Interdisciplinarity and Integration: An Introduction to the Special Issue on Psychopathology in Medical Settings

The impact of COVID-19 on patients with chronic pain seeking care at a tertiary pain clinic

Empirical data on the health impacts of the COVID-19 pandemic remain scarce, especially among patients with chronic pain. We conducted a cross-sectional study matched by season to examine patient-reported health symptoms among patients with chronic pain pre- and post-COVID-19 pandemic onset. Survey responses were analyzed from 7535 patients during their initial visit at a tertiary pain clinic between April 2017-October 2020. Surveys included measures of pain and pain-related physical, emotional, and social function. The post-COVID-19 onset cohort included 1798 initial evaluations, and the control pre-COVID-19 cohort included 5737 initial evaluations. Patients were majority female, White/Caucasian, and middle-aged. The results indicated that pain ratings remained unchanged among patients after the pandemic onset. However, pain catastrophizing scores were elevated when COVID-19 cases peaked in July 2020. Pain interference, physical function, sleep impairment, and emotional support were improved in the post-COVID-19 cohort. Depression, anxiety, anger, and social isolation remained unchanged. Our findings provide evidence of encouraging resilience among patients seeking treatment for pain conditions in the face of the COVID-19 pandemic. However, our findings that pain catastrophizing increased when COVID-19 cases peaked in July 2020 suggests that future monitoring and consideration of the impacts of the pandemic on patients' pain is warranted.

What Factors are Associated with Posttraumatic Growth in Older Adults? A Systematic Review

OBJECTIVES

Posttraumatic growth (PTG) is of increased theoretical and clinical interest. However, less is known about PTG in older adults specifically. This systematic review aimed to identify domains where PTG is studied for older adults; investigate factors associated with PTG in older adults; consider how these might differ between historical and later life traumas.

METHODS

Online databases were searched for quantitative studies examining PTG outcomes in adults aged ≥ 60 years.

RESULTS

15 studies were subject to a narrative synthesis.

CONCLUSIONS

Older adults can experience substantial levels of PTG, from traumas during later life or across the lifespan, and historical wartime traumas. Traumas can be diverse, some studies found equivalent levels of PTG from different traumas across the lifespan. Social processes may be a key variable for older adults. Additional psychosocial factors are found; however, diverse findings reflect no overall model, and this may be consistent with variations found in other PTG literature.

CLINICAL IMPLICATIONS

Clinical considerations are discussed. As diverse studies, findings may not be widely generalizable and directions for further research are highlighted. PROSPERO: CRD42020169318.

¿Podemos ver el mundo igual? interdisciplinariedad en el cuidado paliativo

Los cuidados paliativos según la Organización Mundial (OMS) de la salud son aquellos cuidados que buscan mejorar la calidad de vida de las personas y de sus familias cuando afrontan problemas físicos, psicológicos, sociales o espirituales inherentes a una enfermedad potencialmente mortal; en el mundo se estima que alrededor de 40 millones de personas requieren cuidados paliativos, pero solo el 14% la reciben, igualmente la OMS indica que el 78% de las personas que necesitan cuidados paliativos viven en países en vía de desarrollo, lo que devela una gran de necesidad de atención paliativa no solo a la persona enferma si también a su familia. Los requerimientos en la atención paliativa a nivel mundial, van de la mano con el aumento del envejecimiento que confluye de manera progresiva y casi simultánea con las manifestaciones de desgaste orgánico y los procesos de salud y enfermedad enmarcados en el entorno y en la biografía del individuo, sin embargo no se debe desconocer que las personas en cualquier edad y en cualquier etapa de enfermedad grave son candidatos para recibir cuidados paliativos pudiendo requerir diferentes enfoques de atención según las necesidades propias de cada individuo, por otra parte el conocimiento basado en la genética, ha permitido la hipótesis de la vida, pero la realidad del entorno del individuo está influida desde antes del nacimiento, la historia nutricional, uso de tabaco, exposición a tóxicos ambientales y el ciclo vital se han definido como causantes de alteraciones epigenéticas, que pueden contribuir en las condiciones de enfermedad plausibles de cuidados paliativos en sus etapas avanzadas.