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Rohde G, Helseth S, Hagen M, Mikkelsen HT, Skarstein S, Haraldstad K. The relationship between gender, psychosocial factors, pain, health literacy and health-related quality of life in parents of Norwegian adolescents one year into the COVID-19 pandemic. BMC Public Health 2024; 24:980. [PMID: 38589853 PMCID: PMC11000350 DOI: 10.1186/s12889-024-18525-7] [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] [Received: 09/10/2023] [Accepted: 04/04/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND Stress impacts healthy behaviours and may influence life and health-related quality of life (HRQOL). A stressful event occurred when the COVID-19 pandemic hit in March 2020. The present study aims to explore possible gender differences in stress, psychosocial factors (self-efficacy, self-esteem, loneliness), pain, HL, and HRQOL in parents of adolescents one year into the COVID-19 pandemic, and to explore possible associations between gender, demographic and psychosocial factors, pain, HL, and HRQOL. METHODS Parents of adolescents aged 16-17 took part in the study from January to February 2021, when the COVID-19 pandemic was ongoing. Data on socio-demographics, stress, self-efficacy, self-esteem, pain, HL, loneliness, and HRQOL were collected. HRQOL was assessed using RAND-36. RESULTS Among the 320 parents from the general population, the mean age was 47.6 (standard deviation (SD) = 4.6) years, 81% were mothers, 79% were married or cohabiting, 81% had a university degree, and the majority worked full time (78%) or part time (13%). The average pain score was low, 0.48 (95% CI [0.43-0.54]). However, 50% of the parents reported persistent pain and more mothers reported persistent pain compared to fathers (53% vs. 37%). The parents' mean (SD) score for RAND-36 was 52.1 (95% CI [51.2-53.0]) for the physical component summary (PCS) score and 51.0 (95% CI [50.0-52.1]) for the mental component summary (MCS) score. Mothers reported significantly lower scores for all the eight RAND-36 domains and the PCS and MCS scores. Adjusting for gender, age, living condition, education, pain, HL, self-efficacy and loneliness, we revealed no associations between stress and RAND-36-PCS. University education of four years or more was positively associated (B = 3.29, 95% CI: [0.78-5.80]) with RAND-36-PCS, while persistent pain was negatively associated (B = -7.13, CI: [-9.20- -5.06]). We identified a strong negative association between RAND-36-MCS and stress (B = -43.11, CI: [-48.83- -37.38]) and a positive association with older age (B = 0.21, CI: [ 0.04, 0.39)]. CONCLUSION One year into the COVID-19 pandemic, we identified a strong negative association between stress and mental HRQOL, while pain was strongly negatively associated with physical HRQOL.
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Affiliation(s)
- Gudrun Rohde
- Department of Health and Nursing, Faculty of Health and Sport Sciences, University of Agder, Postbox 422, 4604, Kristiansand, Norway.
- Department of Clinical Research, Sorlandet Hospital, Kristiansand, Norway.
| | - Sølvi Helseth
- Department of Health and Nursing, Faculty of Health and Sport Sciences, University of Agder, Postbox 422, 4604, Kristiansand, Norway
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Milada Hagen
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Hilde Timenes Mikkelsen
- Department of Health and Nursing, Faculty of Health and Sport Sciences, University of Agder, Postbox 422, 4604, Kristiansand, Norway
| | - Siv Skarstein
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Kristin Haraldstad
- Department of Health and Nursing, Faculty of Health and Sport Sciences, University of Agder, Postbox 422, 4604, Kristiansand, Norway
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Connoy L, Solomon M, Longo R, Sud A, Katz J, Dale C, Stanley M, Webster F. Attending to Marginalization in The Chronic Pain Literature: A Scoping Review. Can J Pain 2024; 8:2335500. [PMID: 38831969 PMCID: PMC11146439 DOI: 10.1080/24740527.2024.2335500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 03/22/2024] [Indexed: 06/05/2024]
Abstract
Background There has been a recent and, for many within the chronic pain space, long-overdue increase in literature that focuses on equity, diversity, inclusion, and decolonization (EDI-D) to understand chronic pain among people who are historically and structurally marginalized. Aims In light of this growing attention in chronic pain research, we undertook a scoping review of studies that focus on people living with chronic pain and marginalization to map how these studies were carried out, how marginalization was conceptualized and operationalized by researchers, and identify suggestions for moving forward with marginalization and EDI-D in mind to better support people living with chronic pain. Methods We conducted this scoping review using critical analysis in a manner that aligns with dominant scoping review frameworks and recent developments made to scoping review methodology as well as reporting guidelines. Results Drawing on 67 studies, we begin with a descriptive review of the literature followed by a critical review that aims to identify fissures within the field through the following themes: (1) varying considerations of sociopolitical and socioeconomic contexts, (2) conceptual conflations between sex and gender, and (3) differing approaches to how people living with chronic pain and marginalization are described. Conclusion By identifying strengths and limitations in the research literature, we aim to highlight opportunities for researchers to contribute to a more comprehensive understanding of marginalization in chronic pain experiences.
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Affiliation(s)
- Laura Connoy
- Arthur and Sonia Labatt Family School of Nursing, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Michelle Solomon
- Arthur and Sonia Labatt Family School of Nursing, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Riana Longo
- Arthur and Sonia Labatt Family School of Nursing, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Abhimanyu Sud
- Department of Family and Community Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Joel Katz
- Department of Psychology, Faculty of Health, York University, Toronto, Ontario, Canada
- Department of Anesthesiology and Pain Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Craig Dale
- Lawrence Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
- Tory Trauma Program, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Meagan Stanley
- Western Libraries, Western University, London, Ontario, Canada
| | - Fiona Webster
- Arthur and Sonia Labatt Family School of Nursing, Faculty of Health Sciences, Western University, London, Ontario, Canada
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Abbas J, Hamoud K, Jubran R, Daher A. Has the COVID-19 outbreak altered the prevalence of low back pain among physiotherapy students? JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:2038-2043. [PMID: 34353241 DOI: 10.1080/07448481.2021.1953505] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 05/16/2021] [Accepted: 07/02/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To evaluate the prevalence of low back pain (LBP) among physiotherapy students during the COVID-19 lockdown in the State of Israel. PARTICIPANTS/METHODS One hundred and sixty four physiotherapy students from all four-year student levels were invited to participate. One hundred and thirty-seven students (83.5%) were recruited in the study with 79 females (57.7%) and 58 males (42.3%). We used a structured anonymous questionnaire that sought standard information on age, height, weight, sports activity and low back pain (LBP) prevalence during three periods. RESULTS No significant differences were noted in the prevalence of LBP between the lockdown period compared to 12-month period in all four-year levels. More so, our findings showed that LBP prevalence among physiotherapy students was greater during the 12-month period compared to the lifetime period. CONCLUSIONS This study indicates that COVID-19 lockdown has no negative impact on the prevalence of LBP among physiotherapy students.
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Affiliation(s)
- Janan Abbas
- Department of Physical Therapy, Zefat Academic College, Zefat, Israel
| | - Kamal Hamoud
- Department of Physical Therapy, Zefat Academic College, Zefat, Israel
| | - Rana Jubran
- Department of Physical Therapy, Zefat Academic College, Zefat, Israel
| | - Amira Daher
- Department of Physical Therapy, Zefat Academic College, Zefat, Israel
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Oliveira AMBD, Teixeira DSDC, Menezes FDS, Marques AP, Duarte YADO, Casarotto RA. Socioeconomic and sex inequalities in chronic pain: A population-based cross-sectional study. PLoS One 2023; 18:e0285975. [PMID: 37228121 DOI: 10.1371/journal.pone.0285975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 04/27/2023] [Indexed: 05/27/2023] Open
Abstract
OBJECTIVE We investigated the impact of socioeconomic inequalities on chronic pain of older adults according to sex. MATERIALS AND METHODS This population-based cross-sectional study used survey data from the 2015 cohort of the SABE Study (Saúde, Bem-estar e Envelhecimento), Brazil. Socioeconomic status was examined at individual level (educational attainment, financial independence, and race/skin color) and contextual level (Human Development Index). We analyzed the association between variables using the chi-square test and the Rao & Scott correction. Logistic regression models were adjusted for risk factors. RESULTS The study comprised 1,207 older adults representing 1,365,514 residents 60≥ years of age in the city of São Paulo. Chronic pain was more frequent in females (27.2%) than in males (14.5%) (p<0.001). Females evidenced the worst self-perception of pain, especially those of the most vulnerable socioeconomic strata. Social inequalities impacted chronic pain in different ways between sexes. Among females, unfavorable living conditions (OR = 1.59; 95%CI 1.07; 2,37) and Blacks/Browns females were most likely to have chronic pain (OR = 1.32; 95%CI 1.01; 1.74). Among males, only the individual aspects were significant for the occurrence of chronic pain, such as low educational attainment (OR = 1.88; 95%CI 1.16; 3.04) and insufficient income (OR = 1.63; 95%CI 1.01; 2.62). DISCUSSION The potential for inequality was greater for females than for males reflecting structural factors inherent in a highly unequal society. Conclusions: Equity-oriented health policies are critical to preventing pain in human aging.
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Affiliation(s)
- Ana Maria Braga de Oliveira
- Department of Physiotherapy, Federal University of Sergipe, Lagarto, Brazil
- Rehabilitation Sciences Program, School of Medicine, University of São Paulo, São Paulo, Brazil
| | | | - Fabrício Dos Santos Menezes
- Department of Health Education, Federal University of Sergipe, Lagarto, Brazil
- School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Amélia Pasqual Marques
- Rehabilitation Sciences Program, School of Medicine, University of São Paulo, São Paulo, Brazil
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Li JX, Wang X, Henry A, Anderson CS, Hammond N, Harris K, Liu H, Loffler K, Myburgh J, Pandian J, Smyth B, Venkatesh B, Carcel C, Woodward M. Sex differences in pain expressed by patients across diverse disease states: individual patient data meta-analysis of 33,957 participants in 10 randomized controlled trials. Pain 2023:00006396-990000000-00275. [PMID: 36972472 DOI: 10.1097/j.pain.0000000000002884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 12/28/2022] [Indexed: 03/29/2023]
Abstract
ABSTRACT The experience of pain is determined by many factors and has a significant impact on quality of life. This study aimed to determine sex differences in pain prevalence and intensity reported by participants with diverse disease states in several large international clinical trials. Individual participant data meta-analysis was conducted using EuroQol-5 Dimension (EQ-5D) questionnaire pain data from randomised controlled trials published between January 2000 and January 2020 and undertaken by investigators at the George Institute for Global Health. Proportional odds logistic regression models, comparing pain scores between females and males and fitted with adjustments for age and randomized treatment, were pooled in a random-effects meta-analysis. In 10 trials involving 33,957 participants (38% females) with EQ-5D pain score data, the mean age ranged between 50 and 74. Pain was reported more frequently by females than males (47% vs 37%; P < 0.001). Females also reported greater levels of pain than males (adjusted odds ratio 1.41, 95% CI 1.24-1.61; P < 0.001). In stratified analyses, there were differences in pain by disease group (P for heterogeneity <0.001), but not by age group or region of recruitment. Females were more likely to report pain, and at a higher level, compared with males across diverse diseases, all ages, and geographical regions. This study reinforces the importance of reporting sex-disaggregated analysis to identify similarities and differences between females and males that reflect variable biology and may affect disease profiles and have implications for management.
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Amundsen PA, Underwood M, Burton K, Grotle M, Malmberg-Heimonen I, Kisa A, Småstuen MC, Holmgard TE, Martinsen A, Lothe J, Irgens PMS, Højen M, Monsen SS, Froud R. Individual supported work placements (ReISE) for improving sustained return to work in unemployed people with persistent pain: study protocol for a cohort randomised controlled trial with embedded economic and process evaluations. Trials 2023; 24:179. [PMID: 36906593 PMCID: PMC10006572 DOI: 10.1186/s13063-023-07211-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 03/01/2023] [Indexed: 03/13/2023] Open
Abstract
BACKGROUND Around one-third of workdays lost in Norway are due to musculoskeletal conditions, with persistent (chronic) pain being the most frequent cause of sick leave and work disability. Increasing work participation for people with persistent pain improves their health, quality of life, and well-being and reduces poverty; however, it is not clear how to best help unemployed people who have persistent pain to return to work. The aim of this study is to examine if a matched work placement intervention featuring case manager support and work-focused healthcare improves return to work rates and quality of life for unemployed people in Norway with persistent pain who want to work. METHODS We will use a cohort randomised controlled approach to test the effectiveness and cost-effectiveness of a matched work placement intervention featuring case manager support and work-focused healthcare compared to those receiving usual care in the cohort alone. We will recruit people aged 18-64, who have been out of work for at least 1 month, had pain for more than 3 months, and want to work. Initially, all (n = 228) will be recruited to an observational cohort study on the impact of being unemployed with persistent pain. We will then randomly select one in three to be offered the intervention. The primary outcome of sustained return to work will be measured using registry and self-reported data, while secondary outcomes include self-reported levels of health-related quality of life and physical and mental health. Outcomes will be measured at baseline and 3, 6, and 12 months post-randomisation. We will run a process evaluation parallel to the intervention exploring implementation, continuity of the intervention, reasons for participating, declining participation, and mechanisms behind cases of sustained return to work. An economic evaluation of the trial process will also be conducted. DISCUSSION The ReISE intervention is designed to increase work participation for people with persistent pain. The intervention has the potential to improve work ability by collaboratively navigating obstacles to working. If successful, the intervention may be a viable option for helping people in this population. TRIAL REGISTRATION ISRCTN Registry 85,437,524 Registered on 30 March 2022.
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Affiliation(s)
- Pål André Amundsen
- School of Health Sciences, Kristiana University College, PB 1190, Sentrum, 0107, Oslo, Norway.
| | - Martin Underwood
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK
| | - Kim Burton
- Professor of Occupational Healthcare, University of Huddersfield, Queensgate, Huddersfield, HD1 3DH, UK
| | - Margreth Grotle
- Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, St. Olavs Plass, P.O. Box 4, 0130, Oslo, Norway
| | - Ira Malmberg-Heimonen
- Department of Social Work, Child Welfare and Social Policy, Oslo Metropolitan University, St. Olavs Plass, P.O. Box 4, 0130, Oslo, Norway
| | - Adnan Kisa
- School of Health Sciences, Kristiana University College, PB 1190, Sentrum, 0107, Oslo, Norway
| | - Milada Cvancarova Småstuen
- Department of Nursing and Health Promotion, Faculty of Health Science, Oslo Metropolitan University, St. Olavs Plass, P.O. Box 4, 0130, Oslo, Norway
| | - Thor Einar Holmgard
- User representative from the Norwegian Back Pain Association, Fjellhagen, P.O. Box 9612, 3065, Drammen, Norway
| | - Amy Martinsen
- Department of Research, Innovation and Education, Division of Clinical Neuroscience, Research and Communication Unit for Musculoskeletal Health (FORMI), Oslo University Hospital, Ullevål, Building 37B, P.O. Box 4956 Nydalen, 0424, Oslo, Norway
| | - Jakob Lothe
- Co/FORMI, The Norwegian Council for Musculoskeletal Health, Oslo Universitetssykehus, Nydalen, P.O. Box 4956, 0424, Oslo, Norway
| | | | - Magnus Højen
- School of Health Sciences, Kristiana University College, PB 1190, Sentrum, 0107, Oslo, Norway
| | | | - Robert Froud
- School of Health Sciences, Kristiana University College, PB 1190, Sentrum, 0107, Oslo, Norway.,Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK
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Owiredua C, Flink I, Boersma K. Prevalence and risk factors for pain-specific school absenteeism in adolescents with recurrent pain: A prospective population-based design. Eur J Pain 2023; 27:390-400. [PMID: 36478020 DOI: 10.1002/ejp.2065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 11/16/2022] [Accepted: 12/04/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Adolescents with recurrent pain miss out from school more often than pain-free peers. Research has so far used cross-sectional designs, focusing on non-specific absenteeism in clinical samples. Hence, it is unknown whether estimates of absenteeism are specifically linked to the pain itself or reflects the characteristics of clinical samples. OBJECTIVES This study aimed to prospectively explore pain-related school absenteeism in a non-clinical sample, its variance and potential risk factors. METHODS This prospective study followed a cohort of 1300 Sweden-based adolescents (mean age = 16.9; 17.2% immigrants; 62.7% girls) with recurrent pain (headache, abdominal and/or musculoskeletal pain) through self-reports at two assessment points 12 months apart. RESULTS Overall, 64.2% reported any absenteeism at follow-up and about half of these (26.2%) reported frequent absenteeism. Adolescents who indicated missing school were more often girls, slightly older and had a higher overall pain burden and stressor levels. Yet, after adjusting for previous absenteeism, independent predictors were age, pain intensity, medication use and stress associated with school attendance. Further to this, immigrant status predicted frequent absenteeism. CONCLUSIONS Many adolescents with pain frequently miss out from school due to pain. Identified risk factors points at pain characteristics and coping, stressors associated with participation and advancing age. Taken together, the burden of pain and its correlates emerge earlier and escalate with increasing age hence, early interventions targeting broader domains are needed. SIGNIFICANCE This study adds substantially to the field by estimating the prevalence of pain-specific school absenteeism in a large sample of adolescents with recurrent pain in the general population using a prospective design. Furthermore, it identifies risk factors of pain-specific absenteeism from a broader context of the adolescent's life with independent predictors being the previous history of absenteeism, age, immigrant status, pain intensity, medication use and stress related to school attendance.
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Affiliation(s)
- Christiana Owiredua
- Subject of Psychology, Center for Health and Medical Psychology, School of Law, Psychology and Social Work, Örebro University, Örebro, Sweden
| | - Ida Flink
- Subject of Psychology, Center for Health and Medical Psychology, School of Law, Psychology and Social Work, Örebro University, Örebro, Sweden
| | - Katja Boersma
- Subject of Psychology, Center for Health and Medical Psychology, School of Law, Psychology and Social Work, Örebro University, Örebro, Sweden
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Morgan MM, Ataras K. Sex differences in the impact of pain, morphine administration and morphine withdrawal on quality of life in rats. Pharmacol Biochem Behav 2022; 219:173451. [PMID: 35995262 DOI: 10.1016/j.pbb.2022.173451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 07/27/2022] [Accepted: 08/17/2022] [Indexed: 11/17/2022]
Abstract
The disruptive effects of pain on quality of life are greater in men than in women, but the disruptive effects of opioid administration and withdrawal tend to be greater in women. These sex differences in pain, acute opioid effects, and opioid withdrawal tend to be opposite to sex differences reported in laboratory rats. We hypothesized that sex differences in humans and rats would more closely align if animal research measured quality of life as opposed to traditional evoked behaviors of pain (e.g., nociceptive reflexes) and opioid withdrawal (e.g., wet dog shakes). The present study assessed quality of life in adult female and male rats by measuring voluntary wheel running in the rat's home cage. Hindpaw inflammation induced by administration of Complete Freund's Adjuvant (CFA) into the right hindpaw caused a greater depression of wheel running in male compared to female rats. Twice daily injections of high morphine doses (5-20 mg/kg) and the subsequent morphine withdrawal caused a greater depression of wheel running in female compared to male rats. These sex differences are consistent with human data that shows the impact of pain on quality of life is greater in men than women, but the negative effects of opioid administration and withdrawal are greater in women. The present data indicate that the clinical significance of animal research would be enhanced by shifting the endpoint from pain and opioid evoked behaviors to measures of quality of life such as voluntary wheel running.
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Affiliation(s)
- Michael M Morgan
- Department of Psychology, Washington State University Vancouver, 14204 NE Salmon Creek Ave., Vancouver, WA 98686, United States of America.
| | - Kristin Ataras
- Department of Psychology, Washington State University Vancouver, 14204 NE Salmon Creek Ave., Vancouver, WA 98686, United States of America.
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Caputi V, Bastiaanssen TFS, Peterson V, Sajjad J, Murphy A, Stanton C, McNamara B, Shorten GD, Cryan JF, O'Mahony SM. Sex, pain, and the microbiome: The relationship between baseline gut microbiota composition, gender and somatic pain in healthy individuals. Brain Behav Immun 2022; 104:191-204. [PMID: 35688340 DOI: 10.1016/j.bbi.2022.06.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 05/19/2022] [Accepted: 06/05/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND AND AIM Relative to men, women present with pain conditions more commonly. Although consistent differences exist between men and women in terms of physiological pain sensitivity, the underlying mechanisms are incompletely understood and yet could inform the development of effective sex specific treatments for pain. The gut microbiota can modulate nervous system functioning, including pain signaling pathways. We hypothesized that the gut microbiota and critical components of the gut-brain axis might influence electrical pain thresholds. Further, we hypothesized that sex, menstrual cycle, and hormonal contraceptive use might account for inter-sex differences in pain perception. METHODS Healthy, non-obese males (N = 15) and females (N = 16), (nine of whom were using hormonal contraceptives), were recruited. Male subjects were invited to undergo testing once, whereas females were invited three times across the menstrual cycle, based on self-reported early follicular (EF), late follicular (LF), or mid-luteal (ML) phase. On test days, electrical stimulation on the right ankle was performed; salivary cortisol levels were measured in the morning; levels of lipopolysaccharide-binding protein (LBP), soluble CD14 (sCD14), pro-inflammatory cytokines were assessed in plasma, and microbiota composition and short-chain fatty acids (SCFAs) levels were determined in fecal samples. RESULTS We observed that the pain tolerance threshold/pain sensation threshold (PTT/PST) ratio was significantly lesser in women than men, but not PST or PTT alone. Further, hormonal contraceptive use was associated with increased LBP levels (LF & ML phase), whilst sCD14 levels or inflammatory cytokines were not affected. Interestingly, in women, hormonal contraceptive use was associated with an increase in the relative abundance of Erysipelatoclostridium, and the relative abundances of certain bacterial genera correlated positively with pain sensation thresholds (Prevotella and Megasphera) during the LF phase and cortisol awakening response (Anaerofustis) during the ML phase. In comparison with men, women displayed overall stronger associations between i) SCFAs data, ii) cortisol data, iii) inflammatory cytokines and PTT and PST. DISCUSSION AND CONCLUSION Our findings support the hypothesis that the gut microbiota may be one of the factors determining the physiological inter-sex differences in pain perception. Further research is needed to investigate the molecular mechanisms by which specific sex hormones and gut microbes modulate pain signaling pathways, but this study highlights the possibilities for innovative individual targeted therapies for pain management.
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Affiliation(s)
- Valentina Caputi
- APC Microbiome Ireland, University College Cork, Cork, Ireland; Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland
| | - Thomaz F S Bastiaanssen
- APC Microbiome Ireland, University College Cork, Cork, Ireland; Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland
| | | | - Jahangir Sajjad
- APC Microbiome Ireland, University College Cork, Cork, Ireland; Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland
| | - Amy Murphy
- Teagasc Food Research Centre, Moorepark, Co. Cork, Ireland
| | | | - Brian McNamara
- Department of Clinical Neurophysiology, Cork University Hospital, Co. Cork, Ireland
| | - George D Shorten
- Department of Anaesthesia and Intensive Care Medicine, University College Cork, Cork, Ireland
| | - John F Cryan
- APC Microbiome Ireland, University College Cork, Cork, Ireland; Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland
| | - Siobhain M O'Mahony
- APC Microbiome Ireland, University College Cork, Cork, Ireland; Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland.
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Mayoral Rojals V, Canós Verdecho Á, Soler López B. Assessment of the Management of Patients with Chronic Pain Referred to a Specialized Pain Unit: A Cross-Sectional Multicenter Study (the DUO Project). J Clin Med 2022; 11:jcm11133586. [PMID: 35806871 PMCID: PMC9267154 DOI: 10.3390/jcm11133586] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 06/08/2022] [Accepted: 06/21/2022] [Indexed: 01/27/2023] Open
Abstract
A multicenter cross-sectional study was designed to assess the quality of treatment of 1190 patients with chronic pain at the time of referral to a specialized pain unit. A total of 119 physicians from 77 pain units throughout Spain collected 23 indicators of the quality of care from 10 consecutive clinical records of chronic pain patients (5 men, 5 women). Degenerative spinal diseases (38.6%) and lumbosciatic pain (29.8%) were the most common etiologies. At the time of referral to the pain unit, 9.8% of patients were not receiving any analgesic treatment. Treatment was modified in 88.1% of the patients by adding adjuvant drugs, adding opioids or increasing the doses of analgesic medications, and using analgesic techniques. Women had higher percentages of osteoarthritis, headache and fibromyalgia as the cause of pain, longer duration of pain and severe pain intensity, and a higher proportion of changes in the diagnosis of the underlying condition with which they had been referred to the pain unit. Improvements should be made in the patient management and referral protocols not only in the clinics prior to patient referral to the pain unit, but also in the pain units themselves.
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Affiliation(s)
- Víctor Mayoral Rojals
- Pain Unit, Hospital Universitari de Bellvitge, IDIBELL, L’Hospitalet de Llobregat, 08907 Barcelona, Spain;
| | | | - Begoña Soler López
- Medical Department, E-C-BIO, S.L., Las Rozas, 28230 Madrid, Spain
- Correspondence:
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Petrie KA, Chen JN, Miears H, Grimes JS, Zumwalt M. Gender Differences in Seeking Health Care and Postintervention Pain Outcomes in Foot and Ankle Orthopedic Patients. WOMEN'S HEALTH REPORTS 2022; 3:500-507. [PMID: 35652003 PMCID: PMC9148655 DOI: 10.1089/whr.2021.0076] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 04/11/2022] [Indexed: 11/13/2022]
Abstract
Background: Materials and Methods: Results: Conclusions:
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Affiliation(s)
- Kyla A. Petrie
- School of Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
| | - Jason N. Chen
- School of Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
| | - Hunter Miears
- School of Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
| | - Jerry Speight Grimes
- Department of Orthopedic Surgery, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
| | - Mimi Zumwalt
- Department of Orthopedic Surgery, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
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12
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Walker N, Beek K, Chen H, Shang J, Stevenson S, Williams K, Herzog H, Ahmed J, Cullen P. The Experiences of Persistent Pain Among Women With a History of Intimate Partner Violence: A Systematic Review. TRAUMA, VIOLENCE & ABUSE 2022; 23:490-505. [PMID: 32945245 DOI: 10.1177/1524838020957989] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Women experience persistent pain at higher rates than men; however, women are less likely to be provided with adequate or appropriate care and more likely to have their pain experiences dismissed. The purpose of this review is to consider the complex interaction of the biopsychosocial factors in the experience of persistent pain in order to inform improved models of care. Given persistent pain is among the most frequently reported health consequences of intimate partner violence (IPV), this review focused on studies exploring the association between persistent pain and IPV. Three reviewers independently and systematically searched seven databases. Qualitative and quantitative studies describing the association between IPV and persistent pain published between January 2000 and June 2018 were included. Twelve studies met the inclusion criteria. The included studies demonstrated that a history of IPV places an additional burden on women who experience persistent pain that cannot be explained by an underlying psychological condition. Health care practitioners should be aware of this phenomena to ensure diagnosis, assessment, and treatment plans are targeted accordingly. Future policy directives and research should account for and seek to elucidate this additional burden.
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Affiliation(s)
- Natasha Walker
- School of Population Health, 7800University of New South Wales, Sydney, New South Wales, Australia
- 211065The George Institute for Global Health, Sydney, New South Wales, Australia
- University of Newcastle, New South Wales, Australia
| | - Kristen Beek
- School of Population Health, 7800University of New South Wales, Sydney, New South Wales, Australia
| | - Huan Chen
- The George Institute for Global Health, Beijing, China
| | - Jie Shang
- The George Institute for Global Health, Beijing, China
| | - Sally Stevenson
- The Illawarra Women's Health Centre, Warilla, New South Wales, Australia
| | - Karen Williams
- South Coast Private Hospital, Wollongong, New South Wales, Australia
| | - Hayley Herzog
- 211065The George Institute for Global Health, Sydney, New South Wales, Australia
- Silver School of Social Work, New York University, NY, USA
| | - Jareen Ahmed
- The University of Sydney, New South Wales, Australia
| | - Patricia Cullen
- School of Population Health, 7800University of New South Wales, Sydney, New South Wales, Australia
- 211065The George Institute for Global Health, Sydney, New South Wales, Australia
- Ngarruwan Ngadju, First Peoples Health and Wellbeing Research Centre, Australian Health Services Research Institute, University of Wollongong, New South Wales, Australia
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13
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Azab SMS, Tawfik H, Hayes BD. Intoxication related to substances use in patients presenting to Ain Shams University Poisoning Treatment Center, Cairo, Egypt (2015-2019). Drug Alcohol Rev 2022; 41:1109-1118. [PMID: 35178787 DOI: 10.1111/dar.13443] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 01/14/2022] [Accepted: 01/19/2022] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Illicit drug use may result in several emergencies. Hospital emergency data can help to detect new patterns of substance use and high-risk trends of drug use. This epidemiological study aimed to investigate the pattern and outcome of cases with substance use intoxication who presented to Ain Shams University Poisoning Treatment Centre, Cairo, Egypt. METHODS This retrospective study included all cases of acute intoxication due to use/misuse of substances who presented to the centre during the period (2015-2019). RESULTS The study included 11 281 cases; young adults (aged 20-40 years) represented the greatest proportion of cases (6519, 57.8%). Males were the predominant gender in all age groups (representing 79.2% of the cases). Tramadol was the most common substance of exposure in all age groups except for children and adolescents where cannabis was the most common one. There were 162 fatalities (1.4% of all cases) and opioids had the greatest case fatality rate. DISCUSSION AND CONCLUSIONS Tramadol was the most used drug that resulted in acute intoxication, followed by cannabis. A total of 43.6% of the cases of acute intoxications were due to recreational use/misuse of prescription drugs.
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Affiliation(s)
- Sonya M S Azab
- Department of Forensic Medicine and Toxicology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Hany Tawfik
- Poisoning Treatment Center, Ain Shams University Hospitals, Cairo, Egypt
| | - Bryan D Hayes
- Department of Pharmacy, Massachusetts General Hospital, Boston, Massachusetts, USA.,Department of Emergency Medicine, Division of Medical Toxicology, Harvard Medical School, Boston, Massachusetts, USA
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14
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Latiers F, Vandenabeele M, Poncin W, Reychler G. Prevalence and risk factors of musculoskeletal pain in patients with chronic obstructive pulmonary disease: A systematic review. CLINICAL RESPIRATORY JOURNAL 2021; 15:1286-1301. [PMID: 34459145 DOI: 10.1111/crj.13443] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 08/14/2021] [Accepted: 08/25/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVES This systematic review aimed to discuss the prevalence and the risk factors of the musculoskeletal pain in chronic obstructive pulmonary disease (COPD). DATA SOURCE AND STUDY SELECTION Four databases were analysed (Scopus, PubMed, Cochrane and EMBASE). We excluded systematic reviews, meta-analyses, conference abstracts and case reports. Two authors independently checked for the eligibility of the relevant articles. The risk of bias was evaluated using the Newcastle Ottawa Quality Assessment Scale and the Joanna Briggs Institute critical appraisal checklist. The selection and evaluation of studies followed the PRISMA guidelines. RESULTS Twenty studies were retrieved, including from 21 to 7952 patients with COPD. The prevalence of pain was highly heterogeneous across studies: 7-89.7%. Pain was mostly reported in the lumbar (7-69%) and cervical spine (11-48.3%) and the chest (44-82.8%). The main risk factors for developing pain were old age, sex (female), level of physical activity (low) and comorbidities. CONCLUSION Pain is a very common symptom in patients with COPD. Despite this, few clinical trials have investigated the pain. It appears to be located primarily in the lumbar, cervical and thoracic regions and facilitated by being a female, a low level of physical activity, comorbidity(ies) and old age.
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Affiliation(s)
- Fabien Latiers
- Service de Chirurgie Thoracique et Vasculaire, Cliniques Universitaires Saint-Luc, Brussels, Belgium.,Faculté des Sciences de la Motricité, Université Catholique de Louvain, Louvain-la-Neuve, Belgium.,Secteur de Kinésithérapie et Ergothérapie, Cliniques universitaires Saint-Luc, Brussels, Belgium
| | - Marie Vandenabeele
- Faculté des Sciences de la Motricité, Université Catholique de Louvain, Louvain-la-Neuve, Belgium
| | - William Poncin
- Secteur de Kinésithérapie et Ergothérapie, Cliniques universitaires Saint-Luc, Brussels, Belgium.,Institut de Recherche Expérimentale et Clinique (IREC), Pôle de Pneumologie, ORL & Dermatologie, Université Catholique de Louvain, Brussels, Belgium.,Service de Pneumologie, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Gregory Reychler
- Secteur de Kinésithérapie et Ergothérapie, Cliniques universitaires Saint-Luc, Brussels, Belgium.,Institut de Recherche Expérimentale et Clinique (IREC), Pôle de Pneumologie, ORL & Dermatologie, Université Catholique de Louvain, Brussels, Belgium.,Service de Pneumologie, Cliniques Universitaires Saint-Luc, Brussels, Belgium
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15
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Popok PJ, Greenberg J, Gates MV, Vranceanu AM. A qualitative investigation of activity measurement and change following a mind-body activity program for chronic pain. Complement Ther Clin Pract 2021; 44:101410. [PMID: 33971485 PMCID: PMC8328925 DOI: 10.1016/j.ctcp.2021.101410] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 04/09/2021] [Accepted: 04/28/2021] [Indexed: 10/21/2022]
Abstract
Increasing activity is important yet challenging among people with chronic pain. Objective assessment of activity using accelerometers (i.e., ActiGraph) has gained popularity, but reactivity to assessment and non-adherence to wearing the ActiGraph may bias data. We explored: 1) experiences of wearing the ActiGraph to identify ways to increase adherence and facilitate accurate assessment of activity; and 2) barriers and facilitators to increasing activity following two mind-body activity programs to optimize future interventions. We conducted semi-structured exit interviews with 13 participants with heterogenous chronic pain who completed a randomized controlled trial of two mind-body activity programs. We analyzed transcripts using a framework approach to generate themes. Participants indicated that receiving reminders increased ActiGraph wear adherence and reported that program skills such as gratitude, pacing, mindfulness, and deep breathing were facilitators to increasing activity, while medical problems were barriers. Interventions aiming to increase activity may benefit from emphasizing mind-body skills and sending ActiGraph wear reminders.
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Affiliation(s)
- Paula J Popok
- Integrated Brain Health Clinical and Research Program, Massachusetts General Hospital, Boston, MA, USA
| | - Jonathan Greenberg
- Integrated Brain Health Clinical and Research Program, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Melissa V Gates
- Integrated Brain Health Clinical and Research Program, Massachusetts General Hospital, Boston, MA, USA
| | - Ana-Maria Vranceanu
- Integrated Brain Health Clinical and Research Program, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
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16
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The Effects of Mindfulness-Based Mandala Coloring, Made in Nature, on Chronic Widespread Musculoskeletal Pain: Randomized Trial. Healthcare (Basel) 2021; 9:healthcare9060642. [PMID: 34071674 PMCID: PMC8226655 DOI: 10.3390/healthcare9060642] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 05/17/2021] [Accepted: 05/24/2021] [Indexed: 11/21/2022] Open
Abstract
This study aimed to investigate the effects of mindfulness-based mandala coloring made within nature on individuals with chronic widespread musculoskeletal pain (CWP). Thirty-six participants were randomly allocated. In the experimental group, identical interventions and procedures were administered for each experiment. The control group members were untreated and remained in an urban environment. Overall, the experiment showed significant improvements in tender points (f = 8.791, p = 0.006), total stress level (f = 14.570, p = 0.001), depressive symptoms (f = 15.205, p = 0.001), anger symptoms (f = 7.263, p = 0.011) and salivary cortisol (f = 10.619, p = 0.003) in the experimental group. The results reflect that MBMC within nature is effective in reducing pain, psychological stress responses, and cortisol levels in individuals with CWP. The positive results could be a product of the experimental design rather than the treatment itself. A rigorous experimental design provides better understanding of MBMC within nature.
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17
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Latif ZEH, Skjaervø I, Solli KK, Tanum L. Chronic Pain Among Patients With an Opioid Use Disorder. Am J Addict 2021; 30:366-375. [PMID: 33738870 DOI: 10.1111/ajad.13153] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 12/01/2020] [Accepted: 01/05/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Chronic pain is not well understood in opioid-dependent populations. We report the prevalence of chronic pain and pain characteristics in an opioid-dependent population by treatment type and gender. METHODS This cross-sectional study opportunistically recruited 569 patients (32% women) receiving treatment for opioid use disorder (DSM-5) in Norway during 2016-2018 (83% received opioid maintenance treatment, 17% received treatment without medication). We asked about chronic pain (≥3 months; ICD-11), pain severity (NRS-11), and other pain characteristics. RESULTS Overall, 55% reported chronic pain (≥3 months), with a higher prevalence among women (61% vs 52%, P = .041) and patients receiving methadone (66%) compared with buprenorphine or no medication (46% and 45%, P < .001). Chronic pain was associated with higher age (P < .001) and higher doses of methadone (P = .048). The average duration of pain was 11 years. The most frequently reported pain locations were the lower extremities (59%) and the back (54%), and 69% reported more than one pain location. Constant pain and migrating pain were significantly associated with both moderate (adjusted odds ratio [aOR]: 2.04, confidence interval [CI]: 1.12-3.74 and aOR: 2.44, CI: 1.09-5.43) and severe pain intensity (aOR: 2.08, CI: 1.14-3.80 and aOR: 2.46, CI: 1.10-5.47). Reporting no effect of analgesics was associated with severe pain intensity (aOR: 0.54, CI: 0.29-0.99). CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE Over half reported chronic pain, and rates were highest among women and patients receiving methadone. New contributions to the field are descriptions of pain characteristics by gender and pain severity, and interactions between medication type and age. (© 2021 The Authors. The American Journal on Addictions published by Wiley Periodicals LLC on behalf of The American Academy of Addiction Psychiatry). (Am J Addict 2021;00:00-00).
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Affiliation(s)
- Zill-E Huma Latif
- Department of Research and Development in Mental Health Service, Akershus University Hospital, Lørenskog, Norway
| | - Ingeborg Skjaervø
- Department of Research and Development in Mental Health Service, Akershus University Hospital, Lørenskog, Norway.,Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
| | - Kristin K Solli
- Department of Research and Development in Mental Health Service, Akershus University Hospital, Lørenskog, Norway.,Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway.,Vestfold Hospital Trust, Tønsberg, Norway
| | - Lars Tanum
- Department of Research and Development in Mental Health Service, Akershus University Hospital, Lørenskog, Norway.,Faculty for Health Science, Oslo Metropolitan University, Oslo, Norway
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18
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Martínez-Borba V, Ripoll-Server P, Yakobov E, Suso-Ribera C. Predicting the Physical and Mental Health Status of Individuals With Chronic Musculoskeletal Pain From a Biopsychosocial Perspective: A Multivariate Approach. Clin J Pain 2021; 37:211-218. [PMID: 33399397 DOI: 10.1097/ajp.0000000000000913] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 12/12/2020] [Indexed: 12/18/2022]
Abstract
OBJECTIVES Chronic pain is theoretically conceptualized from a biopsychosocial perspective. However, research into chronic pain still tends to focus on isolated, biological, psychological, or social variables. Simultaneous examination of these variables in the prediction of outcomes is important because communalities between predictors exist. Examination of unique contributions might help guide research and interventions in a more effective way. METHODS The participants were 114 individuals with chronic pain (mean age=58.81, SD=11.85; 58.8% women and 41.2% men) who responded to demographics (age and sex), pain characteristics (duration and sensory qualities), psychological (catastrophizing and perceived injustice), and social (marital adjustment) measures. Multivariate analyses were conducted to investigate their unique contributions to pain-related health variables pain severity, pain interference, disability, anxiety, and depressive symptoms. RESULTS Bivariate analyses evidenced significant associations between pain sensory qualities, catastrophizing, perceived injustice, and all health variables. In multivariate analyses, pain sensory qualities were associated with pain severity (β=0.10; 95% confidence interval [CI]=0.05, 0.14; t=4.28, P<0.001), while perceived injustice was associated with pain interference (β=0.08; 95% CI=0.03, 0.12; t=3.59, P<0.001), disability (β=0.25; 95% CI=0.08, 0.42; t=2.92, P=0.004), anxiety (β=0.18; 95% CI=0.08, 0.27; t=3.65, P<0.001), and depressive symptoms (β=0.14; 95% CI=0.05, 0.23; t=2.92, P=0.004). Age, sex, pain duration, and marital adjustment were not associated with health variables either in bivariate or in multivariate analyses (all P>0.010). DISCUSSION As expected, communalities between biopsychosocial variables exist, which resulted in a reduced number of unique contributions in multivariate analyses. Perceived injustice emerged as a unique contributor to variables, which points to this psychological construct as a potentially important therapeutic target in multidisciplinary treatment of pain.
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Affiliation(s)
- Verónica Martínez-Borba
- Department of Basic and Clinical Psychology and Psychobiology, Universitat Jaume I, Castelló de la Plana, Spain
| | - Paula Ripoll-Server
- Department of Basic and Clinical Psychology and Psychobiology, Universitat Jaume I, Castelló de la Plana, Spain
| | - Esther Yakobov
- Department of Psychology, McGill University, Montreal, Quebec, Canada
| | - Carlos Suso-Ribera
- Department of Basic and Clinical Psychology and Psychobiology, Universitat Jaume I, Castelló de la Plana, Spain
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19
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Chiu V, Chan G, Hall W, Hides L, Lim C, Leung J. Personal Correlates of Support for Medical and Recreational Cannabis Legalization in Australia. Front Psychiatry 2021; 12:551661. [PMID: 33716801 PMCID: PMC7947688 DOI: 10.3389/fpsyt.2021.551661] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 02/05/2021] [Indexed: 01/17/2023] Open
Abstract
Introduction and Aims: Increasingly more Australians are in favor of legalizing medical and recreational cannabis use. This paper explored the personal characteristics of those who supported each of these policies in Australia. Design: Cross-sectional national survey. Methods: This study included 21,729 participants aged 18 years and above who responded to the 2016 National Drug Strategy Household Survey. Participants were provided the assurance of confidentiality for their participations. Logistic regression models were used to examine the relationships between personal characteristics and support for the legalization of medical and recreational cannabis. Results: Overall, 77 and 40% of participants supported the legalization of medical and recreational cannabis respectively. People of older age were more likely to support medical cannabis legalization while those who supported legalization of recreational cannabis use were more likely to be younger. Medical cannabis supporters were more likely to report chronic pain (OR = 1.44, 95% CI: 1.04, 2.00) while recreational cannabis supporters were more likely to suffer high level of psychological distress (OR = 1.28, 95% CI: 1.14, 1.43). Experience with cannabis use was strongly associated with supportive attitudes, with recent cannabis users almost 14 times (OR = 14.13, 95% CI: 5.37, 37.20) and 34 times (OR = 33.74, 95% CI: 24.22, 47.01) more likely to support the legalization of medical and recreational cannabis use, respectively. Discussion and Conclusions: The majority of Australians approve the legalization of cannabis for medicinal purposes but most remain cautious about legalizing recreational cannabis use. The sociodemographic and clinical profile of supporters of medical and recreational legalization suggests a potential interaction of self-interests and beliefs about the harms of cannabis use.
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Affiliation(s)
- Vivian Chiu
- School of Psychology, University of Queensland, Brisbane, QLD, Australia.,National Centre for Youth Substance Use Research, University of Queensland, Brisbane, QLD, Australia.,National Drug and Alcohol Research Centre, University of New South Wales Sydney, Sydney, NSW, Australia
| | - Gary Chan
- National Centre for Youth Substance Use Research, University of Queensland, Brisbane, QLD, Australia
| | - Wayne Hall
- National Centre for Youth Substance Use Research, University of Queensland, Brisbane, QLD, Australia
| | - Leanne Hides
- School of Psychology, University of Queensland, Brisbane, QLD, Australia.,National Centre for Youth Substance Use Research, University of Queensland, Brisbane, QLD, Australia
| | - Carmen Lim
- National Centre for Youth Substance Use Research, University of Queensland, Brisbane, QLD, Australia
| | - Janni Leung
- School of Psychology, University of Queensland, Brisbane, QLD, Australia.,National Centre for Youth Substance Use Research, University of Queensland, Brisbane, QLD, Australia.,National Drug and Alcohol Research Centre, University of New South Wales Sydney, Sydney, NSW, Australia
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20
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Damsgård E, Thrane G, Fleten N, Bagge J, Sørlie T, Anke A, Broderstad AR. Persistent pain associated with socioeconomic and personal factors in a Sami and Non-Sami population in Norway: an analysis of SAMINOR 2 survey data. Int J Circumpolar Health 2020; 79:1787022. [PMID: 32780007 PMCID: PMC7480428 DOI: 10.1080/22423982.2020.1787022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 06/11/2020] [Accepted: 06/12/2020] [Indexed: 11/12/2022] Open
Abstract
In international studies, higher prevalence of persistent pain has been reported in indigenous populations compared to majority populations. The present study aimed to determine the prevalence of persistent pain within a Sami and a non-Sami population in northern Norway, with adjustment for the confounding factors of age, sex, marital status, education, income, mental health, smoking status and ethnic background. Using SAMINOR 2 survey data including Sami and non-Sami populations, we analysed 5,546 responses, from individuals aged 40-79 years, to questions concerning persistent pain (≥ 3 months). In total, 2,426 (43.7%) participants reported persistent pain with differences between Sami women and non-Sami women (44.1% versus 51.1%, respectively), but none between Sami men and non-Sami men (38.7% versus 38.2%, respectively). Elderly Sami women were less likely to report persistent pain than were elderly non-Sami women. In men, no ethnic differences in pain were observed according to age-group. Marital status, education levels, household income, psychological distress, and smoking status did not influence the association between ethnicity and pain. Pain severity and location did not differ between Sami and non-Sami participants. In this study, we found only minor ethnic differences in persistent pain. Similar living conditions and cultural features may explain these findings.
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Affiliation(s)
- Elin Damsgård
- Department of Health and Care Sciences, UiT the Arctic University of Norway , Tromsø, Norway
| | - Gyrd Thrane
- Department of Health and Care Sciences, UiT the Arctic University of Norway , Tromsø, Norway
| | - Nils Fleten
- Department of Community Medicine, UiT the Arctic University of Norway , Tromsø, Norway
| | - Johan Bagge
- Department of Health and Care Sciences, UiT the Arctic University of Norway , Tromsø, Norway
| | - Tore Sørlie
- UiT the Arctic University of Norway , Tromsø, Norway
| | - Audny Anke
- UiT the Arctic University of Norway , Tromsø, Norway
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Sannes AC, Christensen JO, Nielsen MB, Gjerstad J. The influence of age, gender and the FKBP5 genotype on subjective health complaints in the Norwegian working population. J Psychosom Res 2020; 139:110264. [PMID: 33038818 DOI: 10.1016/j.jpsychores.2020.110264] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 09/22/2020] [Accepted: 09/30/2020] [Indexed: 01/30/2023]
Abstract
OBJECTIVE In the present study we examined the potential association between age, gender, the genetic variant FKBP5 rs9470080 and subjective health complaints. METHODS The data were collected through a three-wave nationally representative survey of 1060 Norwegian employees drawn from the Norwegian Central Employee Register by Statistics Norway. The follow-up period was six months. Subjective health complaints were scored by eight items reflecting; headache, neck pain, mid- and low back pain, stomach cramps or intestinal discomfort, problems with sleep onset or maintenance and early morning awakening. Genotyping with regard to FKBP5 rs9470080, previously linked to cortisol sensitivity, was carried out using Taqman assay. RESULTS The baseline data showed that in women, levels of subjective health complaints were highest among those above 50 years of age. Moreover, in women the rs9470080 CC variant at baseline was associated with higher levels of subjective health complaints. However, the effect size was not large, and no relationships were demonstrated between age or genotype and subjective health complaints in men. Also, the study variables were not related to any changes in the levels of subjective health complaints during the follow-up period. CONCLUSION We conclude that our biology such as age and sex, but also single genetic variants found in non-sex chromosomes, may be important in understanding the mechanisms underlying subjective health complaints in the general working population.
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22
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Blackburn A. An evaluation of opioid use during acute hospital admissions. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2020; 29:700-705. [PMID: 32579452 DOI: 10.12968/bjon.2020.29.12.700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Long-term opioid use can begin with the treatment of acute pain. However, there is little evidence concerning the impact that better opioid awareness in the acute phase may have on reducing the use of opioids in the long term. This project explored which opioids are routinely prescribed within an acute hospital setting and how these opioids were used over the course of the hospital stay. Codeine and morphine remain the most commonly prescribed opioids. Opioids were prescribed and given to people across the age range, from 16 to 98 years. The project found that 19% of patients were admitted with a pre-existing opioid. Up to 66% of patients were discharged with opioid medication, with almost 20% leaving with more than one opioid. Regular opioid use routinely exposes patients to long-term opioid use and those patients initiated onto opioid medication during admission should have the benefit of planned de-escalation before discharge.
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Affiliation(s)
- Alison Blackburn
- Nurse Specialist, Inpatient Pain Service, Royal Victoria Infirmary, Newcastle upon Tyne
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23
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Sylwander C, Larsson I, Andersson M, Bergman S. The impact of chronic widespread pain on health status and long-term health predictors: a general population cohort study. BMC Musculoskelet Disord 2020; 21:36. [PMID: 31948483 PMCID: PMC6966859 DOI: 10.1186/s12891-020-3039-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 01/02/2020] [Indexed: 01/06/2023] Open
Abstract
Background Chronic widespread pain (CWP) has a negative impact on health status, but results have varied regarding gender-related differences and reported health status. The aim was to study the impact of CWP on health status in women and men aged 35–54 years in a sample of the general population. The aim was further to investigate lifestyle-related predictors of better health status in those with CWP in a 12- and 21-year perspective. Method A general population cohort study including 975 participants aged 35–54 years, with a 12- and 21-year follow-up. CWP was measured with a pain mannequin, and the questionnaire included questions on lifestyles factors with SF-36 for measurement of health status. Differences in health status were analysed with independent samples t-test and health predictors with logistic regression analysis. Results The prevalence of CWP was higher in women at all time points, but health status was reduced in both women and men with CWP (p < 0.001) with no gender differences of clinical relevance. At the 12-year follow-up, a higher proportion of women than men had developed CWP (OR 2.04; CI 1.27–3.26), and at the 21-year follow-up, a higher proportion of men had recovered from CWP (OR 3.79; CI 1.00–14.33). In those reporting CWP at baseline, a better SF-36 health status (Physical Functioning, Vitality or Mental Health) at the 12-year follow-up was predicted by male gender, having personal support, being a former smoker, and having no sleeping problems. In the 21-year follow-up, predictors of better health were male gender, a weekly intake of alcohol, and having no sleeping problems. Conclusion Women and men with CWP have the same worsening of health status, but men recover from CWP to a greater extent in the long-term. Being male, having social support, being a former smoker, and having no sleeping problems were associated with better health status in those with CWP.
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Affiliation(s)
- Charlotte Sylwander
- Spenshult Research and Development Centre, Bäckagårdsvägen 47, SE-302 74, Halmstad, Sweden. .,School of Health and Welfare, Halmstad University, Halmstad, Sweden.
| | - Ingrid Larsson
- Spenshult Research and Development Centre, Bäckagårdsvägen 47, SE-302 74, Halmstad, Sweden.,School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Maria Andersson
- Spenshult Research and Development Centre, Bäckagårdsvägen 47, SE-302 74, Halmstad, Sweden.,Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden
| | - Stefan Bergman
- Spenshult Research and Development Centre, Bäckagårdsvägen 47, SE-302 74, Halmstad, Sweden.,Primary Health Care Unit, Department of Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Kim SY, Shigemoto Y, Neduvelil A. Survive or Thrive? Longitudinal Relation Between Chronic Pain and Well-Being. Int J Behav Med 2019; 26:486-498. [DOI: 10.1007/s12529-019-09805-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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O'Loughlin I, Newton-John TRO. 'Dis-comfort eating': An investigation into the use of food as a coping strategy for the management of chronic pain. Appetite 2019; 140:288-297. [PMID: 31145944 DOI: 10.1016/j.appet.2019.05.027] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 04/18/2019] [Accepted: 05/21/2019] [Indexed: 12/18/2022]
Abstract
OBJECTIVES Chronic pain and obesity are major public health concerns. Animal and human models have demonstrated that eating high-sugar nutrient-dense foods confers analgesic effects. Moreover, recent research suggests that people with chronic pain may "comfort eat" to cope with their pain. Given the harmful impact of obesity on chronic pain, it is critical to determine whether pain elicits comfort eating amongst individuals with chronic pain to ensure that this potentially maladaptive pain coping strategy is not overlooked in chronic pain treatment. Therefore, this study aimed to: determine whether chronic pain intensity predicts pain-induced comfort eating and identify mediators of this relationship; to determine whether pain-induced comfort eating predicts elevated BMI; and to establish whether BMI predicts chronic pain interference. METHODS This study utilised a cross-sectional online survey design and a sample of 151 adults with chronic pain. RESULTS Over three-quarters of this chronic pain sample reported engaging in pain-induced comfort eating. Chronic pain intensity did not significantly predict pain-induced comfort eating. However, there was a significant indirect effect of chronic pain intensity on pain-induced comfort eating through stress-but not experiential avoidance or pain catastrophising. As predicted, pain-induced comfort eating significantly predicted increased BMI, and BMI in turn significantly predicted greater chronic pain interference. DISCUSSION This study indicates that pain-induced comfort eating is both common and harmful amongst individuals with chronic pain, across the entire BMI spectrum. Pain-induced comfort eating and stress have emerged as promising chronic pain treatment targets. The findings are discussed and interpreted in light of extant research and theory, as well as limitations of the current study. Future research directions and clinical implications are also considered.
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Affiliation(s)
- Imogen O'Loughlin
- Graduate School of Health, University of Technology Sydney, Australia
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Konietzny K, Chehadi O, Streitlein-Böhme I, Rusche H, Willburger R, Hasenbring MI. Mild Depression in Low Back Pain: the Interaction of Thought Suppression and Stress Plays a Role, Especially in Female Patients. Int J Behav Med 2019; 25:207-214. [PMID: 28523481 DOI: 10.1007/s12529-017-9657-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE Mild depression has been shown as a precursor and as a consequence of low back pain, even in early phases of acute or subacute pain. Chronic daily life stress as well as dysfunctional pain-related cognitions such as thought suppression (TS) seem to play a role in the pain-depression cycle; however, the mechanisms of these associations are less understood. Experimentally induced TS, conceived as the attempt to directly suppress sensations such as pain, has been shown to paradoxically cause a delayed and non-volitional return of the suppressed thoughts and sensations and to increase affective distress. These dysfunctional processes are supposed to increase under high cognitive load, such as high stress. METHOD In the present cross-sectional study, we for the first time sought to examine a possible interaction between habitual TS and stress on depression in N = 177 patients with subacute low back pain (SLBP), using the following questionnaires: Subscale Thought Suppression from Avoidance-Endurance Questionnaire, Beck Depression Inventory, and Kiel Interview of Subjective Situation. A three-way ANOVA was conducted with two groups of TS (high/low), stress (high/low) and sex as independent factors and depression as dependent. RESULTS Results indicated a significant three-way interaction with highest depression scores in female patients showing high TS and high stress. Overall main effects for sex and stress indicated higher depression in women and in highly stressed patients. CONCLUSION Our findings support the hypothesis that TS heightens depressive mood under conditions of high cognitive load especially in female patients with SLBP indicating a special vulnerability for depressive mood in women with SLBP.
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Affiliation(s)
- Kerstin Konietzny
- Department of Medical Psychology and Medical Sociology, Faculty of Medicine, Ruhr-University of Bochum, Universitätsstr. 150, 44801, Bochum, Germany.
| | - Omar Chehadi
- Department of Medical Psychology and Medical Sociology, Faculty of Medicine, Ruhr-University of Bochum, Universitätsstr. 150, 44801, Bochum, Germany
| | | | - Herbert Rusche
- Department of General Medicine, Faculty of Medicine, Ruhr-University of Bochum, Bochum, Germany
| | - Roland Willburger
- Department of Orthopedics, Elisabeth Hospital, Ruhr-University of Bochum, Bochum, Germany
| | - Monika Ilona Hasenbring
- Department of Medical Psychology and Medical Sociology, Faculty of Medicine, Ruhr-University of Bochum, Universitätsstr. 150, 44801, Bochum, Germany
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Nøst TH, Steinsbekk A, Bratås O, Grønning K. Twelve-month effect of chronic pain self-management intervention delivered in an easily accessible primary healthcare service - a randomised controlled trial. BMC Health Serv Res 2018; 18:1012. [PMID: 30594190 PMCID: PMC6310959 DOI: 10.1186/s12913-018-3843-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 12/19/2018] [Indexed: 12/13/2022] Open
Abstract
Background To investigate the effects after twelve months related to patient activation and a range of secondary outcomes on persons with chronic pain of a chronic pain self-management course compared to a low-impact outdoor physical activity, delivered in an easily accessible healthcare service in public primary care. Methods An open, pragmatic, parallel group randomised controlled trial was conducted. The intervention group was offered a group-based chronic pain self-management course with 2.5-h weekly sessions for a period of six weeks comprising education that included cognitive and behavioural strategies for pain management, movement exercises, group discussions and sharing of experiences among participants. The control group was offered a drop-in, low-impact, outdoor physical activity in groups in one-hour weekly sessions that included walking and simple strength exercises for a period of six weeks. The primary outcome was patient activation assessed using the Patient Activation Measure (PAM-13). Secondary outcomes included assessments of pain, anxiety and depression, pain self-efficacy, sense of coherence, health-related quality of life, well-being and the 30-s Chair to Stand Test. Analyses were performed using a linear mixed model. Results After twelve months, there were no statistically significant differences between the intervention group (n = 60) and the control group (n = 61) for the primary or the secondary outcomes. The estimated mean difference between the groups for the primary outcome PAM was 4.0 (CI 95% -0.6 to 8.6, p = 0.085). Within both of the groups, there were statistically significant improvements in pain experienced during the previous week, the global self-rated health measure and the 30-s Chair to Stand Test. Conclusions No long-term effect of the chronic pain self-management course was found in comparison with a low-impact physical activity intervention for the primary outcome patient activation or for any secondary outcome. Trial registration ClinicalTrials.gov: NCT02531282. Registered on August 212,015
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Affiliation(s)
- Torunn Hatlen Nøst
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Postbox 8905, 7491, Trondheim, Norway. .,Center for Health Promotion Research, Norwegian University of Science and Technology, Trondheim, Norway.
| | - Aslak Steinsbekk
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Postbox 8905, 7491, Trondheim, Norway
| | - Ola Bratås
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Postbox 8905, 7491, Trondheim, Norway.,Center for Health Promotion Research, Norwegian University of Science and Technology, Trondheim, Norway
| | - Kjersti Grønning
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Postbox 8905, 7491, Trondheim, Norway.,Center for Health Promotion Research, Norwegian University of Science and Technology, Trondheim, Norway
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Dong HJ, Larsson B, Levin LÅ, Bernfort L, Gerdle B. Is excess weight a burden for older adults who suffer chronic pain? BMC Geriatr 2018; 18:270. [PMID: 30409125 PMCID: PMC6225711 DOI: 10.1186/s12877-018-0963-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 10/24/2018] [Indexed: 12/31/2022] Open
Abstract
Background Obesity and chronic pain are common comorbidities and adversely influence each other. Advanced age is associated with more comorbidities and multi-morbidities. In this study, we investigated the burden of overweight/obesity and its comorbidities and their associations with chronic pain in a random population sample of Swedish older adults. Methods The cross-sectional analysis involved a random sample of a population ≥ 65 years in south-eastern Sweden (N = 6243). Data were collected from a postal questionnaire that addressed pain aspects, body mass index (BMI), and health experiences. Chronic pain was defined as pain during the previous three months. According to the 0–10 Numeric Rating Scale, pain scored ≥7 corresponds to severe pain. Binary logistic regression was used to determine the variables associated to pain aspects. Results A total of 2633 (42%) reported chronic pain. More obese older adults (BMI ≥30 kg/m2) experienced chronic pain (58%) than those who were low-normal weight (BMI < 25 kg/m2, 39%) or overweight (25 ≤ BMI < 30 kg/m2, 41%). Obese elderly more frequently had pain in extremities and lower back than their peers. In the multivariate model, obesity (Odds Ratio (OR) 1.59, 95% Confidence Interval (CI) 1.33–1.91) but not overweight (OR 1.08, 95% CI 0.95–1.22) was associated with chronic pain. Obesity (OR 1.53, 95% CI 1.16–2.01) was also significantly related to severe pain. We also found other comorbidities – i.e., traumatic history (OR 2.52, 95% CI 1.99–3.19), rheumatic diseases (OR 5.21, 95% CI 4.54–5.97), age ≥ 85 years (OR 1.66, 95% CI 1.22–2.25), and depression or anxiety diagnosis (OR 1.83, 95% CI 1.32–2.53) – showed stronger associations with pain aspects than weight status. Conclusion: In older adults, excess weight (BMI 30 or above) is a potentially modifiable factor but not the only risk factor that is associated with chronic pain and severe pain. Future studies should investigate the effectiveness of interventions that treat comorbid pain and obesity in older adults.
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Affiliation(s)
- Huan-Ji Dong
- Pain and Rehabilitation Medicine, Department of Medicine and Health Sciences (IMH), Faculty of Health Sciences, Linköping University, SE-581 85, Linköping, Sweden.
| | - Britt Larsson
- Pain and Rehabilitation Medicine, Department of Medicine and Health Sciences (IMH), Faculty of Health Sciences, Linköping University, SE-581 85, Linköping, Sweden
| | - Lars-Åke Levin
- Division of Health Care Analysis, Department of Medical and Health Sciences, Linköping University, SE-581 85, Linköping, Sweden
| | - Lars Bernfort
- Division of Health Care Analysis, Department of Medical and Health Sciences, Linköping University, SE-581 85, Linköping, Sweden
| | - Björn Gerdle
- Pain and Rehabilitation Medicine, Department of Medicine and Health Sciences (IMH), Faculty of Health Sciences, Linköping University, SE-581 85, Linköping, Sweden
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Chrétien R, Lavoie S, Chalaye P, de Vette E, Counil FP, Dallaire F, Lafrenaye S. Reduced endogenous pain inhibition in adolescent girls with chronic pain. Scand J Pain 2018; 18:711-717. [PMID: 30007060 DOI: 10.1515/sjpain-2018-0071] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Accepted: 06/20/2018] [Indexed: 01/21/2023]
Abstract
Background and aims Chronic pain is affecting a growing number of individuals including adolescents. Different endogenous pain inhibitory systems could confer protection against development of chronic pain. Decreased pain perception can be observed following intense pain (i.e. conditioned pain modulation - CPM) or after physical exercise (i.e. exercise-induced analgesia - EIA). Reduced effectiveness of pain inhibitory mechanisms have been reported in several chronic pain conditions. However, the extent of these dysfunctions has not been thoroughly investigated in adolescents suffering from chronic pain. Our hypothesis was that adolescents suffering from chronic pain have less effective CPM and EIA than pain-free teenagers. Methods Twenty-five healthy adolescent girls and 16 teenage girls with chronic pain participated in this study. Only girls were included in this investigation, since chronic pain is more prevalent in females. The effectiveness of CPM was assessed by comparing heat pain stimulations (individually adapted to induce mild pain intensity) performed with a thermode before and after a cold pressor test (CPT; 2 min, 10 °C). EIA was evaluated by comparing pain intensity produced by an ice cube placed on the forearm before and after a graded exercise test on a cycle ergometer. Results Pain intensity produced by heat pain stimulations decreased following CPT in healthy (p<0.05), but not in chronic pain adolescent girls (p=0.4). Pain intensity induced by the ice cube was reduced after exercise in healthy (p<0.05), but not in chronic pain adolescents (p=0.9). The effectiveness of CPM and EIA was inferior in teenage girls suffering from chronic pain compared to healthy participants (p<0.05). Conclusions Endogenous pain inhibitory mechanisms triggered by intense pain or by physical exercise are effective in healthy adolescent girls. Teenage girls living with chronic pain do not show diminished pain perception after a CPT or a graded exercise test. These results suggest that pain inhibitory mechanisms such as CPM and EIA are ineffective in adolescent girls suffering from chronic pain. Implications In a wider context, the findings of the present research could help understand better the mechanisms involved in the development of chronic pain. Improved comprehension of this subject might help prevent chronic pain conditions and thus, reduce the negative impacts of this burden.
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Affiliation(s)
- Raphaëlle Chrétien
- Department of Pediatrics, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Sarah Lavoie
- Department of Pediatrics, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Philippe Chalaye
- Centre de Recherche Clinique Étienne-Le Bel (CRCELB), Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Québec, Canada
| | - Emmanuelle de Vette
- Centre de Recherche Clinique Étienne-Le Bel (CRCELB), Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Québec, Canada
| | | | - Frédéric Dallaire
- Department of Pediatrics, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Sylvie Lafrenaye
- Department of Pediatrics, Université de Sherbrooke, Sherbrooke, Québec, Canada.,Centre de Recherche Clinique Étienne-Le Bel (CRCELB), Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Québec, Canada
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Cardinez N, Lovblom LE, Bai JW, Lewis E, Abraham A, Scarr D, Lovshin JA, Lytvyn Y, Boulet G, Farooqi MA, Orszag A, Weisman A, Keenan HA, Brent MH, Paul N, Bril V, Cherney DZ, Perkins BA. Sex differences in neuropathic pain in longstanding diabetes: Results from the Canadian Study of Longevity in Type 1 Diabetes. J Diabetes Complications 2018; 32:660-664. [PMID: 29929836 DOI: 10.1016/j.jdiacomp.2018.05.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 04/28/2018] [Accepted: 05/01/2018] [Indexed: 10/17/2022]
Abstract
AIM Neuropathy and neuropathic pain are common complications of type 1 diabetes (T1D). We aimed to determine if sex-specific differences in neuropathic pain are present in adults with longstanding T1D. METHODS Canadians with ≥50 years of T1D (n = 361) completed health history questionnaires that included assessment of neuropathy (defined by Michigan Neuropathy Screening Instrument questionnaire components ≥3; NEUROPATHYMNSI-Q) and neuropathic pain. Multivariable logistic regression was used to determine sex-differences in neuropathic pain controlling for neuropathy. RESULTS Participants had mean age 66 ± 9 years, median diabetes duration 53[51,58] years, mean HbA1c 7.5 ± 1.0%, and 207(57%) were female. Neuropathic pain was present in 128(36%) of all participants, more prevalent among those with NEUROPATHYMNSI-Q compared to those without [96(63%) vs. 31(15%), p < 0.001], and more prevalent in females compared to males [87(42%) vs. 41(27%), p = 0.003]. Independent of the presence of NEUROPATHYMNSI-Q and other factors, female sex was associated with the presence of neuropathic pain [OR 2.68 (95% CI 1.4-5.0), p = 0.002]. CONCLUSIONS We demonstrated a novel sex-specific difference in neuropathic pain in females compared to males with longstanding T1D, independent of the presence of neuropathy. Further research using more objective measures of neuropathy than the MNSI is justified to further understand this sex-specific difference.
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Affiliation(s)
- Nancy Cardinez
- Division of Endocrinology and Metabolism, Department of Medicine, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Leif E Lovblom
- Division of Endocrinology and Metabolism, Department of Medicine, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Johnny-Wei Bai
- Division of Endocrinology and Metabolism, Department of Medicine, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Evan Lewis
- Division of Endocrinology and Metabolism, Department of Medicine, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Alon Abraham
- Neuromuscular Diseases Unit of the Department of Neurology, Tel Aviv Sourasky Medical Center, The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Daniel Scarr
- Division of Endocrinology and Metabolism, Department of Medicine, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Julie A Lovshin
- Division of Endocrinology and Metabolism, Department of Medicine, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Yuliya Lytvyn
- Division of Nephrology, Department of Medicine, University of Toronto, Ontario, Canada
| | - Genevieve Boulet
- Division of Endocrinology and Metabolism, Department of Medicine, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Mohammed A Farooqi
- Division of Endocrinology and Metabolism, Department of Medicine, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Andrej Orszag
- Division of Endocrinology and Metabolism, Department of Medicine, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Alanna Weisman
- Division of Endocrinology and Metabolism, Department of Medicine, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Hillary A Keenan
- Research Division, Joslin Diabetes Center, Boston, MA, USA; Genzyme Corporation, Cambridge, MA, USA
| | - Michael H Brent
- Department of Ophthalmology and Vision Sciences, Department of Medicine, University of Toronto, Ontario, Canada
| | - Narinder Paul
- Joint Department of Medical Imaging, Division of Cardiothoracic Radiology, University Health Network, Toronto, Ontario, Canada
| | - Vera Bril
- Neuromuscular Diseases Unit of the Department of Neurology, Tel Aviv Sourasky Medical Center, The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - David Z Cherney
- Division of Nephrology, Department of Medicine, University of Toronto, Ontario, Canada
| | - Bruce A Perkins
- Division of Endocrinology and Metabolism, Department of Medicine, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.
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The role of pain in chronic pain patients’ perception of health-related quality of life: a cross-sectional SQRP study of 40,000 patients. Scand J Pain 2018; 18:417-429. [DOI: 10.1515/sjpain-2018-0003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2018] [Accepted: 04/24/2018] [Indexed: 01/03/2023]
Abstract
Abstract
Background and aims
Health-related quality of life (Hr-QoL) reflects the burden of a condition on an overarching level. Pain intensity, disability and other factors influence how patients with chronic pain perceive their condition, e.g. Hr-QoL. However, the relative importance of these factors is unclear and there is an ongoing debate as to what importance pain measures have in this group. We investigated the importance of current pain level and mood on aspects of Hr-QoL in patients with chronic pain and investigated whether such relationships are influenced by demographics.
Methods
Data was obtained from the Swedish Quality Registry for Pain Rehabilitation (SQRP), between 2008 and 2016 on patients ≥18 years old who suffered from chronic pain and were referred to participating specialist clinics. Dependent variables were general Hr-QoL [using two scales from European Quality of Life instrument: EQ5D Index and the European Quality of Life instrument health scale (EQ thermometer)] and specific Hr-QoL [from the Short Form Health Survey (SF36) the physical component summary (SF36-PCS) and the mental (psychological) component summary (SF36-MCS)]. Independent variables were sociodemographic variables, pain variables, psychological distress and pain attitudes. Principal component analysis (PCA) was used for multivariate correlation analyses of all investigated variables and Orthogonal Partial Least Square Regression (OPLS) for multivariate regressions on health aspects.
Results
There was 40,518 patients (72% women). Pain intensity and interference showed the strongest multivariate correlations with EQ5D Index, EQ thermometer and SF36-PCS. Psychological distress variables displayed the strongest multivariate correlations with SF36-MCS. Demographic properties did not significantly influence variations in the investigated Hr-QoL variables.
Conclusions
Pain, mood and pain attitudes were significantly correlated with Hr-QoL variables, but these variables cannot explain most of variations in Hr-QoL variables. The results pinpoint that broad assessments (including pain intensity aspects) are needed to capture the clinical presentation of patients with complex chronic pain conditions.
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Glambek M, Nielsen MB, Gjerstad J, Einarsen S. Gender differences in the relationship between workplace bullying and subjective back and neck pain: A two-wave study in a Norwegian probability sample. J Psychosom Res 2018; 106:73-75. [PMID: 29455903 DOI: 10.1016/j.jpsychores.2018.01.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 01/09/2018] [Accepted: 01/16/2018] [Indexed: 12/30/2022]
Abstract
OBJECTIVE The association between exposure to bullying at work and subsequent pain reports is relatively well-established, but few studies have examined possible moderators of this relationship. As gender is a known risk factor for pain, with women reporting pain levels of higher intensity and longer duration, a possible gender difference in the relationship between bullying and pain has been suggested, but not sufficiently tested. The objective of the present study was therefore to examine whether gender moderates the prospective relationship between exposure to workplace bullying behaviours and subsequent subjective back and neck pain. METHODS A national probability sample of Norwegian workers (N=1003) was collected at two time points with a six-month time-lag. Assumptions were tested using regression and moderation analyses. RESULTS Exposure to bullying behaviours was associated with increased reports of subjective back and neck pain over time, and this relationship was moderated by gender. However, the interaction took a different form than expected, with back and neck pain increasing in response to bullying among men only, to a degree that nullified the baseline gender difference. CONCLUSION The assumption that being female is a vulnerability factor for the development of pain in the aftermath of psychosocial stressors such as bullying was contradicted in the present study. Instead, women's relatively high baseline pain levels remain stable over time even after exposure to workplace bullying, while men's relatively low baseline pain levels increase in response to bullying, ultimately becoming tangent to the pain reported by women.
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Affiliation(s)
- Mats Glambek
- Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Norway.
| | - Morten Birkeland Nielsen
- National Institute of Occupational Health, Oslo, Norway; Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Norway
| | - Johannes Gjerstad
- National Institute of Occupational Health, Oslo, Norway; Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Norway
| | - Ståle Einarsen
- Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Norway
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Saxena AK, Jain PN, Bhatnagar S. The Prevalence of Chronic Pain among Adults in India. Indian J Palliat Care 2018; 24:472-477. [PMID: 30410260 PMCID: PMC6199848 DOI: 10.4103/ijpc.ijpc_141_18] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background The prevalence of chronic pain (CP) is well described in Europe, America, and Australia. However, little knowledge is available of the prevalence of CP within Asia or Southeast Asia. Given the cultural and genetic variation in pain causation, manifestation, and reporting, the findings of previous western studies cannot be extrapolated to Asian countries. A prevalence study was needed to be carried out to quantify the magnitude and impact of CP in the adult population in India. Methods Two sets of questionnaires were designed. The first, a screening questionnaire was used telephonically to identify the prevalence of CP, and should there be CP; the second, a detailed questionnaire was administered, to characterize the features and impact of pain. The interviews were carried out face-to-face. Results A total of 4326 Indian patients were screened, and 836 completed a detailed pain questionnaire during 2006. The prevalence of CP was found to be 19.3% (n = 836). There was a higher prevalence in females (25.2%). Pain prevalence increased steeply beyond the age of 65 years old. There was a significant impact of CP on work and daily function. Conclusion This Indian adults' population survey about CP found a higher prevalence of CP as compared to other Asian pain prevalence studies; however, the impact of pain was just as significant. In a rapidly aging population, CP is emerging as a significant healthcare problem which may likely to exert an increasing toll on the existing social infrastructure within the next two decades.
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Affiliation(s)
- Ashok Kumar Saxena
- Department of Anaesthesia and Pain Medicine, UCMS and GTB Hospital, Delhi, India
| | - Parmanand N Jain
- Department of Anaesthesiology, Critical Care and Pain, Division of Pain, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Sushma Bhatnagar
- Department of Anesthesiology, Pain and Palliative Care, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
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Lee AL, Goldstein RS, Brooks D. Chronic Pain in People With Chronic Obstructive Pulmonary Disease: Prevalence, Clinical and Psychological Implications. CHRONIC OBSTRUCTIVE PULMONARY DISEASES (MIAMI, FLA.) 2017; 4:194-203. [PMID: 28848931 PMCID: PMC5556911 DOI: 10.15326/jcopdf.4.3.2016.0172] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/23/2016] [Indexed: 01/22/2023]
Abstract
Background: Although pain is a common symptom in chronic obstructive pulmonary disease (COPD), pain characteristics such as frequency, duration and type are unclear. The primary study aim was to identify these pain characteristics in individuals with COPD versus healthy control participants. The secondary aim was to explore the clinical and psychological associations with pain in those with COPD. Methods: Participants with COPD and age and gender-matched, healthy controls completed questionnaires to elicit pain characteristics. Those with COPD also had assessments of dyspnea, health-related quality of life, psychological associations (anxiety and depression) and physical activity. Results: Sixty-four participants with COPD (mean [standard deviation (SD)] age 71[10] , forced expiratory volume in 1 second [FEV1] 38% predicted) and 64 control participants (mean [SD] age 67 [13] , FEV1 91% predicted) were included. Chronic pain was more prevalent in individuals with COPD compared to control participants (41% versus 29%, p=0.03). The pain was more prevalent in the chest and upper back (p=0.04). COPD participants with chest or upper back pain had a higher total lung capacity (mean difference 2.0L, 95% confidence interval [CI] 0.6 to 3.0L) compared to COPD participants without pain. Greater dyspnea (p<0.001), more depression (p=0.02) and lower physical activity levels (p=0.03) were also present in people with COPD experiencing pain. Conclusions: Chronic pain is common in COPD. It is associated with higher dyspnea and depression and lower physical activity.
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Affiliation(s)
- Annemarie L. Lee
- Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, Ontario, Canada
- Department of Physical Therapy, University of Toronto, Ontario, Canada
| | - Roger S. Goldstein
- Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, Ontario, Canada
- Department of Physical Therapy, University of Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Ontario, Canada
| | - Dina Brooks
- Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, Ontario, Canada
- Department of Physical Therapy, University of Toronto, Ontario, Canada
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Rovner GS, Sunnerhagen KS, Björkdahl A, Gerdle B, Börsbo B, Johansson F, Gillanders D. Chronic pain and sex-differences; women accept and move, while men feel blue. PLoS One 2017; 12:e0175737. [PMID: 28441403 PMCID: PMC5404887 DOI: 10.1371/journal.pone.0175737] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2016] [Accepted: 03/30/2017] [Indexed: 11/26/2022] Open
Abstract
Purpose The aim of this study is to explore differences between male and female patients entering a rehabilitation program at a pain clinic in order to gain a greater understanding of different approaches to be used in rehabilitation. Method 1371 patients referred to a specialty pain rehabilitation clinic, completed sociodemographic and pain related questionnaires. They rated their pain acceptance (CPAQ-8), their kinesiophobia (TSK), the impact of pain in their life (MPI), anxiety and depression levels (HAD) and quality of life scales: the SF-36, LiSat-11, and the EQ-5D. Because of the large sample size of the study, the significance level was set at the p ≤.01. Results Analysis by t-test showed that when both sexes experience the same pain severity, women report significantly higher activity level, pain acceptance and social support while men report higher kinesiophobia, mood disturbances and lower activity level. Conclusion Pain acceptance (CPAQ-8) and kinesiophobia (TSK) showed the clearest differences between men and women. Pain acceptance and kinesiophobia are behaviorally defined and have the potential to be changed.
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Affiliation(s)
- Graciela S. Rovner
- Rehabilitation Medicine, Institute of Neuroscience and Physiology, University of Gothenburg at Sahlgrenska Academy, Gothenburg, Sweden
- Division of Rehabilitation Medicine, Department of Clinical Sciences, Karolinska Institutet Danderyd University Hospital, Stockholm, Sweden
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden
| | - Katharina S. Sunnerhagen
- Rehabilitation Medicine, Institute of Neuroscience and Physiology, University of Gothenburg at Sahlgrenska Academy, Gothenburg, Sweden
- * E-mail:
| | - Ann Björkdahl
- Rehabilitation Medicine, Institute of Neuroscience and Physiology, University of Gothenburg at Sahlgrenska Academy, Gothenburg, Sweden
- Ersta Skondal University College, Campus Bracke, Gothenburg, Sweden
| | - Björn Gerdle
- Pain and Rehabilitation Centre, and Department of Medical and Health Sciences, Linkoping University, Linkoping, SE-581 85 Linköping, Sweden
| | - Björn Börsbo
- Division of Community Medicine, Department of Medical and Health Sciences, Linkoping University, Linkoping, Sweden
- Clinical Department of Rehabilitation Medicine, County Hospital Ryhov, Jonkoping, Sweden
| | | | - David Gillanders
- School of Health in Social Science, University of Edinburgh, Edinburgh, United Kingdom
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Durai M, O'Keeffe MG, Searchfield GD. Examining the short term effects of emotion under an Adaptation Level Theory model of tinnitus perception. Hear Res 2016; 345:23-29. [PMID: 28027920 DOI: 10.1016/j.heares.2016.12.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 12/11/2016] [Accepted: 12/16/2016] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Existing evidence suggests a strong relationship between tinnitus and emotion. The objective of this study was to examine the effects of short-term emotional changes along valence and arousal dimensions on tinnitus outcomes. Emotional stimuli were presented in two different modalities: auditory and visual. The authors hypothesized that (1) negative valence (unpleasant) stimuli and/or high arousal stimuli will lead to greater tinnitus loudness and annoyance than positive valence and/or low arousal stimuli, and (2) auditory emotional stimuli, which are in the same modality as the tinnitus, will exhibit a greater effect on tinnitus outcome measures than visual stimuli. STUDY DESIGN Auditory and visual emotive stimuli were administered to 22 participants (12 females and 10 males) with chronic tinnitus, recruited via email invitations send out to the University of Auckland Tinnitus Research Volunteer Database. Emotional stimuli used were taken from the International Affective Digital Sounds- Version 2 (IADS-2) and the International Affective Picture System (IAPS) (Bradley and Lang, 2007a, 2007b). The Emotion Regulation Questionnaire (Gross and John, 2003) was administered alongside subjective ratings of tinnitus loudness and annoyance, and psychoacoustic sensation level matches to external sounds. RESULTS Males had significantly different emotional regulation scores than females. Negative valence emotional auditory stimuli led to higher tinnitus loudness ratings in males and females and higher annoyance ratings in males only; loudness matches of tinnitus remained unchanged. The visual stimuli did not have an effect on tinnitus ratings. The results are discussed relative to the Adaptation Level Theory Model of Tinnitus. CONCLUSIONS The results indicate that the negative valence dimension of emotion is associated with increased tinnitus magnitude judgements and gender effects may also be present, but only when the emotional stimulus is in the auditory modality. Sounds with emotional associations may be used for sound therapy for tinnitus relief; it is of interest to determine whether the emotional component of sound treatments can play a role in reversing the negative responses discussed in this paper.
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Affiliation(s)
- Mithila Durai
- Department of Audiology, University of Auckland, Auckland, New Zealand; Center for Brain Research, University of Auckland, Auckland, New Zealand
| | - Mary G O'Keeffe
- Department of Audiology, University of Auckland, Auckland, New Zealand
| | - Grant D Searchfield
- Department of Audiology, University of Auckland, Auckland, New Zealand; Center for Brain Research, University of Auckland, Auckland, New Zealand.
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Symptoms and function in patients with articular cartilage lesions in 1,000 knee arthroscopies. Knee Surg Sports Traumatol Arthrosc 2016; 24:1610-6. [PMID: 25502829 DOI: 10.1007/s00167-014-3472-9] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Accepted: 12/04/2014] [Indexed: 02/08/2023]
Abstract
PURPOSE Focal chondral lesions of the knee are commonly occurring. A lot is known about their frequency, size and localisation in arthroscopic series, but less about the symptoms they elicit and little about how the arthroscopic findings and symptoms correlate. The purposes of the present study included to investigate the relationship between articular cartilage lesion factors and patient factors, and to compare the symptoms and function of cartilage lesion patients to those of patients with a deficient ACL. METHODS A prospective registration was conducted of preoperative data including Lysholm knee score and perioperative findings in 1,000 consecutive patients undergoing an arthroscopic procedure of the knee-including microfracture of articular cartilage defects and ACL reconstructions. RESULTS Chondral or osteochondral lesions were found in 57 % of the arthroscopies. The mean Lysholm score in this subgroup was 55. The mean Lysholm score was significantly lower in women (50, SD 19) compared to men (59, SD 18, p < 0.001). Among the chondral lesion factors, only kissing (vs. non-kissing) lesions and multiple (vs. single) lesions influenced symptoms and function to a more than negligible degree. Microfracture in one or two articular cartilage defects was performed in 187 patients. The microfracture group had a significant lower mean Lysholm score (54, SD 18) than a group of patients (N = 71) undergoing ACL reconstruction group (67, SD 17, p < 0.001). CONCLUSION The study confirms that articular cartilage lesions are both common and cumbersome. Women seem to have more problems than men, whereas chondral lesion factors-such as localisation and size-seem to influence symptoms and function to a small degree. These aspects should be addressed when designing outcome studies, and should also be of interest to the orthopaedic surgeon-in the day-by-day clinical work. When treating these patients, our prime focus need to be on knee function rather than the cartilage defect as the relationship between the latter and the former is unclear. LEVEL OF EVIDENCE Case-control study, Level III.
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Martins SS, Sampson L, Cerdá M, Galea S. Worldwide Prevalence and Trends in Unintentional Drug Overdose: A Systematic Review of the Literature. Am J Public Health 2016; 105:e29-49. [PMID: 26451760 DOI: 10.2105/ajph.2015.302843] [Citation(s) in RCA: 206] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Drug overdose is an important, yet an inadequately understood, public health problem. Global attention to unintentional drug overdose has been limited by comparison with the scope of the problem. There has been a substantial increase in drug overdose incidence and prevalence in several countries worldwide over the past decade, contributing to both increased costs and mortality. OBJECTIVES The aim of this study was to systematically synthesize the peer-reviewed literature to document the global epidemiological profile of unintentional drug overdoses and the prevalence, time trends, mortality rates, and correlates of drug overdoses. We searched different combinations of Medical Subject Headings (MeSH) terms in PubMed for articles published from 1980 until July 2013, and we organized these results in tabular spreadsheets and compared them. We restricted the search to English-language articles that deal with unintentional overdose, focusing on 1 or more of the following key constructs: prevalence, time trends, mortality rates, and correlates. The term "overdose" as a MeSH major topic yielded 1076 publications. In addition, we searched the following combinations of nonmajor MeSH terms: "street drugs" and "overdose" yielded 180, "death" and "overdose" yielded 114, and "poisoning" and "drug users" yielded 17. There was some overlap among the searches. Based on the search and inclusion and exclusion criteria, we selected a total of 169 relevant articles for this article based on a close review of abstracts. RESULTS We found wide variability in lifetime prevalence of experiencing a nonfatal overdose or witnessing an overdose, and in mortality rates attributable to overdose. Lifetime prevalence of witnessed overdose among drug users (n = 17 samples) ranged from 50% to 96%, with a mean of 73.3%, a median of 70%, and a standard deviation of 14.1%. Lifetime prevalence of drug users personally experiencing a nonfatal overdose (n = 27 samples), ranged from 16.6% to 68.0% with a mean of 45.4%, a median of 47%, and a standard deviation of 14.4%. Population-based crude overdose mortality rates (n = 28 samples) ranged from 0.04 to 46.6 per 100 000 person-years. This range is likely attributable to the diversity in regions, time periods, and samples. Most studies on longitudinal trends of overdose death rates or overdose-related hospitalization rates showed increases in overdose death rates and in overdose-related hospitalization rates across time, which have led to peaks in these rates at the present time. An overall trend of increasing deaths from prescription opioid use and decreasing deaths from illicit drug use in the past several years has been noted across most of the literature. With the increase in prescription opioid overdose deaths, drug overdose is not just an urban problem: rural areas have seen an important increase in overdose deaths. Lastly, cocaine, prescription opioids, and heroin are the drugs most commonly associated with unintentional drug overdoses worldwide and the demographic and psychiatric correlates associated with unintentional drug overdoses are similar globally. CONCLUSIONS There is a need to invest in research to understand the distinct determinants of prescription drug overdose worldwide. Several other countries need to collect in a systematic and continuous fashion such data on sales of prescription opioids and other prescription drugs, nonmedical use of prescription drugs, and hospitalization secondary to overdoses on prescription drugs. The sparse evidence on the environmental determinants of overdose suggests a need for research that will inform the types of environmental interventions we can use to prevent drug overdose. Methodological issues for future studies include enhancing data collection methods on unintentional fatal and nonfatal overdoses, and collecting more detailed information on drug use history, source of drug use (for prescription drugs), and demographic and psychiatric history characteristics of the individual who overdosed.
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Affiliation(s)
- Silvia S Martins
- Silvia S. Martins is with the Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY. Laura Sampson and Sandro Galea are with the Department of Epidemiology, Boston University School of Public Health, Boston, MA. Magdalena Cerdá is with the Department of Emergency Medicine, University of California, Davis
| | - Laura Sampson
- Silvia S. Martins is with the Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY. Laura Sampson and Sandro Galea are with the Department of Epidemiology, Boston University School of Public Health, Boston, MA. Magdalena Cerdá is with the Department of Emergency Medicine, University of California, Davis
| | - Magdalena Cerdá
- Silvia S. Martins is with the Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY. Laura Sampson and Sandro Galea are with the Department of Epidemiology, Boston University School of Public Health, Boston, MA. Magdalena Cerdá is with the Department of Emergency Medicine, University of California, Davis
| | - Sandro Galea
- Silvia S. Martins is with the Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY. Laura Sampson and Sandro Galea are with the Department of Epidemiology, Boston University School of Public Health, Boston, MA. Magdalena Cerdá is with the Department of Emergency Medicine, University of California, Davis
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Ahlgren C, Fjellman-Wiklund A, Hamberg K, Johansson EE, Stålnacke BM. The meanings given to gender in studies on multimodal rehabilitation for patients with chronic musculoskeletal pain – a literature review. Disabil Rehabil 2016; 38:2255-70. [DOI: 10.3109/09638288.2015.1127435] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Abstract
There are significant gender differences in course, symptomology, and treatment of substance use disorders. In general data from clinical and preclinical studies of substance use disorders suggest that women are more vulnerable than men to the deleterious consequences of drug use at every phase of the addiction process. In addition data from epidemiologic studies suggest that the gender gap in the prevalence of substance use is narrowing particularly among adolescence. Therefore, understanding the role of estrogen and progesterone in mediating responses to drugs of abuse is of critical importance to women's health. In this review we will discuss findings from clinical and preclinical studies of (1) reproductive cycle phase; (2) endogenous ovarian hormones; and (3) hormone replacement on responses to stimulants, nicotine, alcohol, opioids, and marijuana. In addition, we discuss data from recent studies that have advanced our understanding of the neurobiologic mechanisms that interact with estrogen and progesterone to mediate drug-seeking behavior.
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McCall-Hosenfeld J, Winter M, Heeren T, Liebschutz JM. The association of interpersonal trauma with somatic symptom severity in a primary care population with chronic pain: exploring the role of gender and the mental health sequelae of trauma. J Psychosom Res 2014; 77:196-204. [PMID: 25149029 PMCID: PMC4143800 DOI: 10.1016/j.jpsychores.2014.07.011] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Revised: 07/11/2014] [Accepted: 07/14/2014] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Female trauma survivors develop somatic symptoms more frequently than males. We propose a model for somatic symptom development among trauma survivors, focusing on gender. METHODS Among 597 urban primary care patients with chronic pain, we examined the association between somatic symptom severity and three interpersonal trauma types: 1) sexual trauma (ST), 2) intimate partner violence (IPV), and 3) childhood trauma history (≥3 adverse childhood experiences (3+ACE)). We developed a structural equation model in which PTSD, depression, and substance abuse were evaluated as potential mediators of the path between trauma exposure and somatic symptom severity, and explored the role of gender in this model. RESULTS 350 (59%) respondents were female; the mean age was 47. Women reported significantly more somatic symptoms than men, although somatic symptoms were increased among all interpersonal trauma survivors. In models in which the potential intervening variables are considered in aggregate, we did not find a signficant interaction between gender and trauma on somatic symptom severity, with the exception of 3+ACEs. A structural equation model showed depression and substance abuse, for men, and depression, for women, were associated with somatic symptom severity. PTSD was not associated with somatic symptom severity. Paths from trauma exposures to mental health sequelae were stronger for men. CONCLUSIONS Women have more severe somatic symptoms. With the exception of 3+ACEs, the association between trauma and somatic symptoms is amplified in both genders. Structural equation models showed the pathways differed by gender in function and strength of association.
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Affiliation(s)
- Jennifer McCall-Hosenfeld
- Departments of Medicine and Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA
| | - Michael Winter
- Data Coordinating Center, Boston University School of Public Health, Boston, MA, United States.
| | - Timothy Heeren
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, United States.
| | - Jane M. Liebschutz
- Section of General Internal Medicine, Boston Medical Center, Boston University School of Medicine, Boston, MA;
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Jonsdottir T, Jonsdottir H, Lindal E, Oskarsson GK, Gunnarsdottir S. Predictors for chronic pain-related health care utilization: a cross-sectional nationwide study in Iceland. Health Expect 2014; 18:2704-19. [PMID: 25059634 DOI: 10.1111/hex.12245] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/02/2014] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Individuals with chronic pain are among the most frequent users of health care. Still, a significant percentage does not utilize health care for pain. A range of factors predict chronic pain-related health care utilization. DESIGN A cross-sectional study aimed at identifying predictors of chronic pain-related health care utilization and comparing predictors between men and women. METHODS A postal questionnaire measuring sociodemographic variables, pain characteristics, health-related quality of life (HRQoL) and pain-related health care utilization, was sent to a sample of 4500 individuals randomly drawn from the national population of Iceland. The relationships between sociodemographic and pain-related factors and pain-related health care utilization among participants reporting chronic pain (≥3 months) were tested by using bivariate and multivariate statistical analysis. RESULTS Among participants reporting chronic pain, 53.2% had consulted a health care provider for pain during the previous 6 months. Predictors for chronic pain-related health care utilization differed between men and women. Interference with life and pain pattern was the strongest predictors among women, as compared with interference with life and the physical components of HRQoL for men. Pain-related health care utilization was not linked to sociodemographic factors. CONCLUSIONS Pain-related variables are better predictors of chronic pain-related health care utilization than sociodemographic factors. Even though gender does not predict chronic pain-related health care utilization, there are gender differences in the relationships between pain-related variables and health care utilization. Men tend to postpone health care consultations for chronic pain longer than women.
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Affiliation(s)
- Thorbjorg Jonsdottir
- Faculty of Nursing, School of Health Sciences, University of Iceland, Reykjavik, Iceland.,Faculty of Nursing, School of Health Sciences, University of Akureyri, Akureyri, Iceland
| | - Helga Jonsdottir
- Faculty of Nursing, School of Health Sciences, University of Iceland, Reykjavik, Iceland.,Landspitali, The National University Hospital of Iceland, Reykjavik, Iceland
| | - Eirikur Lindal
- Private Practice, Reykjavik, University of Akureyri, Akureyri, Iceland
| | - Gudmundur K Oskarsson
- Faculty of Business Administration, School of Business and Science, University of Akureyri, Akureyri, Iceland
| | - Sigridur Gunnarsdottir
- Faculty of Nursing, School of Health Sciences, University of Iceland, Reykjavik, Iceland.,Landspitali, The National University Hospital of Iceland, Reykjavik, Iceland
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Ligthart L, Visscher CM, van Houtem CMHH, Geels LM, Vink JM, de Jongh A, Boomsma DI. Comorbidity among multiple pain symptoms and anxious depression in a Dutch population sample. THE JOURNAL OF PAIN 2014; 15:945-55. [PMID: 24981129 DOI: 10.1016/j.jpain.2014.06.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Revised: 06/16/2014] [Accepted: 06/17/2014] [Indexed: 11/17/2022]
Abstract
UNLABELLED Most studies on pain focus on specific disorders, which makes it difficult to compare characteristics across different types of pain symptoms. In this large population-based study, we examine the prevalence and comorbidity patterns among pain symptoms across a wide range of anatomic sites (back, neck, head, abdomen, joints, chest, face, teeth, and "other") in relation to anxious depression and a range of demographic, health, and lifestyle variables. Self-report data were collected in 11,787 adult participants of The Netherlands Twin Registry (mean age 44.5 years, 62% female), including twins and relatives of twins. Headache and abdominal pain were strongly associated with female sex, whereas chest pain and toothache were not. Joint pain strongly increased with age, whereas headache and abdominal pain decreased with age. Most other pain sites were only weakly associated with age. A highly consistent pattern of comorbidity was observed: All pain symptoms were correlated with all other pain symptoms, as well as with anxious depression. Frequent and widespread pain (ie, pain at multiple sites) was most strongly associated with anxious depression. These observations reflect important differences between specific pain symptoms, suggesting partly separate etiologies, but also highlight the importance of shared mechanisms underlying pain symptoms in general. PERSPECTIVE The association of pain with sex and age strongly depends on pain location. However, all pain sites are consistently associated with other pain sites as well as with anxious depression. This provides important clues with respect to both similarities and differences in the mechanisms underlying different types of pain.
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Affiliation(s)
- Lannie Ligthart
- Department of Biological Psychology, VU University Amsterdam, Amsterdam, The Netherlands; EMGO+ Institute for Health and Care, VU University Medical Centre, Amsterdam, The Netherlands.
| | - Corine M Visscher
- Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University Amsterdam, MOVE Research Institute Amsterdam, Amsterdam, The Netherlands
| | - Caroline M H H van Houtem
- Department of Social Dentistry and Behavioural Sciences, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands
| | - Lot M Geels
- Department of Biological Psychology, VU University Amsterdam, Amsterdam, The Netherlands; EMGO+ Institute for Health and Care, VU University Medical Centre, Amsterdam, The Netherlands
| | - Jacqueline M Vink
- Department of Biological Psychology, VU University Amsterdam, Amsterdam, The Netherlands; Neuroscience Campus Amsterdam, Amsterdam, The Netherlands
| | - Ad de Jongh
- Department of Social Dentistry and Behavioural Sciences, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands; School of Health Sciences, Salford University, Manchester, United Kingdom
| | - Dorret I Boomsma
- Department of Biological Psychology, VU University Amsterdam, Amsterdam, The Netherlands; EMGO+ Institute for Health and Care, VU University Medical Centre, Amsterdam, The Netherlands; Neuroscience Campus Amsterdam, Amsterdam, The Netherlands
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Leegaard M, Valeberg BT, Haugstad GK, Utne I. Survey of Pain Curricula for Healthcare Professionals in Norway. ACTA ACUST UNITED AC 2014. [DOI: 10.1177/010740831403400110] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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The Experience of Loss in Patients Suffering from Chronic Pain Attending a Pain Management Group Based on Cognitive-Behavioral Therapy. Pain Manag Nurs 2014; 15:12-21. [DOI: 10.1016/j.pmn.2012.04.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2011] [Revised: 04/13/2012] [Accepted: 04/17/2012] [Indexed: 11/22/2022]
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Fear of severe pain mediates sex differences in pain sensitivity responses to thermal stimuli. PAIN RESEARCH AND TREATMENT 2014; 2014:897953. [PMID: 24523963 PMCID: PMC3913346 DOI: 10.1155/2014/897953] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/28/2013] [Accepted: 10/15/2013] [Indexed: 11/17/2022]
Abstract
The purpose of this paper was to examine the relationship of sex and pain-related fear in pain intensity reports to thermal stimuli and whether sex differences in reported pain intensity were mediated by pain-related fear. 177 participants, 124 female (23.5 ± 4.5 years old), filled out a demographic and fear of pain questionnaire (FPQ-III). Experimental pain testing was performed using thermal stimuli applied to the lower extremity. Participants rated the intensity of pain using the numerical pain rating scale (NPRS). Independent t-tests, Sobel's test, and linear regression models were performed to examine the relationships between sex, fear of pain, and pain sensitivity. We found significant sex differences for thermal pain threshold temperatures (t = 2.04, P = 0.04) and suprathreshold pain ratings for 49°C (t = -2.12, P = 0.04) and 51°C (t = -2.36, P = 0.02). FPQ-severe score mediated the effect of suprathreshold pain ratings of 49° (t = 2.00, P = 0.05), 51° (t = 2.07, P = 0.04), and pain threshold temperatures (t = -2.12, P = 0.03). There are differences in the pain sensitivity between sexes, but this difference may be mediated by baseline psychosocial factors such as fear of pain.
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Yoon J, Choi KH, Kim TW, Yang SY, Sim MK. Reliability and validity of the korean version of the pain disability questionnaire. Ann Rehabil Med 2013; 37:814-23. [PMID: 24466516 PMCID: PMC3895521 DOI: 10.5535/arm.2013.37.6.814] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2013] [Accepted: 08/04/2013] [Indexed: 01/21/2023] Open
Abstract
Objective To translate the English version of the Pain Disability Questionnaire (PDQ) into Korean and to investigate the reliability and validity of the Korean version of the PDQ (K-PDQ) in patients suffering chronic disabling musculoskeletal disorders (CDMDs). Methods The English version of the PDQ was translated into Korean. Ten patients with CDMDs were randomly selected for a pilot study to assess the comprehensibility of the pre-final version. One hundred and thirty-nine patients suffering from CDMDs for more than 3 months were enrolled in this study. Follow-up questionnaires were obtained to examine the test-retest reliability. Concurrent validity was evaluated by comparing the K-PDQ with the visual analogue scale (VAS). Construct validity was evaluated by comparing the K-PDQ with the brief form of the World Health Organization quality of life assessment instrument (WHOQOL-BREF) using Pearson correlation coefficient. Reliability was assessed using the intraclass correlation coefficient (ICC), and internal consistency was determined by Cronbach's alpha. Results Test-retest reliability was assessed in 70 patients, with an average time interval of 12 days. The ICC was 0.958 (p<0.001). Internal consistency reached Cronbach's alpha of 0.933 for the functional component and 0.870 for the psychosocial component. The correlation coefficient for the K-PDQ when compared with the VAS was 0.834 in the first assessment and 0.831 in the second assessment. All domains of the WHOQOL-BREF showed a significant negative correlation with the K-PDQ. Conclusion The K-PDQ is a reliable and valid instrument for measuring disability and can be used to assess disability and treatment outcomes in Korean patients with CDMD.
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Affiliation(s)
- Jisun Yoon
- Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Kyoung Hyo Choi
- Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Tae Woo Kim
- Department of Rehabilitation Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Seo Yon Yang
- Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Mi Kyung Sim
- Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Taylor LEV, Stotts NA, Humphreys J, Treadwell MJ, Miaskowski C. A biopsychosocial-spiritual model of chronic pain in adults with sickle cell disease. Pain Manag Nurs 2013; 14:287-301. [PMID: 24315252 PMCID: PMC3857562 DOI: 10.1016/j.pmn.2011.06.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2010] [Revised: 06/04/2011] [Accepted: 06/06/2011] [Indexed: 01/30/2023]
Abstract
Chronic pain in adults with sickle cell disease (SCD) is a complex multidimensional experience that includes biologic, psychologic, sociologic, and spiritual factors. To date, three models of pain associated with SCD (i.e., biomedical model, biopsychosocial model for SCD pain, and Health Beliefs Model) have been published. The biopsychosocial multidimensional approach to chronic pain developed by Turk and Gatchel is a widely used model of chronic pain. However, this model has not been applied to chronic pain associated with SCD. In addition, a spiritual/religious dimension is not included in this model. Because spirituality/religion is central to persons affected by SCD, that dimension needs to be added to any model of chronic pain in adults with SCD. In fact, data from one study suggest that spirituality/religiosity is associated with decreased pain intensity in adults with chronic pain from SCD. A biopsychosocial-spiritual model is proposed for adults with chronic pain from SCD, because it embraces the whole person. This model includes the biologic, psychologic, sociologic, and spiritual factors relevant to adults with SCD based on past and current research. The purpose of this paper is to describe an adaptation of Turk and Gatchel's model of chronic pain for adults with SCD and to summarize research findings that support each component of the revised model (i.e., biologic, psychologic, sociologic, spiritual). The paper concludes with a discussion of implications for the use of this model in research.
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Affiliation(s)
- Lou Ella V Taylor
- Department of Physiological Nursing University of California, San Francisco.
| | - Nancy A Stotts
- Department of Physiological Nursing University of California, San Francisco
| | - Janice Humphreys
- Department of Family Health Care Nursing University of California, San Francisco
| | - Marsha J Treadwell
- Sickle Cell Center, Children's Hospital and Research Center, Oakland, California
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Mangerud WL, Bjerkeset O, Lydersen S, Indredavik MS. Chronic pain and pain-related disability across psychiatric disorders in a clinical adolescent sample. BMC Psychiatry 2013; 13:272. [PMID: 24139217 PMCID: PMC3853574 DOI: 10.1186/1471-244x-13-272] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2013] [Accepted: 10/15/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND People who suffer from psychiatric disorders are burdened with a high prevalence of chronic illnesses and pain, but evidence on pain prevalence among adolescents with psychiatric disorders is scarce. The aim of this study was to investigate the frequency and location of self-reported chronic pain and pain-related disability in adolescent psychiatric patients. METHODS This study was part of the larger Health Survey administered at the Department of Child and Adolescent Psychiatry (CAP) at St. Olav's University Hospital, in Trondheim, Norway. All patients aged 13-18 years who visited the CAP clinic at least once between February 15, 2009 and February 15, 2011 were invited to participate. A total of 717 (43.5% of eligible/invited patients) participated; of these, 566 were diagnosed with one or more psychiatric disorders. The adolescents completed a questionnaire, which included questions about pain and pain-related disability. Clinical diagnoses were classified by a clinician according to International Statistical Classification of Diseases and Related Health Problems, 10th revision criteria. RESULTS In adolescents with psychiatric disorders, 70.4% reported chronic pain, and 37.3% experienced chronic pain in three or more locations (multisite pain). Chronic musculoskeletal pain was the most prevalent type of pain (57.7%). Pain-related disability was found in 22.2% of the sample. The frequency of chronic pain and multisite pain increased with age, and girls reported a higher frequency of chronic pain, multisite pain and pain-related disability than boys did. There was an increased risk of chronic pain among adolescents with mood or anxiety disorders versus those with hyperkinetic disorders, yet this was not present after adjusting for sex. Comorbidity between hyperkinetic and mood or anxiety disorders involved an increased risk of pain-related disability. CONCLUSIONS In this study, seven out of 10 adolescents with psychiatric disorders reported chronic pain. These findings indicate the importance of early detection of chronic pain in adolescents with psychiatric disorders, to provide targeted treatment and reduce poor long-term outcomes.
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Affiliation(s)
- Wenche L Mangerud
- Regional Centre for Child and Youth Mental Health and Child Welfare, Faculty of Medicine, Norwegian University of Science and Technology, Medical Technical Research Centre, Postbox 8905, N-7491 Trondheim, Norway.
| | - Ottar Bjerkeset
- Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway,Department of Research and Development, Levanger Hospital, Nord-Trøndelag Health Trust, Levanger, Norway
| | - Stian Lydersen
- Regional Centre for Child and Youth Mental Health and Child Welfare, Faculty of Medicine, Norwegian University of Science and Technology. Medical Technical Research Centre, Postbox 8905, N-7491 Trondheim, Norway
| | - Marit S Indredavik
- Regional Centre for Child and Youth Mental Health and Child Welfare, Faculty of Medicine, Norwegian University of Science and Technology. Medical Technical Research Centre, Postbox 8905, N-7491 Trondheim, Norway,Department of Child and Adolescent Psychiatry, St. Olav’s University Hospital, Trondheim, Norway
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