circuitry encoding pain catastrophizing in FM will prove to be important in identifying and evaluating the success of interventions targeting negative affect in chronic pain management.
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Affiliation(s)
| | | | - Asimina Lazaridou
- Harvard Medical School, Brigham and Women's Hospital, and Massachusetts General Hospital, Boston
| | - Olivia Franceschelli
- Harvard Medical School, Brigham and Women's Hospital, and Massachusetts General Hospital, Boston
| | | | | | | | | | - Laura Galenkamp
- Harvard Medical School, Brigham and Women's Hospital, and Massachusetts General Hospital, Boston
| | | | - Ajay D Wasan
- University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, and Massachusetts General Hospital, Boston
| | - Robert R Edwards
- Harvard Medical School, Brigham and Women's Hospital, and Massachusetts General Hospital, Boston
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Morina N, Bryant RA, Doolan EL, Martin-Sölch C, Plichta MM, Pfaltz MC, Schnyder U, Schick M, Nickerson A. The impact of enhancing perceived self-efficacy in torture survivors. Depress Anxiety 2018; 35:58-64. [PMID: 28881455 DOI: 10.1002/da.22684] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Revised: 08/16/2017] [Accepted: 08/20/2017] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Perceived self-efficacy (SE) is an important factor underlying psychological well-being. Refugees suffer many experiences that can compromise SE. This study tested the impact of enhancing perceived SE on coping with trauma reminders and distress tolerance in tortured refugees. METHODS Torture survivors (N = 40) were administered a positive SE induction in which they retrieved mastery-related autobiographical memories, or a non-SE (NSE) induction, and then viewed trauma-related images. Participants rated their distress following presentation of each image. Participants then completed a frustration-inducing mirror-tracing task to index distress tolerance. RESULTS Participants in the SE condition reported less distress and negative affect, and improved coping in relation to viewing the trauma-related images than those in the NSE condition. The SE induction also led to greater persistence with the mirror-tracing task than the NSE induction. CONCLUSIONS These findings provide initial evidence that promoting SE in tortured refugees can assist with managing distress from trauma reminders, and promoting greater distress tolerance. Enhancing perceived SE in tortured refugees may increase their capacity to tolerate distress during therapy, and may be a useful means to improve treatment response.
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Affiliation(s)
- Naser Morina
- Department of Psychiatry and Psychotherapy, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Richard A Bryant
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - Emma L Doolan
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - Chantal Martin-Sölch
- Unit of Clinical and Health Psychology, Department of Psychology, University of Fribourg, Fribourg, Switzerland
| | - Michael M Plichta
- Department of Psychiatry and Psychotherapy, University Hospital Zurich, University of Zurich, Zurich, Switzerland.,Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Monique C Pfaltz
- Department of Psychiatry and Psychotherapy, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Ulrich Schnyder
- Department of Psychiatry and Psychotherapy, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Matthis Schick
- Department of Psychiatry and Psychotherapy, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Angela Nickerson
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
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12
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Galioto R, O’Leary KC, Thomas JG, Demos K, Lipton RB, Gunstad J, Pavlović JM, Roth J, Rathier L, Bond DS. Lower inhibitory control interacts with greater pain catastrophizing to predict greater pain intensity in women with migraine and overweight/obesity. J Headache Pain 2017; 18:41. [PMID: 28357702 PMCID: PMC5371536 DOI: 10.1186/s10194-017-0748-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2017] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Pain catastrophizing (PC) is associated with more severe and disabling migraine attacks. However, factors that moderate this relationship are unknown. Failure of inhibitory control (IC), or the ability to suppress automatic or inappropriate responses, may be one such factor given previous research showing a relationship between higher PC and lower IC in non-migraine samples, and research showing reduced IC in migraine. Therefore, we examined whether lower IC interacts with increased PC to predict greater migraine severity as measured by pain intensity, attack frequency, and duration. METHODS Women (n = 105) aged 18-50 years old (M = 38.0 ± 1.2) with overweight/obesity and migraine who were seeking behavioral treatment for weight loss and migraine reduction completed a 28-day smartphone-based headache diary assessing migraine headache severity. Participants then completed a modified computerized Stroop task as a measure of IC and self-report measures of PC (Pain Catastrophizing Scale [PCS]), anxiety, and depression. Linear regression was used to examine independent and joint associations of PC and IC with indices of migraine severity after controlling for age, body mass index (BMI) depression, and anxiety. RESULTS Participants on average had BMI of 35.1 ± 6.5 kg/m2and reported 5.3 ± 2.6 migraine attacks (8.3 ± 4.4 migraine days) over 28 days that produced moderate pain intensity (5.9 ± 1.4 out of 10) with duration of 20.0 ± 14.2 h. After adjusting for covariates, higher PCS total (β = .241, SE = .14, p = .03) and magnification subscale (β = .311, SE = .51, p < .01) scores were significant independent correlates of longer attack duration. IC interacted with total PCS (β = 1.106, SE = .001, p = .03) rumination (β = 1.098, SE = .001, p = .04), and helplessness (β = 1.026, SE = .001, p = .04) subscale scores to predict headache pain intensity, such that the association between PC and pain intensity became more positive at lower levels of IC. CONCLUSIONS Results showed that lower IC interacted with higher PC, both overall and specific subcomponents, to predict higher pain intensity during migraine attacks. Future studies are needed to determine whether interventions to improve IC could lead to less painful migraine attacks via improvements in PC.
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Affiliation(s)
- Rachel Galioto
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI USA
- Rhode Island Hospital, Providence, RI USA
- Neuropsychology Program, Rhode Island Hospital, 593 Eddy St., Providence, RI 02903 USA
| | - Kevin C. O’Leary
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI USA
- The Miriam Hospital Weight Control and Diabetes Research Center, Providence, RI USA
| | - J. Graham Thomas
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI USA
- The Miriam Hospital Weight Control and Diabetes Research Center, Providence, RI USA
| | - Kathryn Demos
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI USA
- The Miriam Hospital Weight Control and Diabetes Research Center, Providence, RI USA
| | - Richard B. Lipton
- Department of Neurology, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY USA
| | - John Gunstad
- Department of Psychological Sciences, Kent State University, Kent, OH USA
| | - Jelena M. Pavlović
- Department of Neurology, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY USA
| | - Julie Roth
- Department of Neurology, Alpert Medical School of Brown University/Rhode Island Hospital, Providence, RI USA
| | - Lucille Rathier
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI USA
- The Miriam Hospital Weight Control and Diabetes Research Center, Providence, RI USA
| | - Dale S. Bond
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI USA
- The Miriam Hospital Weight Control and Diabetes Research Center, Providence, RI USA
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13
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Mortazavi Nasiri FS, Pakdaman S, Dehghani M, Togha M. The Relationship between Pain Catastrophizing and Headache-Related Disability: The Mediating Role of Pain Intensity. JAPANESE PSYCHOLOGICAL RESEARCH 2017. [DOI: 10.1111/jpr.12162] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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14
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Orr SL, Christie SN, Akiki S, McMillan HJ. Disability, Quality of Life, and Pain Coping in Pediatric Migraine: An Observational Study. J Child Neurol 2017; 32:717-724. [PMID: 28393667 DOI: 10.1177/0883073817702025] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVES The objective was to examine the relationship between disability, health-related quality of life (HrQoL), and pain coping in pediatric migraineurs. METHOD Eighty-five patients with migraine were recruited from Pediatric Neurology clinics. Participants completed the Pediatric Migraine Disability Assessment Scale, the Pediatric Quality of Life Inventory, the Pain Coping Questionnaire, and the Pain Catastrophizing Scale. Means were compared to published norms using t-tests. Spearman correlations and logistic regression were used to explore the relationships between the variables. RESULTS Mean HrQoL scores were lower than norms for controls and chronically ill pediatric patients ( P < .0001). Patients reported lower mean pain coping scores and higher mean pain catastrophizing scores than norms ( P < .0001). After controlling for age and sex, only the relationship between disability and HrQoL remained significant (OR = 0.91, 95% CI: 0.86-0.95). CONCLUSION Pediatric patients with migraine report lower HrQoL, fewer pain coping strategies and more catastrophizing than controls, while disability is inversely associated with HrQoL.
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Affiliation(s)
- Serena L Orr
- 1 University of Ottawa, Ottawa, Ontario, Canada.,2 Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | | | - Salwa Akiki
- 2 Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - Hugh J McMillan
- 1 University of Ottawa, Ottawa, Ontario, Canada.,2 Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
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15
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Cioffi I, Farella M, Chiodini P, Ammendola L, Capuozzo R, Klain C, Vollaro S, Michelotti A. Effect of weather on temporal pain patterns in patients with temporomandibular disorders and migraine. J Oral Rehabil 2017; 44:333-339. [DOI: 10.1111/joor.12498] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2017] [Indexed: 11/29/2022]
Affiliation(s)
- I. Cioffi
- Discipline of Orthodontics; Faculty of Dentistry; University of Toronto - University of Toronto Center for the Study of Pain; Toronto ON Canada
- Section of Orthodontics; Department of Neuroscience, Reproductive Sciences and Oral Sciences; University of Naples Federico II; Naples Italy
| | - M. Farella
- Sir John Walsh Research Institute; University of Otago; Dunedin New Zealand
| | - P. Chiodini
- Medical Statistics Unit; University of Campania Luigi Vanvitelli; Naples Italy
| | - L. Ammendola
- Section of Orthodontics; Department of Neuroscience, Reproductive Sciences and Oral Sciences; University of Naples Federico II; Naples Italy
| | - R. Capuozzo
- Section of Orthodontics; Department of Neuroscience, Reproductive Sciences and Oral Sciences; University of Naples Federico II; Naples Italy
| | - C. Klain
- Section of Orthodontics; Department of Neuroscience, Reproductive Sciences and Oral Sciences; University of Naples Federico II; Naples Italy
| | - S. Vollaro
- Section of Orthodontics; Department of Neuroscience, Reproductive Sciences and Oral Sciences; University of Naples Federico II; Naples Italy
| | - A. Michelotti
- Section of Orthodontics; Department of Neuroscience, Reproductive Sciences and Oral Sciences; University of Naples Federico II; Naples Italy
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16
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Kokonyei G, Szabo E, Kocsel N, Edes A, Eszlari N, Pap D, Magyar M, Kovacs D, Zsombok T, Elliott R, Anderson IM, William Deakin JF, Bagdy G, Juhasz G. Rumination in migraine: Mediating effects of brooding and reflection between migraine and psychological distress. Psychol Health 2016; 31:1481-1497. [PMID: 27616579 PMCID: PMC5062042 DOI: 10.1080/08870446.2016.1235166] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Accepted: 09/05/2016] [Indexed: 01/09/2023]
Abstract
OBJECTIVE The relationship between migraine and psychological distress has been consistently reported in cross-sectional and longitudinal studies. We hypothesised that a stable tendency to perseverative thoughts such as rumination would mediate the relationship between migraine and psychological distress. Design and Main Outcomes Measures: Self-report questionnaires measuring depressive rumination, current psychological distress and migraine symptoms in two independent European population cohorts, recruited from Budapest (N = 1139) and Manchester (N = 2004), were used. Structural regression analysis within structural equation modelling was applied to test the mediational role of brooding and reflection, the components of rumination, between migraine and psychological distress. Sex, age and lifetime depression were controlled for in the analysis. RESULTS Migraine predicted higher brooding and reflection scores, and brooding proved to be a mediator between migraine and psychological distress in both samples, while reflection mediated the relationship significantly only in the Budapest sample. CONCLUSIONS Elevated psychological distress in migraine is partially attributed to ruminative response style. Further studies are needed to expand our findings to clinical samples and to examine how rumination links to the adjustment to migraine.
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Affiliation(s)
- Gyongyi Kokonyei
- MTA-SE-NAP B Genetic Brain Imaging Migraine Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
- Institute of Psychology, Eötvös Loránd University, Budapest, Hungary
| | - Edina Szabo
- MTA-SE-NAP B Genetic Brain Imaging Migraine Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
- Doctoral School of Psychology, Eötvös Loránd University, Budapest, Hungary
| | - Natalia Kocsel
- MTA-SE-NAP B Genetic Brain Imaging Migraine Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
- Doctoral School of Psychology, Eötvös Loránd University, Budapest, Hungary
| | - Andrea Edes
- MTA-SE-NAP B Genetic Brain Imaging Migraine Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
- MTA-SE Neuropsychopharmacology and Neurochemistry Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
| | - Nora Eszlari
- MTA-SE Neuropsychopharmacology and Neurochemistry Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
- Faculty of Pharmacy, Department of Pharmacodynamics, Semmelweis University, Budapest, Hungary
| | - Dorottya Pap
- Faculty of Pharmacy, Department of Pharmacodynamics, Semmelweis University, Budapest, Hungary
| | - Mate Magyar
- MTA-SE-NAP B Genetic Brain Imaging Migraine Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
- Faculty of Medicine, Department of Neurology, Semmelweis University, Budapest, Hungary
| | - David Kovacs
- MTA-SE Neuropsychopharmacology and Neurochemistry Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
- Faculty of Pharmacy, Department of Pharmacodynamics, Semmelweis University, Budapest, Hungary
| | - Terezia Zsombok
- MTA-SE-NAP B Genetic Brain Imaging Migraine Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
- Faculty of Medicine, Department of Neurology, Semmelweis University, Budapest, Hungary
| | - Rebecca Elliott
- Neuroscience and Psychiatry Unit, The University of Manchester, Manchester, UK
- Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK
| | - Ian Muir Anderson
- Neuroscience and Psychiatry Unit, The University of Manchester, Manchester, UK
- Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK
| | - John Francis William Deakin
- Neuroscience and Psychiatry Unit, The University of Manchester, Manchester, UK
- Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK
| | - Gyorgy Bagdy
- MTA-SE Neuropsychopharmacology and Neurochemistry Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
- Faculty of Pharmacy, Department of Pharmacodynamics, Semmelweis University, Budapest, Hungary
| | - Gabriella Juhasz
- MTA-SE-NAP B Genetic Brain Imaging Migraine Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
- Faculty of Pharmacy, Department of Pharmacodynamics, Semmelweis University, Budapest, Hungary
- Neuroscience and Psychiatry Unit, The University of Manchester, Manchester, UK
- Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK
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17
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Engel-Yeger B, Keren A, Berkovich Y, Sarfaty E, Merom L. The role of physical status versus mental status in predicting the quality of life of patients with lumbar disk herniation. Disabil Rehabil 2016; 40:302-308. [PMID: 27866425 DOI: 10.1080/09638288.2016.1253114] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE To explore the role of physical status versus mental status in predicting the quality of life (QOL) of patients with lumbar disk herniation (LDH). METHOD In this correlative study 51 patients with LDH were recruited in their conservative stage of treatment. After profiling their physical status, all participants reported about pain level (according to VAS), pain perception using the Pain Catastrophizing Scale (PCS), and disability level (according to Oswestry Low Back Pain Disability Questionnaire). Their mental status was evaluated using the Spielberger's State-Trait Anxiety Inventory (STAI) and the Beck Depression Inventory (BDI-II). Their QOL was evaluated by the World Health Organization Quality of Life Questionnaire, brief version (WHOQOL-BREF). RESULTS Physical status/disability level correlated with anxiety and depression. While Physical status predicted physical QOL, mental status, and mainly anxiety and depression were the significant predictors of psychological, social, and environmental QOL. CONCLUSIONS Mental status may play a significant role in reducing most QOL domains among patients with LDH. The evaluation and intervention process should consider both physical and mental status and their relation to the person's QOL. Since QOL is a major parameter in determining intervention type and success this elaborated perspective may contribute to the intervention planning and outcomes. Implications for rehabilitaion A significant mental distress may accompany the physical disability of patients with LDH. The role of this mental distress in reducing the QOL of patients with LDH may be greater than that of their physical disability. The evaluation and intervention for patients with LDH should refer to both physical and mental status and explore their impacts on quality of life in order to elevate intervention success.
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Affiliation(s)
- Batya Engel-Yeger
- a Department of Occupational Therapy, Faculty of Social Welfare and Health Sciences , University of Haifa , Haifa , Israel
| | - Amit Keren
- b Rambam Health Care Campus , Orthopedic Spine Unit , Haifa , Israel
| | - Yaron Berkovich
- b Rambam Health Care Campus , Orthopedic Spine Unit , Haifa , Israel
| | - Elad Sarfaty
- c The Ruth and Bruce Rappaport Faculty of Medicine , Technion , Haifa , Israel
| | - Lior Merom
- b Rambam Health Care Campus , Orthopedic Spine Unit , Haifa , Israel.,d Assuta Medical Center , Haifa , Israel
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18
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Jaracz J, Gattner K, Jaracz K, Górna K. Unexplained Painful Physical Symptoms in Patients with Major Depressive Disorder: Prevalence, Pathophysiology and Management. CNS Drugs 2016; 30:293-304. [PMID: 27048351 PMCID: PMC4839032 DOI: 10.1007/s40263-016-0328-5] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Patients with major depression often report pain. In this article, we review the current literature regarding the prevalence and consequences, as well as the pathophysiology, of unexplained painful physical symptoms (UPPS) in patients with major depressive disorder (MDD). UPPS are experienced by approximately two-thirds of depressed patients. The presence of UPPS makes a correct diagnosis of depression more difficult. Moreover, UPPS are a predictor of a poor response to treatment and a more chronic course of depression. Pain, in the course of depression, also has a negative impact on functioning and quality of life. Frequent comorbidity of depression and UPPS has inspired the formulation of an hypothesis regarding a shared neurobiological mechanism of both conditions. Evidence from neuroimaging studies has shown that frontal-limbic dysfunction in depression may explain abnormal pain processing, leading to the presence of UPPS. Increased levels of proinflamatory cytokines and substance P in patients with MDD may also clarify the pathophysiology of UPPS. Finally, dysfunction of the descending serotonergic and noradrenergic pathways that normally suppress ascending sensations has been proposed as a core mechanism of UPPS. Psychological factors such as catastrophizing also play a role in both depression and chronic pain. Therefore, pharmacological treatment and/or cognitive therapy are recommended in the treatment of depression with UPPS. Some data suggest that serotonin and noradrenaline reuptake inhibitors (SNRIs) are more effective than selective serotonin reuptake inhibitors (SSRIs) in the alleviation of depression and UPPS. However, the pooled analysis of eight randomised clinical trials showed similar efficacy of duloxetine (an SNRI) and paroxetine (an SSRI) in reducing UPPS in depression. Further integrative studies examining genetic factors (e.g. polymorphisms of genes for interleukins, serotonin transporter and receptors), molecular factors (e.g. cytokines, substance P) and neuroimaging findings (e.g. functional studies during painful stimulation) might provide further explanation of the pathophysiology of UPPS in MDD and therefore facilitate the development of more effective methods of treatment.
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Affiliation(s)
- Jan Jaracz
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Szpitalna str 27/33, 60-572, Poznan, Poland.
| | - Karolina Gattner
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Szpitalna str 27/33, 60-572, Poznan, Poland
| | - Krystyna Jaracz
- Department of Neurological and Psychiatric Nursing, Poznan University of Medical Sciences, Poznan, Poland
| | - Krystyna Górna
- Department of Neurological and Psychiatric Nursing, Poznan University of Medical Sciences, Poznan, Poland
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19
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Bond DS, Buse DC, Lipton RB, Thomas JG, Rathier L, Roth J, Pavlovic JM, Evans EW, Wing RR. Clinical Pain Catastrophizing in Women With Migraine and Obesity. Headache 2015; 55:923-33. [PMID: 26087348 DOI: 10.1111/head.12597] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2015] [Indexed: 12/18/2022]
Abstract
OBJECTIVE/BACKGROUND Obesity is related to migraine. Maladaptive pain coping strategies (eg, pain catastrophizing) may provide insight into this relationship. In women with migraine and obesity, we cross-sectionally assessed: (1) prevalence of clinical catastrophizing; (2) characteristics of those with and without clinical catastrophizing; and (3) associations of catastrophizing with headache features. METHODS Obese women migraineurs seeking weight loss treatment (n = 105) recorded daily migraine activity for 1 month via smartphone and completed the Pain Catastrophizing Scale (PCS). Clinical catastrophizing was defined as total PCS score ≥30. The six-item Headache Impact Test (HIT-6), 12-item Allodynia Symptom Checklist (ASC-12), Headache Management Self-Efficacy Scale (HMSE), and assessments for depression (Centers for Epidemiologic Studies Depression Scale) and anxiety (seven-item Generalized Anxiety Disorder Scale) were also administered. Using PCS scores and body mass index (BMI) as predictors in linear regression, we modeled a series of headache features (ie, headache days, HIT-6, etc) as outcomes. RESULTS One quarter (25.7%; 95% confidence interval [CI] = 17.2-34.1%) of participants met criteria for clinical catastrophizing: they had higher BMI (37.9 ± 7.5 vs 34.4 ± 5.7 kg/m(2) , P = .035); longer migraine attack duration (160.8 ± 145.0 vs 97.5 ± 75.2 hours/month, P = .038); higher HIT-6 scores (68.7 ± 4.6 vs 64.5 ± 3.9, P < .001); more allodynia (7.0 ± 4.1 vs 4.5 ± 3.5, P < .003), depression (25.4 ± 12.4 vs 13.3 ± 9.2, P < .001), and anxiety (11.0 ± 5.2 vs 5.6 ± 4.1, P < .001); and lower self-efficacy (80.1 ± 25.6 vs 104.7 ± 18.9, P < .001) compared with participants without clinical catastrophizing. The odds of chronic migraine were nearly fourfold greater in those with (n = 8/29.6%) vs without (n = 8/10.3%) clinical catastrophizing (odds ratio = 3.68; 95%CI = 1.22-11.10, P = .021). In all participants, higher PCS scores were related to more migraine days (β = 0.331, P = .001), longer attack duration (β = 0.390, P < .001), higher HIT-6 scores (β = 0.425, P < .001), and lower HMSE scores (β = -0.437, P < .001). Higher BMI, but not higher PCS scores, was related to more frequent attacks (β = -0.203, P = .044). CONCLUSIONS One quarter of participants with migraine and obesity reported clinical catastrophizing. These individuals had more frequent attacks/chronicity, longer attack duration, higher pain sensitivity, greater headache impact, and lower headache management self-efficacy. In all participants, PCS scores were related to several migraine characteristics, above and beyond the effects of obesity. Prospective studies are needed to determine sequence and mechanisms of relationships between catastrophizing, obesity, and migraine.
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Affiliation(s)
- Dale S Bond
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University/The Miriam Hospital Weight Control and Diabetes Research Center, Providence, RI, USA
| | - Dawn C Buse
- Department of Neurology and the Montefiore Headache Center, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY, USA
| | - Richard B Lipton
- Department of Neurology and the Montefiore Headache Center, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY, USA
| | - J Graham Thomas
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University/The Miriam Hospital Weight Control and Diabetes Research Center, Providence, RI, USA
| | - Lucille Rathier
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University/The Miriam Hospital, Providence, RI, USA
| | - Julie Roth
- Department of Neurology, Alpert Medical School of Brown University, Providence, RI, USA
| | - Jelena M Pavlovic
- Department of Neurology and the Montefiore Headache Center, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY, USA
| | - E Whitney Evans
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University/The Miriam Hospital Weight Control and Diabetes Research Center, Providence, RI, USA
| | - Rena R Wing
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University/The Miriam Hospital Weight Control and Diabetes Research Center, Providence, RI, USA
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