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Scaini S, Michelini G, De Francesco S, Fagnani C, Medda E, Stazi MA, Battaglia M. Adolescent pain, anxiety, and depressive problems: a twin study of their co-occurrence and the relationship to substance use. Pain 2022; 163:e488-e494. [PMID: 34294665 DOI: 10.1097/j.pain.0000000000002400] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 06/30/2021] [Indexed: 11/25/2022]
Abstract
ABSTRACT Data on the etiological factors underlying the co-occurrence of common adolescent pain with anxiety and depression symptoms are very limited. Opioid prescriptions for adolescent pain problems are on the rise in North America and constitute a risk factor for diversion, misuse, and substance use. In this study, we aimed to investigate the phenotypic and etiological association among pain, depression, and anxiety and to test their link to substance use in adolescents. By taking advantage of the Italian National Twin Registry and of the relatively low incidence of opioid prescriptions in Italy, we applied multivariate modelling analyses to 748 Italian adolescent twins (374 pairs, mean age 16 ± 1.24 years). Twins' responses to the Achenbach Youth Self-Report questionnaire were used to build a composite adolescent pain index and to measure anxiety, depression, and substance use. All monozygotic within-pair correlations were higher than the dizygotic correlations, indicating genetic influences for adolescent pain, anxiety, and depressive problems. A common latent liability factor influenced by genetic and environmental elements shared among pain, depression, and anxiety provided the best fit to explain the co-occurrence of adolescent pain, anxiety, and depression problems. A common phenotypic factor capturing all 3 phenotypes was positively associated (β = 0.19, P < 0.001, confidence interval: 0.10-0.27) with substance use. These findings indicate that several intertwined mechanisms, including genetic factors, can explain a shared liability to common adolescent pain, anxiety, and depression problems. Their association with substance use remains traceable even in societies with relatively low prevalence of opioid prescriptions.
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Affiliation(s)
- Simona Scaini
- Child and Youth Lab, Sigmund Freud University, Milan, Italy
| | - Giorgia Michelini
- Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, United States
| | | | - Corrado Fagnani
- Centre for Behavioural Sciences and Mental Health, Istituto Superiore di Sanità, Rome, Italy
| | - Emanuela Medda
- Centre for Behavioural Sciences and Mental Health, Istituto Superiore di Sanità, Rome, Italy
| | - Maria Antonietta Stazi
- Centre for Behavioural Sciences and Mental Health, Istituto Superiore di Sanità, Rome, Italy
| | - Marco Battaglia
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, ON, Canada
- Cundill Centre for Child and Youth Depression, Toronto, ON, Canada
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Delgado-Gallén S, Soler MD, Albu S, Pachón-García C, Alviárez-Schulze V, Solana-Sánchez J, Bartrés-Faz D, Tormos JM, Pascual-Leone A, Cattaneo G. Cognitive Reserve as a Protective Factor of Mental Health in Middle-Aged Adults Affected by Chronic Pain. Front Psychol 2021; 12:752623. [PMID: 34759872 PMCID: PMC8573249 DOI: 10.3389/fpsyg.2021.752623] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 09/16/2021] [Indexed: 12/25/2022] Open
Abstract
Chronic pain is associated with worse mental health and cognitive impairment, which can be a cause or a consequence of brain structure and function alterations, e.g., maladaptive plasticity, antinociceptive system dysregulation. Cognitive reserve reflects the effectiveness of the internal connections of the brain and it has been shown to be a protective factor in brain damage, slowing cognitive aging or reducing the risk of mental health disorders. The current study explored the impact of chronic pain on psychosocial factors, mental health, and cognition. Furthermore, we aimed to examine the role of cognitive reserve in the relationship between mental health and chronic pain clinical characteristics in middle-aged adults. The study group consisted of 477 volunteers from the Barcelona Brain Health Initiative who completed online surveys on pain, mental health, cognitive reserve, and psychosocial factors (sleep and quality of life). We described the differences in sociodemographic data, psychosocial factors, mental health, and self-perceived cognitive impairment, and neuropsychological assessment, between participants reporting pain compared with those without pain, as well as the main characteristics of the chronic pain group. Finally, to study the role of cognitive reserve in the modulation of the relationship between chronic pain and mental health, we compared variables between subgroups of participants with high/low pain intensity and cognitive reserve. The results showed that chronic pain was reported by 45.5% of middle-aged adults. Our results revealed that participants with chronic pain were older and had worse health status than people without pain. The presence of chronic pain affected working memory, mental health, and daily life activities. Moreover, cognitive reserve moderated the influence of pain intensity on mental health, resulting in less mental health affection in people suffering from high pain intensity with high cognitive reserve. In conclusion, the construct of the cognitive reserve could explain differential susceptibility between chronic pain and its mental health association and be a powerful tool in chronic pain assessment and treatment, principally due to its modifiable nature.
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Affiliation(s)
- Selma Delgado-Gallén
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la Universitat Autònoma de Barcelona (UAB), Badalona, Spain
- Departament de Medicina, Facultat de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
| | - M. Dolors Soler
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la Universitat Autònoma de Barcelona (UAB), Badalona, Spain
- Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Sergiu Albu
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la Universitat Autònoma de Barcelona (UAB), Badalona, Spain
- Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Catherine Pachón-García
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la Universitat Autònoma de Barcelona (UAB), Badalona, Spain
- Departament de Medicina, Facultat de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
| | - Vanessa Alviárez-Schulze
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la Universitat Autònoma de Barcelona (UAB), Badalona, Spain
- Departament de Medicina, Facultat de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
| | - Javier Solana-Sánchez
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la Universitat Autònoma de Barcelona (UAB), Badalona, Spain
- Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - David Bartrés-Faz
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la Universitat Autònoma de Barcelona (UAB), Badalona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
| | - Josep M. Tormos
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la Universitat Autònoma de Barcelona (UAB), Badalona, Spain
- Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Alvaro Pascual-Leone
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la Universitat Autònoma de Barcelona (UAB), Badalona, Spain
- Hinda and Arthur Marcus Institute for Aging Research and Center for Memory Health, Hebrew SeniorLife, Boston, MA, United States
- Department of Neurology, Harvard Medical School, Boston, MA, United States
| | - Gabriele Cattaneo
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la Universitat Autònoma de Barcelona (UAB), Badalona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Spain
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Battaglia M, Garon-Carrier G, Brendgen M, Feng B, Dionne G, Vitaro F, Tremblay RE, Boivin M. Trajectories of pain and anxiety in a longitudinal cohort of adolescent twins. Depress Anxiety 2020; 37:475-484. [PMID: 31944483 DOI: 10.1002/da.22992] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 12/15/2019] [Accepted: 12/20/2019] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Adolescence is critical to intercept chronic/persistent pain and decipher its association with anxiety. We ascertained adolescent pain trajectories, their demographic and clinical correlates, the longitudinal association with opiate prescriptions at age 19, and the etiology of the covariation between adolescent pain problems and anxiety symptoms. METHODS Longitudinal assessment of: 6 common pain problems at age 12, 13, 14, 15, and 17 years; 7 common anxiety symptoms at age 12, 13, and 14 years; opiates' prescriptions at age 19, in the Quebec Newborn Twin Study birth cohort of 667 twin pairs born between 1995-1998. RESULTS Analyses yielded three trajectories of: "none-to-minimal" (34.3%), "sporadic" (56.7%), and "frequent" (9.0%) pain problems between age 12-17. Anxiety (odds ratios [OR] ORage12 : 2.38; confidence interval [CI]: 1.26-4.47; ORage13 : 3.96; CI: 1.73-9.05; ORage14 : 5.45; CI: 2.67-11.11), the female sex (OR: 3.69; CI: 2.20-6.21), and lower socioeconomic status (OR: 0.87; CI: 0.77-0.98) were associated with the "frequent" compared to the "none-to-minimal" pain trajectory. Only the "frequent" pain trajectory predicted opioid prescriptions at age 19 (OR: 4.14; CI: 1.16-14.55). A twin bivariate latent growth curve model and a cross-lagged model showed that genetic factors and non-shared environmental factors common to both phenotypes influence the longitudinal association between anxiety and adolescent pain problems. CONCLUSIONS The relatively common, adolescent "frequent pain" trajectory predicts early opioid prescriptions, and anxiety and adolescent pain share multiple etiological components. These data can inform diagnostic reasoning, clinical practice, and help reducing opioid prescriptions and abuse.
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Affiliation(s)
- Marco Battaglia
- Department of Psychiatry, The University of Toronto, Toronto, Canada.,Child, Youth and Emerging Adults Programme, Centre for Addiction and Mental Health, Toronto, Canada
| | | | - Mara Brendgen
- Department of Psychology, Université du Québec à Montréal, Montréal, Canada
| | - Bei Feng
- School of Psychology, Université Laval, Québec, Canada
| | | | - Frank Vitaro
- School of Psychoeducation, Université de Montréal, Montréal, Canada
| | - Richard E Tremblay
- Department of Pediatrics and Psychology, Université de Montréal, Montréal, Canada.,School of Public Health, Physiotherapy and Sport Sciences, University College Dublin, Dublin, Ireland
| | - Michel Boivin
- School of Psychology, Université Laval, Québec, Canada
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Sociodemographic patterns of pain in an urban community sample: an examination of intersectional effects of sex, race, age, and poverty status. Pain 2020; 161:1044-1051. [DOI: 10.1097/j.pain.0000000000001793] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Abstract
BACKGROUND Pain comorbid with depression is frequently encountered in clinical settings and often leads to significant impaired functioning. Given the complexity of comorbidities, it is important to address both pain and depressive symptoms when evaluating treatment options. AIM To review studies addressing pain comorbid with depression, and to report the impact of current treatments. METHOD A systematic search of the literature databases was conducted according to predefined criteria. Two authors independently conducted a focused analysis of the full-text articles and reached a consensus on 28 articles to be included in this review. RESULTS Overall, studies suggested that pain and depression are highly intertwined and may co-exacerbate physical and psychological symptoms. These symptoms could lead to poor physical functional outcomes and longer duration of symptoms. An important biochemical basis for pain and depression focuses on serotonergic and norepinephrine systems, which is evident in the pain-ameliorating properties of serotonergic and norepinephrine antidepressants. Alternative pharmacotherapies such as ketamine and cannabinoids appear to be safe and effective options for improving depressive symptoms and ameliorating pain. In addition, cognitive-behavioral therapy may be a promising tool in the management of chronic pain and depression. CONCLUSION The majority of the literature indicates that patients with pain and depression experience reduced physical, mental, and social functioning as opposed to patients with only depression or only pain. In addition, ketamine, psychotropic, and cognitive-behavioral therapies present promising options for treating both pain and depression.
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Kim J, Lyon D, Weaver MT, Keenan G, Chen X(J. The role of psychological distress in the relationship between the severity of pressure injury and pain intensity in hospitalized adults. J Adv Nurs 2019; 75:1219-1228. [PMID: 30456856 PMCID: PMC7227670 DOI: 10.1111/jan.13913] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 10/02/2018] [Indexed: 12/01/2022]
Abstract
AIMS To examine the effect of psychological distress in mediating the relationship between the severity of pressure injury and pain intensity in hospitalized adults. BACKGROUND Despite the prevalence of pressure injury (previously known as pressure ulcers) in hospitalized adults, the current knowledge of pain associated with pressure injury is limited and findings are inconsistent. There is also a lack of understanding of the relationship between psychological distress and pain from pressure injury. DESIGN Retrospective cross-sectional secondary analysis of data from electronic health records. METHODS The data were retrieved from the third day of admission in the period between 2013 - 2016 through the Integrated Data Repository (IDR). Electronic health records were reviewed to collect data as needed. The mediation effect was tested by using path analysis implemented through Mplus. RESULTS Path analysis revealed that the severity of pressure injuries and psychological distress have significant direct effects on pain intensity in hospitalized adults. However, the relationship between the severity of pressure injury and pain intensity was not significantly mediated by psychological distress. CONCLUSION Hospitalized adults who have more severe pressure injury and more treatments for psychological distress experienced greater pain intensity. Healthcare providers must pay attention to treating psychological distress among hospitalized adults to manage pain. Further study is needed to validate these findings and it should incorporate more appropriate measures of psychological distress. The lack of standardized nursing documentation in electronic health records severely limits the usefulness of data from electronic health records for nursing research.
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Affiliation(s)
- Junglyun Kim
- Department of Family, Community and Health System Science, College of Nursing, University of Florida, Gainesville, Florida
| | - Debra Lyon
- Department of Biobehavioral Nursing, College of Nursing, University of Florida, Gainesville, Florida
| | - Michael T. Weaver
- Department of Biobehavioral Nursing, College of Nursing, University of Florida, Gainesville, Florida
| | - Gail Keenan
- Department of Family, Community and Health System Science, College of Nursing, University of Florida, Gainesville, Florida
| | - Xinguang (Jim) Chen
- Department of Epidemiology, College of Public Health and Health Professions & College of Medicine, University of Florida, Gainesville, Florida
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Contreras EFR, Fernandes G, Ongaro PCJ, Campi LB, Gonçalves DAG. Systemic diseases and other painful conditions in patients with temporomandibular disorders and migraine. Braz Oral Res 2018; 32:e77. [DOI: 10.1590/1807-3107bor-2018.vol32.0077] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2017] [Accepted: 02/21/2018] [Indexed: 02/17/2023] Open
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8
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Mallon T, Ernst A, Brettschneider C, König HH, Luck T, Röhr S, Weyerer S, Werle J, Mösch E, Weeg D, Fuchs A, Pentzek M, Kleineidam L, Heser K, Riedel-Heller S, Maier W, Wiese B, Scherer M. Prevalence of pain and its associated factors among the oldest-olds in different care settings - results of the AgeQualiDe study. BMC FAMILY PRACTICE 2018; 19:85. [PMID: 29885656 PMCID: PMC5994256 DOI: 10.1186/s12875-018-0768-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 05/21/2018] [Indexed: 01/09/2023]
Abstract
BACKGROUND The prevalence of pain is very common in the oldest age group. Managing pain successfully is a key topic in primary care, especially within the ageing population. Different care settings might have an impact on the prevalence of pain and everyday life. METHODS Participants from the German longitudinal cohort study on Needs, Health Service Use, Costs and Health-related Quality of Life in a large Sample of Oldest-old Primary Care Patients (85+) (AgeQualiDe) were asked to rate their severity of pain as well as the impairment with daily activities. Besides gender, age, education, BMI and use of analgesics we focused on the current housing situation and on cognitive state. Associations of the dependent measures were tested using four ordinal logistic regression models. Model 1 and 4 consisted of the overall sample, model 2 and 3 were divided according to no cognitive impairment (NCI) and mild cognitive impairment (MCI). RESULTS Results show a decline in pain at very old age but nonetheless a high prevalence among the 85+ year olds. Sixty-three per cent of the participants report mild to severe pain and 69% of the participants mild to extreme impairment due to pain with daily activities. Use of analgesics, depression and living at home with care support are significantly associated with higher and male gender with lower pain ratings. CONCLUSIONS Sufficient pain management among the oldest age group is inevitable. Outpatient care settings are at risk of overlooking pain. Therefore focus should be set on pain management in these settings.
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Affiliation(s)
- Tina Mallon
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Annette Ernst
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christian Brettschneider
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Tobias Luck
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany
| | - Susanne Röhr
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany
| | - Siegfried Weyerer
- Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Jochen Werle
- Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Edelgard Mösch
- Department of Psychiatry, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Dagmar Weeg
- Department of Psychiatry, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Angela Fuchs
- Institute of General Practice, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Michael Pentzek
- Institute of General Practice, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | | | - Kathrin Heser
- Department of Psychiatry, University of Bonn, Bonn, Germany
| | - Steffi Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany
| | - Wolfgang Maier
- Department of Psychiatry, University of Bonn, Bonn, Germany.,DZNE, German Center for Neurodegenerative Diseases, Bonn, Germany
| | - Birgitt Wiese
- Work Group Medical Statistics and IT-Infrastructure, Institute for General Practice, Hannover Medical School, Hannover, Germany
| | - Martin Scherer
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Are Migraine and Tension-Type Headache Genetically Related? An Investigation of Twin Family Data. Twin Res Hum Genet 2018; 21:112-118. [DOI: 10.1017/thg.2018.5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Migraine and tension-type headache (TTH) are often viewed as distinct entities and defined as such in the International Classification of Headache Disorders, 2nd edition (ICHD-II) criteria, although there is also empirical evidence to suggest they may be etiologically similar. This study aims to investigate whether migraine and TTH are etiologically related conditions. First, we explored whether migraine and TTH were associated with the same environmental and lifestyle risk factors at the population level. Second, we examined comorbidity of migraine and TTH in a twin design. By comparing the associations in monozygotic (MZ) and dizygotic (DZ) twin pairs, we investigated whether the comorbidity can be explained by genetic factors that influence both conditions. Results indicated that migraine and TTH were largely associated with the same environmental and lifestyle factors, including younger age, female sex, higher body mass index, more depression, stress at home, and less participation in regular exercise, with consistently stronger effects for migraine than for TTH. Migraine in one twin was significantly associated with TTH in the other twin. A stronger cross-trait, cross-twin association in MZ than DZ twins suggested that this comorbidity may also be partly due to shared genetic factors, although the difference in associations was not significant. In conclusion, our findings are consistent with the hypothesis that migraine and TTH have partly shared etiologies. For both treatment and research, it may be advisable not to make a rigid distinction, but to treat migraine and TTH as related conditions.
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Fishbain DA, Pulikal A, Lewis JE, Gao J. Chronic Pain Types Differ in Their Reported Prevalence of Post -Traumatic Stress Disorder (PTSD) and There Is Consistent Evidence That Chronic Pain Is Associated with PTSD: An Evidence-Based Structured Systematic Review. PAIN MEDICINE 2018; 18:711-735. [PMID: 27188666 DOI: 10.1093/pm/pnw065] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Objectives The hypotheses of this systematic review were the following: 1) Prevalence of post-traumatic stress disorder (PTSD) will differ between various types of chronic pain (CP), and 2) there will be consistent evidence that CP is associated with PTSD. Methods Of 477 studies, 40 fulfilled the inclusion/exclusion criteria of this review and were grouped according to the type of CP. The reported prevalence of PTSD for each grouping was determined by aggregating all the patients in all the studies in that group. Additionally all patients in all groupings were combined. Percentage of studies that had found an association between CP and PTSD was determined. The consistency of the evidence represented by the percentage of studies finding an association was rated according to the Agency for Health Care Policy and Research guidelines. Results Grouping PTSD prevalence differed ranging from a low of 0.69% for chronic low back pain to a high of 50.1% in veterans. Prevalence in the general population with CP was 9.8%. Of 19 studies, 16 had found an association between CP and PTSD (84.2%) generating an A consistency rating (consistent multiple studies). Three of the groupings had an A or B (generally consistent) rating. The veterans grouping received a C (finding inconsistent) rating. Conclusion The results of this systematic review confirmed the hypotheses of this review.
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Affiliation(s)
- David A Fishbain
- Department of Psychiatry, Miller School of Medicine at the University of Miami, Florida, USA.,Neurological Surgery, Miller School of Medicine at the University of Miami, Florida, USA,Anesthesiology, Miller School of Medicine at the University of Miami, Florida, USA.,Department of Psychiatry, Miami VA Medical Center, Miami, Florida, USA.,State Farm Insurance Bloomington, Illinois, USA
| | - Aditya Pulikal
- Department of Psychiatry, Miller School of Medicine at the University of Miami, Florida, USA
| | - John E Lewis
- Department of Psychiatry, Miller School of Medicine at the University of Miami, Florida, USA
| | - Jinrun Gao
- State Farm Insurance Bloomington, Illinois, USA
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Pagé MG, Fortier M, Ware MA, Choinière M. As if one pain problem was not enough: prevalence and patterns of coexisting chronic pain conditions and their impact on treatment outcomes. J Pain Res 2018; 11:237-254. [PMID: 29416373 PMCID: PMC5790081 DOI: 10.2147/jpr.s149262] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION The presence of multiple coexisting chronic pain (CP) conditions (eg, low-back pain and migraines) within patients has received little attention in literature. The goals of this observational longitudinal study were to determine the prevalence of coexisting CP conditions, identify the most frequent ones and patterns of coexistence, investigate the relationships among patients' biopsychosocial characteristics and number of CP conditions, and determine the impact of coexisting CP conditions on treatment response. PATIENTS AND METHODS A total of 3,966 patients attending multidisciplinary pain-treatment centers who were enrolled in the Quebec Pain Registry were included. Patients completed self-report and nurse-administered questionnaires before their first visit and 6 months later. Results were analyzed using descriptive statistics, factor and cluster analyses, negative binomials with log-link generalized linear models, and linear mixed-effect models. RESULTS A third of patients reported coexisting CP conditions. No specific patterns of comorbidities emerged. The presence of coexisting CP conditions was associated with longer pain duration, older age, being female, and poorer quality of life. The presence of more than one CP condition did not have a clinically significant impact on treatment responses. DISCUSSION The novelty of the study results relate to the heterogeneity that was found in the patterns of coexistence of CP conditions and the fact that having multiple CP conditions did not clinically impact treatment response. These results highlight the need for future research that examines causes of coexistence among CP conditions across the spectrum of CP, as opposed to focusing on specific conditions, and to examine whether multiple CP conditions impact on additional domains, such as treatment satisfaction. These results highlight the importance of studying the pathophysiological mechanisms underlying the development of coexisting CP conditions, in order eventually to prevent/minimize their occurrence and/or develop optimal treatment and management approaches.
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Affiliation(s)
- M Gabrielle Pagé
- Centre de recherche du Centre hospitalier de l’Université de Montréal (CRCHUM)
- Department of Biomedical Sciences, Faculty of Medicine, Université de Montréal
| | - Maude Fortier
- Centre de recherche du Centre hospitalier de l’Université de Montréal (CRCHUM)
| | - Mark A Ware
- Department of Family Medicine
- Department of Anesthesia, Faculty of Medicine
- Alan Edwards Centre for Research on Pain, McGill University
| | - Manon Choinière
- Centre de recherche du Centre hospitalier de l’Université de Montréal (CRCHUM)
- Department of Anesthesiology, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
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Pain as a risk factor for common mental disorders. Results from the Netherlands Mental Health Survey and Incidence Study-2: a longitudinal, population-based study. Pain 2017; 159:712-718. [DOI: 10.1097/j.pain.0000000000001133] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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van Houtem CMHH, van Wijk AJ, Boomsma DI, Ligthart L, Visscher CM, De Jongh A. The factor structure of dental fear. Eur J Oral Sci 2017; 125:195-201. [PMID: 28421630 DOI: 10.1111/eos.12343] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2017] [Indexed: 11/28/2022]
Abstract
There is limited empirical information as to whether or how stimuli associated with dental fear can be classified into distinct subtypes. The purpose of the current study was to develop a descriptive framework for the classification of dental fear. Data were collected using a survey among Dutch twin families (n = 11,771). The sample was randomly divided into two subsamples of, respectively, 5,920 and 5,851 individuals. An exploratory factor analysis (EFA) was performed on the first subsample to delineate the multidimensional structure of a set of 28 dental-fear-provoking objects and situations. The second sample was used to confirm the newly derived model using confirmatory factor analysis (CFA). The EFA yielded a three-factor solution with 70.7% explained variance pertaining to: (i) invasive treatment or pain; (ii) losing control; and (iii) physical sensations. The CFA showed an acceptable fit to the data, thereby confirming the stability of the three-factor structure. There are at least three different subtypes of dental fear. As these subtypes require a different treatment approach in clinical practice, it could be important to assess the severity of patients' fear response along these three dimensions.
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Affiliation(s)
- Caroline M H H van Houtem
- Department of Social Dentistry, ACTA, University of Amsterdam and VU University Amsterdam, Amsterdam, the Netherlands
| | - Arjen J van Wijk
- Department of Social Dentistry, ACTA, University of Amsterdam and VU University Amsterdam, Amsterdam, the Netherlands
| | - Dorret I Boomsma
- Department of Biological Psychology, VU University, Amsterdam, the Netherlands
| | - Lannie Ligthart
- Department of Biological Psychology, VU University, Amsterdam, the Netherlands
| | - Corine M Visscher
- Department of Oral Kinesiology ACTA, Research Institute MOVE, University of Amsterdam and VU University Amsterdam, Amsterdam, the Netherlands
| | - Ad De Jongh
- Department of Social Dentistry, ACTA, University of Amsterdam and VU University Amsterdam, Amsterdam, the Netherlands.,School of Health Sciences, Salford University, Manchester, UK
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14
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de Heer EW, Vriezekolk JE, van der Feltz-Cornelis CM. Poor Illness Perceptions Are a Risk Factor for Depressive and Anxious Symptomatology in Fibromyalgia Syndrome: A Longitudinal Cohort Study. Front Psychiatry 2017; 8:217. [PMID: 29163236 PMCID: PMC5671978 DOI: 10.3389/fpsyt.2017.00217] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Accepted: 10/17/2017] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Patients with widespread pain, such as in fibromyalgia, are vulnerable for depression and anxiety, which composes a relevant public health problem. Identifying risk factors for the onset of depression and anxiety is therefore warranted. Objective of this study was to determine whether severe pain, maladaptive coping, and poor illness perceptions are associated with depressive and anxious symptomatology in fibromyalgia. METHOD Consecutive patients referred to an outpatient clinic completed sets of physical and psychological questionnaires at baseline and at 18-month follow-up. A total of 452 patients with fibromyalgia syndrome (FMS) were eligible for inclusion, and subsequently, 280 patients returned the baseline questionnaire. Depressive and anxious symptomatology was measured with the Hospital Anxiety and Depression Scale. To measure pain severity, coping style, and illness perceptions, the Fibromyalgia Impact Questionnaire, Pain Coping Inventory, and the Illness Perception Questionnaire-Revised (IPQ-R) were used, respectively. Multivariable logistic regression analyses, bootstrapping and calibration, were performed to examine the association of pain severity, pain coping, and illness perception with depressive and anxiety symptoms at follow-up, adjusted for sociodemographic variables. Initial level of depressive and anxiety symptoms was selected as covariates. RESULTS Mean age was 42.6 years and 95.4% were female. At 18-month follow-up, 68 (of the 195) patients were depressed and 80 (of the 197) were anxious. Only the IPQ-R subscale "emotional representations" showed a significant positive association with depressive symptoms at follow-up (OR = 1.10), next to the initial level of depressive symptoms (OR = 1.30). In case of anxiety, only the IPQ-R subscale "treatment control" showed a significant negative association with anxiety symptoms at follow-up (OR = 0.87), next to the initial level of anxiety symptoms (OR = 1.45). CONCLUSION Our data suggest that not pain severity or maladaptive coping, but poor illness perceptions are important in elevated depressive and anxious symptomatology. Patients with fibromyalgia who think their illness negatively affects their mental well-being are at increased risk for more depressive symptoms, and those who think treatment of their illness will not be effective are at increased risk for more anxiety symptoms. Strengthening illness beliefs and reducing catastrophic thinking, therefore, seem crucial factors in the treatment of patients with FMS.
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Affiliation(s)
- Eric W de Heer
- Centre of Excellence for Body, Mind and Health, GGz Breburg, Tilburg, Netherlands.,Tranzo Department, Tilburg School of Behavioural and Social Sciences, Tilburg University, Tilburg, Netherlands
| | | | - Christina M van der Feltz-Cornelis
- Centre of Excellence for Body, Mind and Health, GGz Breburg, Tilburg, Netherlands.,Tranzo Department, Tilburg School of Behavioural and Social Sciences, Tilburg University, Tilburg, Netherlands
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15
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McIntosh AM, Hall LS, Zeng Y, Adams MJ, Gibson J, Wigmore E, Hagenaars SP, Davies G, Fernandez-Pujals AM, Campbell AI, Clarke TK, Hayward C, Haley CS, Porteous DJ, Deary IJ, Smith DJ, Nicholl BI, Hinds DA, Jones AV, Scollen S, Meng W, Smith BH, Hocking LJ. Genetic and Environmental Risk for Chronic Pain and the Contribution of Risk Variants for Major Depressive Disorder: A Family-Based Mixed-Model Analysis. PLoS Med 2016; 13:e1002090. [PMID: 27529168 PMCID: PMC4987025 DOI: 10.1371/journal.pmed.1002090] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Accepted: 06/13/2016] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Chronic pain is highly prevalent and a significant source of disability, yet its genetic and environmental risk factors are poorly understood. Its relationship with major depressive disorder (MDD) is of particular importance. We sought to test the contribution of genetic factors and shared and unique environment to risk of chronic pain and its correlation with MDD in Generation Scotland: Scottish Family Health Study (GS:SFHS). We then sought to replicate any significant findings in the United Kingdom Biobank study. METHODS AND FINDINGS Using family-based mixed-model analyses, we examined the contribution of genetics and shared family environment to chronic pain by spouse, sibling, and household relationships. These analyses were conducted in GS:SFHS (n = 23,960), a family- and population-based study of individuals recruited from the Scottish population through their general practitioners. We then examined and partitioned the correlation between chronic pain and MDD and estimated the contribution of genetic factors and shared environment in GS:SFHS. Finally, we used data from two independent genome-wide association studies to test whether chronic pain has a polygenic architecture and examine whether genomic risk of psychiatric disorder predicted chronic pain and whether genomic risk of chronic pain predicted MDD. These analyses were conducted in GS:SFHS and repeated in UK Biobank, a study of 500,000 from the UK population, of whom 112,151 had genotyping and phenotypic data. Chronic pain is a moderately heritable trait (heritability = 38.4%, 95% CI 33.6% to 43.9%) that is significantly concordant in spouses (variance explained 18.7%, 95% CI 9.5% to 25.1%). Chronic pain is positively correlated with depression (ρ = 0.13, 95% CI 0.11 to 0.15, p = 2.72x10-68) and shows a tendency to cluster within families for genetic reasons (genetic correlation = 0.51, 95%CI 0.40 to 0.62, p = 8.24x10-19). Polygenic risk profiles for pain, generated using independent GWAS data, were associated with chronic pain in both GS:SFHS (maximum β = 6.18x10-2, 95% CI 2.84 x10-2 to 9.35 x10-2, p = 4.3x10-4) and UK Biobank (maximum β = 5.68 x 10-2, 95% CI 4.70x10-2 to 6.65x10-2, p < 3x10-4). Genomic risk of MDD is also significantly associated with chronic pain in both GS:SFHS (maximum β = 6.62x10-2, 95% CI 2.82 x10-2 to 9.76 x10-2, p = 4.3x10-4) and UK Biobank (maximum β = 2.56x10-2, 95% CI 1.62x10-2 to 3.63x10-2, p < 3x10-4). Limitations of the current study include the possibility that spouse effects may be due to assortative mating and the relatively small polygenic risk score effect sizes. CONCLUSIONS Genetic factors, as well as chronic pain in a partner or spouse, contribute substantially to the risk of chronic pain for an individual. Chronic pain is genetically correlated with MDD, has a polygenic architecture, and is associated with polygenic risk of MDD.
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Affiliation(s)
- Andrew M. McIntosh
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, United Kingdom
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, United Kingdom
- * E-mail:
| | - Lynsey S. Hall
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, United Kingdom
| | - Yanni Zeng
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, United Kingdom
| | - Mark J. Adams
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, United Kingdom
| | - Jude Gibson
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, United Kingdom
| | - Eleanor Wigmore
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, United Kingdom
| | - Saskia P. Hagenaars
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, United Kingdom
- Department of Psychology, University of Edinburgh, Edinburgh, United Kingdom
| | - Gail Davies
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, United Kingdom
- Department of Psychology, University of Edinburgh, Edinburgh, United Kingdom
| | | | - Archie I. Campbell
- Institute for Genetics and Molecular Medicine, University of Edinburgh, Western General Hospital, Edinburgh, United Kingdom
| | - Toni-Kim Clarke
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, United Kingdom
| | - Caroline Hayward
- Institute for Genetics and Molecular Medicine, University of Edinburgh, Western General Hospital, Edinburgh, United Kingdom
| | - Chris S. Haley
- Institute for Genetics and Molecular Medicine, University of Edinburgh, Western General Hospital, Edinburgh, United Kingdom
| | - David J. Porteous
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, United Kingdom
- Institute for Genetics and Molecular Medicine, University of Edinburgh, Western General Hospital, Edinburgh, United Kingdom
| | - Ian J. Deary
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, United Kingdom
- Department of Psychology, University of Edinburgh, Edinburgh, United Kingdom
| | - Daniel J. Smith
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Barbara I. Nicholl
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - David A. Hinds
- 23andMe Inc., Mountain View, California, United States of America
| | - Amy V. Jones
- Pfizer WRD, Human Genetics and Computational Biomedicine, Granta Park, Cambridge, United Kingdom
| | - Serena Scollen
- Pfizer WRD, Human Genetics and Computational Biomedicine, Granta Park, Cambridge, United Kingdom
| | - Weihua Meng
- Division of Population Health Sciences, University of Dundee, Ninewells Hospital and Medical School, Dundee, United Kingdom
| | - Blair H. Smith
- Division of Population Health Sciences, University of Dundee, Ninewells Hospital and Medical School, Dundee, United Kingdom
| | - Lynne J. Hocking
- The Institute of Medical Sciences, University of Aberdeen, Foresterhill, Aberdeen, United Kingdom
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16
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Zhang H, Zhang H, Wei Y, Lian Y, Chen Y, Zheng Y. Treatment of chronic daily headache with comorbid anxiety and depression using botulinum toxin A: a prospective pilot study. Int J Neurosci 2016; 127:285-290. [PMID: 27439999 DOI: 10.1080/00207454.2016.1196687] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Psychiatric comorbidities, including depression and anxiety, are clinical entities associated with chronic daily headache (CDH). Botulinum toxin A (BTA) is a Food and Drug Administration approved drug for the treatment of chronic migraine, a subtype form of CDH. This study aimed to investigate the potential efficacy and safety of BTA for controlling psychiatric symptoms in CDH patients. METHODS A prospective, open-label, pilot study (n = 30; 7 males, 23 females) was performed. A single low-dose of BTA (40-120 U) was injected into the pericranial muscle at multiple sites. Participants were evaluated before and 1, 4, 8, 12, 16, 20 and 24 weeks after BTA treatment. Primary outcomes included: (1) headache severity, determined by a visual analog scale; (2) depression and anxiety severity, assessed via the Hamilton Depression and Anxiety Rating Scales (HAM-D and HAM-A, respectively); (3) headache frequency per month and (4) single headache episode duration. RESULTS Headache severity was significantly ameliorated one week after treatment. Depression and anxiety symptoms were significantly reduced one month after treatment. At month four, the headache incidence per month decreased from 28.83 ± 2.95 to 17.57 ± 11.30 d (p < 0.001), and the single headache duration decreased from 12.03 ± 9.47 to 6.63 ± 8.98 h (p < 0.001). Furthermore, the percentage of patients who required analgesics significantly decreased. BTA was well tolerated, and the adverse events were mild and transient. CONCLUSION BTA treatment alleviated the severity and frequency of CDH, with improvements in depression and anxiety. These novel findings indicate that BTA may represent an effective and safe intervention to target psychiatric comorbidities in CDH.
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Affiliation(s)
- Hongwei Zhang
- a Department of Neurology , The First Affiliated Hospital of Zhengzhou University , Zhengzhou , China.,b Department of Neurology , The General Hospital of Pingmei Group , Pingdingshan , China
| | - Haifeng Zhang
- a Department of Neurology , The First Affiliated Hospital of Zhengzhou University , Zhengzhou , China
| | - Yingjie Wei
- a Department of Neurology , The First Affiliated Hospital of Zhengzhou University , Zhengzhou , China
| | - Yajun Lian
- a Department of Neurology , The First Affiliated Hospital of Zhengzhou University , Zhengzhou , China
| | - Yuan Chen
- a Department of Neurology , The First Affiliated Hospital of Zhengzhou University , Zhengzhou , China
| | - Yake Zheng
- a Department of Neurology , The First Affiliated Hospital of Zhengzhou University , Zhengzhou , China
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17
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Kim J, Ahn H, Lyon DE, Stechmiller J. Building a Biopsychosocial Conceptual Framework to Explore Pressure Ulcer Pain for Hospitalized Patients. Healthcare (Basel) 2016; 4:healthcare4010007. [PMID: 27417595 PMCID: PMC4934541 DOI: 10.3390/healthcare4010007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2015] [Revised: 12/10/2015] [Accepted: 12/28/2015] [Indexed: 01/15/2023] Open
Abstract
Although pressure ulcers are a prevalent condition, pain associated with pressure ulcers is not fully understood. Indeed, previous studies do not shed light on the association between pressure ulcer stages and the experience of pain. Especially, pain characteristics of suspected deep tissue injury, which is a new category that was recently added by the National Pressure Ulcer Advisory Panel, are yet unknown. This is concerning because the incidence of pressure ulcers in hospitalized patients has increased exponentially over the last two decades, and health care providers are struggling to ensure providing adequate care. Thus, in order to facilitate the development of effective interventions, this paper presents a conceptual framework to explore pressure ulcer pain in hospitalized patients. The concepts were derived from a biopsychosocial model of pain, and the relationships among each concept were identified through a literature review. Major propositions are presented based on the proposed conceptual framework, which integrates previous research on pressure ulcer pain, to ultimately improve understanding of pain in hospitalized patients with pressure ulcers.
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Affiliation(s)
- Junglyun Kim
- Department of Family, Community and Health System Science, University of Florida College of Nursing, P.O. BOX 100197, Gainesville, FL 32610-0197, USA.
| | - Hyochol Ahn
- Department of Family, Community and Health System Science, University of Florida College of Nursing, P.O. BOX 100197, Gainesville, FL 32610-0197, USA.
| | - Debra E Lyon
- Department of Family, Community and Health System Science, University of Florida College of Nursing, P.O. BOX 100197, Gainesville, FL 32610-0197, USA.
| | - Joyce Stechmiller
- Department of Family, Community and Health System Science, University of Florida College of Nursing, P.O. BOX 100197, Gainesville, FL 32610-0197, USA.
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18
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Hoogwout SJ, Paananen MV, Smith AJ, Beales DJ, O'Sullivan PB, Straker LM, Eastwood PR, McArdle N, Champion D. Musculoskeletal pain is associated with restless legs syndrome in young adults. BMC Musculoskelet Disord 2015; 16:294. [PMID: 26467305 PMCID: PMC4607251 DOI: 10.1186/s12891-015-0765-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2015] [Accepted: 10/08/2015] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND In recent years, there is considerable evidence of a relationship between the sensorimotor disorder restless legs syndrome (RLS) and pain disorders, including migraine and fibromyalgia. An association between multi-site pain and RLS has been reported in adult women. In the current study, we explored the association between musculoskeletal (MSK) pain and RLS in a large cohort of young adults. METHODS Twenty two year olds (n = 1072), followed since birth of part of the Western Australian Pregnancy Cohort (Raine) Study, provided data on MSK pain (duration, severity, frequency, number of pain sites). RLS was considered present when 4 diagnostic criteria recommended by the International Restless Legs Syndrome Study Group were met (urge to move, dysaesthesia, relief by movement, worsening symptoms during the evening/night) and participants had these symptoms at least 5 times per month. Associations between MSK pain and RLS were analyzed by multivariable logistic regression with bias-corrected bootstrapped confidence intervals, with final models adjusted for sex, psychological distress and sleep quality. RESULTS The prevalence of RLS was 3.0 % and MSK pain was reported by 37.4 % of the participants. In multivariable logistic regression models, strong associations were found between RLS-diagnosis and long duration (three months or more) of MSK pain (odds ratio 3.6, 95 % confidence interval 1.4-9.2) and reporting three or more pain sites (4.9, 1.6-14.6). CONCLUSIONS Different dimensions of MSK pain were associated with RLS in young adults, suggestive of shared pathophysiological mechanisms. Overlap between these conditions requires more clinical and research attention.
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Affiliation(s)
- Stijn J Hoogwout
- Faculty of Medical Sciences, University of Groningen, PO Box 72, 9700 AB, Groningen, The Netherlands.
- , Offenbachlaan 14, 2253 CR, Voorschoten, The Netherlands.
| | - Markus V Paananen
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, P.O. Box 8000, FI-90014, Oulu, Finland.
| | - Anne J Smith
- School of Physiotherapy and Exercise Science, Curtin University, GPO Box U1987, Perth, Western Australia, 6845, Australia.
| | - Darren J Beales
- School of Physiotherapy and Exercise Science, Curtin University, GPO Box U1987, Perth, Western Australia, 6845, Australia.
| | - Peter B O'Sullivan
- School of Physiotherapy and Exercise Science, Curtin University, GPO Box U1987, Perth, Western Australia, 6845, Australia.
| | - Leon M Straker
- School of Physiotherapy and Exercise Science, Curtin University, GPO Box U1987, Perth, Western Australia, 6845, Australia.
| | - Peter R Eastwood
- Centre for Sleep Science, School of Anatomy, Physiology & Human Biology, University of Western Australia, 35 Stirling Highway, Crawley, WA, 6009, Australia.
| | - Nigel McArdle
- Centre for Sleep Science, School of Anatomy, Physiology & Human Biology, University of Western Australia, 35 Stirling Highway, Crawley, WA, 6009, Australia.
| | - David Champion
- Department of Anaesthesia and Pain Medicine, Sydney Children's Hospital, High Street, Randwick, NSW, 2031, Australia.
- University of New South Wales, UNSW, Sydney, NSW, 2052, Australia.
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19
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Grimby-Ekman A, Gerdle B, Björk J, Larsson B. Comorbidities, intensity, frequency and duration of pain, daily functioning and health care seeking in local, regional, and widespread pain - a descriptive population-based survey (SwePain). BMC Musculoskelet Disord 2015; 16:165. [PMID: 26205125 PMCID: PMC4511999 DOI: 10.1186/s12891-015-0631-1] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Accepted: 07/14/2015] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The clinical knowledge of factors related to the spread of pain on the body has increased and understanding these factors is essential for effective pain treatment. This population-based study examines local (LP), regional (RP), and widespread pain (WSP) on the body regarding comorbidities, pain aspects, and impact of pain and elucidates how the spread of pain varies over time. MATERIAL AND METHODS A postal questionnaire that addressed pain aspects (intensity, frequency, duration and anatomical spreading on a body manikin), comorbidities and implications of pain (i.e., work situation, physical activity, consumption of health care and experience of hospitality and treatment of health care) was sent to 9000 adults living in southeastern Sweden. Of these, 4774 (53 %) completed and returned the questionnaire. After 9 weeks, a follow-up questionnaire was sent to the 2983 participants who reported pain in the first questionnaire (i.e. 62 % of 4774 subjects). Of these, 1940 completed and returned the questionnaire (i.e. 65 % of 2983 subjects). The follow-up questionnaire included the same items as the first questionnaire. RESULTS This study found differences in intensity, frequency and duration of pain, comorbidities, aspects of daily functioning and health care seeking in three pain categories based on spreading of pain: LP, RP and WSP. Compared to the participants with RP and LP, the participants with WSP had lower education and worse overall health, including more frequent heart disease and hypertension. In addition, participants with WSP had more intense, frequent, and long-standing pain, required more medical consultations, and experienced more impact on work. The participants with RP constituted an intermediate group regarding frequency and intensity of pain, and impact on work. The participants with LP were the least affected group regarding these factors. A substantial transition to RP had occurred by the 9-week follow-up. CONCLUSIONS This study shows an association between increased spread of pain and prevalence of heart disease, hypertension, more severe pain characteristics (i.e., intensity, frequency and duration), problems with common daily activities and increased health care seeking. The WSP group was the most affected group and the LP group was the least affected group. Regarding these factors, RP was an obvious intermediate group. The transitions between the pain categories warrant research that broadly investigates factors that increase and decrease pain.
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Affiliation(s)
- Anna Grimby-Ekman
- Occupational and Environmental Medicine, University of Gothenburg, Gothenburg, Sweden.
- Division of Community Medicine, Department of Medical and Health Sciences, Faculty of Health Sciences, Linköping University, Pain and Rehabilitation Center, Anaesthetics, Operations and Specialty Surgery Center, County Council of Östergötland, Linköping, Sweden.
| | - Björn Gerdle
- Division of Community Medicine, Department of Medical and Health Sciences, Faculty of Health Sciences, Linköping University, Pain and Rehabilitation Center, Anaesthetics, Operations and Specialty Surgery Center, County Council of Östergötland, Linköping, Sweden.
| | - Jonas Björk
- Division of Occupational and Environmental Medicine, AMM, Lund University, Lund, Sweden.
| | - Britt Larsson
- Division of Community Medicine, Department of Medical and Health Sciences, Faculty of Health Sciences, Linköping University, Pain and Rehabilitation Center, Anaesthetics, Operations and Specialty Surgery Center, County Council of Östergötland, Linköping, Sweden.
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20
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van Houtem CMHH, van Wijk AJ, Boomsma DI, Ligthart L, Visscher CM, de Jongh A. Self-reported gagging in dentistry: prevalence, psycho-social correlates and oral health. J Oral Rehabil 2015; 42:487-94. [PMID: 25784089 DOI: 10.1111/joor.12289] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/21/2015] [Indexed: 11/30/2022]
Abstract
Although gagging has a profound effect on the delivery of dental care, it is a relatively under-investigated phenomenon. This study aimed to derive a prevalence estimate of gagging during dental treatment based on patient-reported information, to determine some socio-demographic and psychological correlates and to assess the relationship of gagging with self-reported oral health and avoidance of dental care. Data were collected with a survey among Dutch twin families (n = 11 771). Estimated overall prevalence of gagging during dental treatment was 8·2% (95% CI 7·7-8·7). Patients' self-report of gagging was found to be significantly associated with female sex, a lower level of education and higher levels of dental trait anxiety, gagging-related fears (e.g. fear of objects in the mouth), anxious depression and neuroticism. Gagging also appeared to be significantly associated with untreated cavities, gingival bleeding and wearing full dentures, but not with avoidance of dental care. It can be concluded that individuals who report to gag during dental treatment are moderately dentally anxious, fear-specific situations that can trigger a gagging response and, albeit visiting the dentist equally frequently, report to have a poorer oral health compared to those who do not gag.
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Affiliation(s)
- C M H H van Houtem
- Department of Social Dentistry and Behavioural Sciences ACTA, University of Amsterdam and VU University, Amsterdam, The Netherlands
| | - A J van Wijk
- Department of Social Dentistry and Behavioural Sciences ACTA, University of Amsterdam and VU University, Amsterdam, The Netherlands
| | - D I Boomsma
- Department of Biological Psychology, VU University, Amsterdam, The Netherlands
| | - L Ligthart
- Department of Biological Psychology, VU University, Amsterdam, The Netherlands
| | - C M Visscher
- Department of Oral Kinesiology ACTA, Research Institute MOVE, University of Amsterdam and VU University, Amsterdam, The Netherlands
| | - A de Jongh
- Department of Social Dentistry and Behavioural Sciences ACTA, University of Amsterdam and VU University, Amsterdam, The Netherlands.,School of Health Sciences, Salford University, Manchester, UK
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21
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RUS MAKOVEC M, VINTAR N, MAKOVEC S. Self - Reported Depression, Anxiety and Evaluation of Own Pain in Clinical Sample of Patients with Different Location of Chronic Pain. Zdr Varst 2014; 54:1-10. [PMID: 27646616 PMCID: PMC4820143 DOI: 10.1515/sjph-2015-0001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Accepted: 09/18/2014] [Indexed: 12/18/2022] Open
Abstract
Background Depression, anxiety and chronic pain are frequent co-occurrent disorders. Patients with these mental disorders experience more intense pain that lasts for a longer time. Method Questionnaire with 228 variables was applied to 109 randomly chosen patients that were treated at an outpatient clinic for treatment of chronic pain of the University Clinical Centre Ljubljana from March to June 2013. 87 patients responded to the questionnaire (79.8%). Location of pain considering diagnosis was the criterion in the discriminant analysis (soft tissue disorders; headache; symptoms not elsewhere classified; back pain) and following summative scores as predictors: level of depression and anxiety (The Zung Self-Rating Depression/Anxiety Scale), evaluation of pain and perceptions of being threatened in social relations. Results Average age of participants was M = 52.7 years (SD 13.9), with 70.9% female, 29.1% male participants. 63% of respondents achieved clinically important level of depression and 54% clinically important level of anxiety. On univariate level, the highest level of depression and anxiety was found for back pain and the lowest for headache. No significant difference was found in evaluation of pain and perceptions of being threatened in social relations regarding location of pain. Self-evaluation of depression has, in the framework of discriminant analysis, the largest weight for prediction of differentiation between different locations of pain. Conclusion Different locations of pain have different connections with mood levels. The results of research on a preliminary level indicate the need to consider mental experience in the treatment of chronic pain.
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Affiliation(s)
- Maja RUS MAKOVEC
- University Psychiatric Hospital Ljubljana, Center for Mental Health, Poljanski nasip 58, 1000 Ljubljana, Slovenia
- Corresponding author: Tel: +386 1 300 34 75; E-mail:
| | - Neli VINTAR
- University Medical Centre Ljubljana, Clinical Department of Anesteziology, Zaloška 7, 1000 Ljubljana, Slovenia
| | - Samo MAKOVEC
- University of Ljubljana, Medical Faculty, Vrazov trg 2, 1000 Ljubljana, Slovenia
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