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Marunica Karšaj J, Grubišić F, Balen D, Jug J, Grazio S. Chronic non-specific low back pain disability and depressive symptoms in working men and women: a cross-sectional study. Rheumatol Int 2024:10.1007/s00296-024-05697-z. [PMID: 39327275 DOI: 10.1007/s00296-024-05697-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2024] [Accepted: 08/09/2024] [Indexed: 09/28/2024]
Abstract
Chronic non-specific low back pain (LBP) is a serious public health issue that impairs the functional abilities of working men and women. The burden and experience of chronic non-specific LBP are largely influenced by psychological and psychosocial aspects. The objective was to investigate the association between the severity of chronic non-specific LBP disability and depressive symptoms in a sample of Croatian working active men and women with an age distribution from 35 to 65 years. The Roland Morris Disability Questionnaire (RMDQ) assessed disability, whereas the Beck Depression Inventory-II assessed depressive symptoms. During the routine outpatient visit self-reported RMDQ and BDI-II were completed from 203 recruited patients, divided into categories concerning disability scores. The median (IQR) age of 48.59 ± 6.48 was in the lower and the median (IQR) age of 50.65 ± 7.68 in the higher disability category. Disability was significantly associated (p < 0.05) with higher age (r = 0.177), working experience (r = 0.161), LBP duration (r = 0.195), greater pain intensity (r = 0.474 during activity, r = 0.227 at rest), and BDI-II score (r = 0.466). Higher BDI-II scores were associated with confirmatory answers on the 15th, 19th, and 22nd questions in RMDQ (p < 0.05). In patients with chronic non-specific LBP, higher degrees of disability were linked to severe depressive symptoms, aging, longer working experience, and increased pain intensity. These findings support pretreatment screening for depressive symptoms in order to develop individually customized and efficient multidisciplinary therapies.
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Affiliation(s)
- Jelena Marunica Karšaj
- University Department of Rheumatology, Physical and Rehabilitation Medicine, Sestre milosrdnice University Hospital Center, Vinogradska cesta 29, Zagreb, 10000, Croatia
| | - Frane Grubišić
- University Department of Rheumatology, Physical and Rehabilitation Medicine, Sestre milosrdnice University Hospital Center, Vinogradska cesta 29, Zagreb, 10000, Croatia
| | - Diana Balen
- University Department of Rheumatology, Physical and Rehabilitation Medicine, Sestre milosrdnice University Hospital Center, Vinogradska cesta 29, Zagreb, 10000, Croatia
| | - Juraj Jug
- Health center Zagreb - West, Krapinska 45, Zagreb, 10000, Croatia
| | - Simeon Grazio
- University Department of Rheumatology, Physical and Rehabilitation Medicine, Sestre milosrdnice University Hospital Center, Vinogradska cesta 29, Zagreb, 10000, Croatia.
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Burek DJ, Ibrahim KM, Hall AG, Sharma A, Musiek ES, Morón JA, Carlezon WA. Inflammatory pain in mice induces light cycle-dependent effects on sleep architecture. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.08.28.610124. [PMID: 39257818 PMCID: PMC11383991 DOI: 10.1101/2024.08.28.610124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/12/2024]
Abstract
As a syndrome, chronic pain comprises physical, emotional, and cognitive symptoms such as disability, negative affect, feelings of stress, and fatigue. A rodent model of long-term inflammatory pain, induced by complete Freund's adjuvant (CFA) injection, has previously been shown to cause anhedonia and dysregulated naturalistic behaviors, in a manner similar to animal models of stress. We examined whether this extended to alterations in circadian rhythms and sleep, such as those induced by chronic social defeat stress, using actigraphy and wireless EEG. CFA-induced inflammatory pain profoundly altered sleep architecture in male and female mice. Injection of the hind paw, whether with CFA or saline, reduced some measures of circadian rhythmicity such as variance, period, and amplitude. CFA increased sleep duration primarily in the dark phase, while sleep bout length was decreased in the light and increased in the dark phase. Additionally, CFA reduced wake bout length, especially during the dark phase. Increases in REM and SWS duration and bouts were most significant in the dark phase, regardless of whether CFA had been injected at its onset or 12 hours prior. Taken together, these results indicate that inflammatory pain acutely promotes but also fragments sleep.
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Ji Y, Xiang X. The Reciprocal Relationship of Physical Capacity and Mental Health: A Random Intercept Cross-Lagged Panel Model Analysis. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2023; 66:924-941. [PMID: 37006136 DOI: 10.1080/01634372.2023.2197017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 03/27/2023] [Accepted: 03/27/2023] [Indexed: 06/19/2023]
Abstract
This study investigates the mutual influence of mental health and physical capacity in older adults, considering potential gender differences. Data from 7,504 Medicare beneficiaries aged 65+ from the NHATS 2011-2015 surveys were analyzed using a random intercept cross-lagged panel model in Mplus. Results revealed moderate within-person effects of physical capacity on mental health (βt12 = -.19, βt23 = -.32, βt34 = -.42, βt45 = -.40), while the reverse relationship showed smaller effects (βt12 = -.02, βt23 = -.03, βt34 = -.03, βt45 = -.02). Gender differences emerged, with the influence of mental health on physical capacity being significant in men but not women. Additionally, correlations between changes in physical capacity and mental health were stronger for men. Lastly, lagged effects of physical capacity on mental health were notably stronger than the reverse. The findings suggest that enhancing physical capacity may alleviate depression and anxiety symptoms in older adults, particularly men.
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Affiliation(s)
- Yuanyuan Ji
- School of Public Administration, Hohai University, Nanjing, China
- School of Management, Nanjing Audit University Jinshen College, Nanjing, China
| | - Xiaoling Xiang
- School of Social Work, University of Michigan, Ann Arbor, MI, USA
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Alhajri N, Boudreau SA, Mouraux A, Graven-Nielsen T. Pain-free default mode network connectivity contributes to tonic experimental pain intensity beyond the role of negative mood and other pain-related factors. Eur J Pain 2023; 27:995-1005. [PMID: 37255228 DOI: 10.1002/ejp.2141] [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: 02/16/2023] [Revised: 05/08/2023] [Accepted: 05/13/2023] [Indexed: 06/01/2023]
Abstract
BACKGROUND Alterations in the default mode network (DMN) connectivity across pain stages suggest a possible DMN involvement in the transition to persistent pain. AIM This study examined whether pain-free DMN connectivity at lower alpha oscillations (8-10 Hz) accounts for a unique variation in experimental peak pain intensity beyond the contribution of factors known to influence pain intensity. METHODS Pain-free DMN connectivity was measured with electroencephalography prior to 1 h of capsaicin-evoked pain using a topical capsaicin patch on the right forearm. Pain intensity was assessed on a (0-10) numerical rating scale and the association between peak pain intensity and baseline measurements was examined using hierarchical multiple regression in 52 healthy volunteers (26 women). The baseline measurements consisted of catastrophizing (helplessness, rumination, magnification), vigilance, depression, negative and positive affect, sex, age, sleep, fatigue, thermal and mechanical pain thresholds and DMN connectivity (medial prefrontal cortex [mPFC]-posterior cingulate cortex [PCC], mPFC-right angular gyrus [rAG], mPFC-left Angular gyrus [lAG], rAG-mPFC and rAG-PCC). RESULTS Pain-free DMN connectivity increased the explained variance in peak pain intensity beyond the contribution of other factors (ΔR2 = 0.10, p = 0.003), with the final model explaining 66% of the variation (R2 = 0.66, ANOVA: p < 0.001). In this model, negative affect (β = 0.51, p < 0.001), helplessness (β = 0.49, p = 0.007), pain-free mPFC-lAG connectivity (β = 0.36, p = 0.003) and depression (β = -0.39, p = 0.009) correlated significantly with peak pain intensity. Interestingly, negative affect and depression, albeit both being negative mood indices, showed opposing relationships with peak pain intensity. CONCLUSIONS This work suggests that pain-free mPFC-lAG connectivity (at lower alpha) may contribute to individual variations in pain-related vulnerability. SIGNIFICANCE These findings could potentially lead the way for investigations in which DMN connectivity is used in identifying individuals more likely to develop chronic pain.
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Affiliation(s)
- Najah Alhajri
- Center for Neuroplasticity and Pain (CNAP), Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Shellie Ann Boudreau
- Center for Neuroplasticity and Pain (CNAP), Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - André Mouraux
- Institute of Neuroscience (IONS), Université catholique de Louvain, Brussels, Belgium
| | - Thomas Graven-Nielsen
- Center for Neuroplasticity and Pain (CNAP), Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
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Lopez FV, Schade R, Ratajska A, Kenney L, Rodriguez K, Ray A, Santos L, Scott BM, Trifilio E, Bowers D. Unpacking the NIH Toolbox Emotion Battery in Persons With Parkinson's disease. Arch Clin Neuropsychol 2023; 38:205-212. [PMID: 36446750 PMCID: PMC9940110 DOI: 10.1093/arclin/acac088] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 09/22/2022] [Accepted: 10/16/2022] [Indexed: 12/05/2022] Open
Abstract
OBJECTIVE Examine the relationship between the National Institutes of Health Toolbox Emotion Battery (Emotion Toolbox) and traditional measures in Parkinson's disease (PD). METHOD Persons with PD (n = 30) and cognitively healthy older adults (OA; n = 40) completed the Emotion Toolbox consisting of Well-Being, Negative Affect, and Social Satisfaction scores along with traditional measures of depression (Beck Depression Inventory-II [BDI-II]), anxiety (State-Trait Anxiety Inventory [STAI]), and apathy (Apathy Scale [AS]); total raw scores). RESULTS Separate bootstrapped analyses of covariance indicated that the PD group scored higher on BDI-II and STAI-State compared to OA (ps < .01); groups did not differ on Emotion Toolbox. In the PD group, bootstrapped partial correlations indicated that Negative Affect was positively related to BDI-II and STAI (ps ≤ .001). Social Satisfaction was negatively related to BDI-II and STAI-Trait (.05 < ps < .004). Psychological Well-Being was negatively related to BDI-II, AS, and STAI (p < .004). No relationships emerged in OA. In the PD group, separate binary logistic regressions showed that traditional measures (BDI-II, AS, and STAI-Trait) correctly classified 79.6% those with formal psychiatric diagnoses (presence vs. absence; p < .011), whereas Emotion Toolbox measures correctly classified 73.3% (p < .019). CONCLUSIONS The Emotion Toolbox showed moderate-strong correlations with traditional measures in persons with PD. Even so, it did not capture the group differences between PD and OA and had a somewhat lower classification accuracy rate for persons with PD who had a formal psychiatric diagnosis than traditional measures. Together, findings question the utility of the Emotion Toolbox as a stand-alone emotion screener in PD.
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Affiliation(s)
- Francesca V Lopez
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL 32610, USA
| | - Rachel Schade
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL 32610, USA
| | - Adrianna Ratajska
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL 32610, USA
| | - Lauren Kenney
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL 32610, USA
| | - Katie Rodriguez
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL 32610, USA
| | - Alyssa Ray
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL 32610, USA
| | - Lauren Santos
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL 32610, USA
| | - Bonnie M Scott
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL 32610, USA
| | - Erin Trifilio
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL 32610, USA
| | - Dawn Bowers
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL 32610, USA
- Department of Neurology, Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL 32610, USA
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Sorel JC, Oosterhoff JHF, Broekman BFP, Jaarsma RL, Doornberg JN, IJpma FFA, Jutte PC, Spekenbrink-Spooren A, Gademan MGJ, Poolman RW. Do symptoms of anxiety and/or depression and pain intensity before primary Total knee arthroplasty influence reason for revision? Results of an observational study from the Dutch arthroplasty register in 56,233 patients. Gen Hosp Psychiatry 2022; 78:42-49. [PMID: 35853417 DOI: 10.1016/j.genhosppsych.2022.07.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 07/01/2022] [Accepted: 07/05/2022] [Indexed: 12/27/2022]
Abstract
OBJECTIVE Anxiety, depression and greater pain intensity before total knee arthroplasty (TKA) may increase the probability of revision surgery for remaining symptoms even without clear pathology or technical issues. We aimed to assess whether preoperative anxiety/depression and pain intensity are associated with revision TKA for less clear indications. METHODS Less clear indications for revision were defined after a Delphi process in which consensus was reached among 59 orthopaedic knee experts. We performed a cox regression analyses on primary TKA patients registered in the Dutch Arthroplasty Registry (LROI) who completed the EuroQol 5D 3 L (EQ5D-3 L) anxiety/depression score to examine associations between preoperative anxiety/depression and pain (Numeric Rating Scale (NRS)) with TKA revision for less clear reasons. These analyses were adjusted for age, BMI, sex, smoking, ASA score, EQ5D-3 L thermometer and OKS score. RESULTS In total, 25.9% patients of the 56,233 included patients reported moderate or severe symptoms of anxiety/depression on the EQ5D-3 L anxiety/depression score. Of those, 615 revisions (45.5%) were performed for less clear reasons for revision (patellar pain, malalignment, instability, progression of osteoarthritis or arthrofibrosis). Not EQ5D-3 L anxiety/depression score, but higher NRS pain at rest and EQ5D-3 L pain score were associated with revision for less clear reason (HR: 1.058, 95% CI 1.019-1.099 & HR: 1.241, 95% CI 1.044-1.476, respectively). CONCLUSION Our findings suggest that pain intensity is a risk factor for TKA revision for a less clear reason. The finding that preoperative pain intensity was associated with reason for revision confirms a likely influence of subjective, personal factors on offer and acceptance of TKA revision. The association between anxiety/depression and reason for revision after TKA may also be found when including more specific outcome measures to assess anxiety/depression and we therefore hope to encourage further research on this topic with our study, ideally in a prospective setting. STUDY DESIGN Longitudinal Cohort Study Level III, Delphi Consensus.
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Affiliation(s)
- Juliette C Sorel
- Department of Orthopaedic Surgery, Leiden University Medical Centre, Leiden, the Netherlands.
| | | | - Birit F P Broekman
- Department of Psychiatry and Medical Psychology, OLVG Hospital / Amsterdam UMC, VU University, Amsterdam, the Netherlands.
| | - Ruurd L Jaarsma
- Department of Orthopaedic & Trauma Surgery, Flinders Medical Centre, Flinders University, Adelaide, SA, Australia.
| | - Job N Doornberg
- Department of Orthopaedic Surgery, University Medical Centre Groningen, the Netherlands.
| | - Frank F A IJpma
- Department of Trauma Surgery, University Medical Center Groningen, Groningen, the Netherlands.
| | - Paul C Jutte
- Department of Orthopaedic Surgery, University Medical Centre Groningen, the Netherlands.
| | | | - Maaike G J Gademan
- Department of Orthopaedic Surgery, Leiden University Medical Centre, Leiden, the Netherlands; Department of Clinical Epidemiology, Leiden University Medical Centre, Leiden, the Netherlands.
| | - Rudolf W Poolman
- Department of Orthopaedic Surgery, Leiden University Medical Centre, Leiden, the Netherlands; Department of Orthopaedic and Trauma Surgery, Joint Research, OLVG Hospital, Amsterdam, the Netherlands.
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Schwab R, Stewen K, Ost L, Kottmann T, Theis S, Elger T, Schmidt MW, Anic K, Kalb SR, Brenner W, Hasenburg A. Predictors of Psychological Distress in Women with Endometriosis during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084927. [PMID: 35457794 PMCID: PMC9024970 DOI: 10.3390/ijerph19084927] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 04/04/2022] [Accepted: 04/12/2022] [Indexed: 12/14/2022]
Abstract
Background: Endometriosis is a multifaceted chronic pain condition that can have a negative impact on mental health. Patients suffering from chronic pain may face an additional psychological burden during adversity, such as the COVID-19 pandemic. The main aim of this research was to evaluate the prevalence of self-reported depression and anxiety, the influence of demographic, endometriosis-specific, pandemic-specific factors, and resilience on mental health outcomes of patients with endometriosis. Methods: An online survey was conducted through patient support groups of women suffering from endometriosis during the first wave of the COVID-19 pandemic. The PHQ-4 questionnaire, which combines two items of the Patient Health Questionnaire for Depression (PHQ-2) and two items from the Generalized Anxiety Disorder Scale (GAD-2) was used to assess self-reported mental health. The Brief Resilience Score (BRS) was employed to evaluate resilience. Independent risk and protective factors for mental health were investigated by multivariate logistic regression analyses. Results: The PHQ-4 questionnaire was completed by 274 respondents. More than 40% reached depression (PHQ-2) and anxiety (GAD-2) scores of ≥3, and more than 20% achieved PHQ-2 and GAD-2 scores of ≥5. High resilience was found to be a reliable and strong independent protector for the probability of developing adverse psychological outcomes: OR 0.295, p < 0.001 for developing generalized anxiety disorder (GAD-2 ≥ 3), and OR 0.467, p < 0.001 for having major depression (PHQ-2 ≥ 3). Conclusions: Pain-induced disability is an independent risk factor for developing major depression and anxiety, while resilience was identified as a potential protective parameter in terms of positive psychological outcomes in women with endometriosis. The results of this study may help to identify women at risk for adverse mental health outcomes and should encourage healthcare practitioners to establish strategies for the reduction of negative psychological and psychiatric impacts on patients with endometriosis.
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Affiliation(s)
- Roxana Schwab
- Department of Obstetrics and Gynecology, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany; (K.S.); (L.O.); (S.T.); (T.E.); (M.W.S.); (K.A.); (S.R.K.); (W.B.); (A.H.)
- Correspondence: ; Tel.: +49-6131-17-0
| | - Kathrin Stewen
- Department of Obstetrics and Gynecology, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany; (K.S.); (L.O.); (S.T.); (T.E.); (M.W.S.); (K.A.); (S.R.K.); (W.B.); (A.H.)
| | - Laura Ost
- Department of Obstetrics and Gynecology, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany; (K.S.); (L.O.); (S.T.); (T.E.); (M.W.S.); (K.A.); (S.R.K.); (W.B.); (A.H.)
| | - Tanja Kottmann
- CRO Dr. Med. Kottmann GmbH & Co. KG, 59077 Hamm, Germany;
| | - Susanne Theis
- Department of Obstetrics and Gynecology, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany; (K.S.); (L.O.); (S.T.); (T.E.); (M.W.S.); (K.A.); (S.R.K.); (W.B.); (A.H.)
| | - Tania Elger
- Department of Obstetrics and Gynecology, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany; (K.S.); (L.O.); (S.T.); (T.E.); (M.W.S.); (K.A.); (S.R.K.); (W.B.); (A.H.)
| | - Mona Wanda Schmidt
- Department of Obstetrics and Gynecology, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany; (K.S.); (L.O.); (S.T.); (T.E.); (M.W.S.); (K.A.); (S.R.K.); (W.B.); (A.H.)
| | - Katharina Anic
- Department of Obstetrics and Gynecology, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany; (K.S.); (L.O.); (S.T.); (T.E.); (M.W.S.); (K.A.); (S.R.K.); (W.B.); (A.H.)
| | - Stefanie Roxana Kalb
- Department of Obstetrics and Gynecology, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany; (K.S.); (L.O.); (S.T.); (T.E.); (M.W.S.); (K.A.); (S.R.K.); (W.B.); (A.H.)
| | - Walburgis Brenner
- Department of Obstetrics and Gynecology, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany; (K.S.); (L.O.); (S.T.); (T.E.); (M.W.S.); (K.A.); (S.R.K.); (W.B.); (A.H.)
| | - Annette Hasenburg
- Department of Obstetrics and Gynecology, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany; (K.S.); (L.O.); (S.T.); (T.E.); (M.W.S.); (K.A.); (S.R.K.); (W.B.); (A.H.)
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Cheng X, Zhang L. Health Service Needs from a Household Perspective: An Empirical Study in Rural Empty Nest Families in Sinan and Dangyang, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19020628. [PMID: 35055450 PMCID: PMC8775500 DOI: 10.3390/ijerph19020628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 12/29/2021] [Accepted: 12/31/2021] [Indexed: 02/04/2023]
Abstract
This study aimed to explore the health service needs of empty nest families from a household perspective. A multistage random sampling strategy was conducted to select 1606 individuals in 803 empty nest households in this study. A questionnaire was used to ask each individual about their health service needs in each household. The consistency rate was calculated based on their consistent answers to the questionnaire. We used a collective household model to analyze individuals’ public health service needs on the family level. According to the results, individuals’ consistency rates of health service needs in empty nest households, such as diagnosis and treatment service (H1), chronic disease management service (H2), telemedicine care (H3), physical examination service (H4), health education service (H5), mental healthcare (H6), and traditional Chinese medicine service (H7) were 40.30%, 89.13%, 98.85%, 58.93%, 57.95%, 72.84%, and 63.40%, respectively. Therefore, family-level health service needs could be studied from a family level. Health service needs of H1, H3, H4, H5, and H7 for individuals in empty nest households have significant correlations with each other (r = 0.404, 0.177, 0.286, 0.265, 0.220, p < 0.001). This will be helpful for health management in primary care in rural China; the concordance will alleviate the pressure of primary care and increase the effectiveness of doctor–patient communication. Health service needs in empty nest households who took individuals’ public needs as household needs (n = 746) included the H4 (43.3%) and H5 (24.9%) and were always with a male householder (94.0%) or at least one had chronic diseases (82.4%). Health service needs in empty nest households that considered one member’s needs as household needs (n = 46) included the H1 (56.5%), H4 (65.2%), H5 (63.0%), and H7 (45.7%), and the member would be the householder of the family (90.5%) or had a disease within two weeks (100.0%). In conclusion, family members’ roles and health status play an important role in health service needs in empty nest households. Additionally, physical examination and health education services are the two health services that are most needed by empty nest households, and are suitable for delivering within a household unit.
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Affiliation(s)
- Xueyan Cheng
- Shanghai Health Development Research Center (Shanghai Medical Information Center), Shanghai 200032, China;
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Liang Zhang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
- School of Political Science and Public Administration, Wuhan University, Wuhan 430030, China
- Correspondence:
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9
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Bagdas D, Sevdar G, Gul Z, Younis R, Cavun S, Tae HS, Ortells MO, Arias HR, Gurun MS. (E)-3-furan-2-yl-N-phenylacrylamide (PAM-4) decreases nociception and emotional manifestations of neuropathic pain in mice by α7 nicotinic acetylcholine receptor potentiation. Neurol Res 2021; 43:1056-1068. [PMID: 34281483 DOI: 10.1080/01616412.2021.1949684] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Clinical intervention of pain is often accompanied by changes in affective behaviors, so both assays of affective and sensorial aspects of nociception play an important role in the development of novel analgesics. Although positive allosteric modulation (PAM) of α7 nicotinic acetylcholine receptors (nAChRs) has been recognized as a novel approach for the relief of sensorial aspects of pain, their effects on affective components of pain remain unclear. Therefore, we investigated whether PAM-4, a highly selective α7-nAChR PAM, attenuates inflammatory and neuropathic pain, as well as the concomitant depressive/anxiety comorbidities. The anti-nociceptive activity of PAM-4 was assessed in mice using the formalin test and chronic constriction injury (CCI)-induced neuropathic pain model. The anxiolytic- and antidepressant-like activity of PAM-4 was evaluated using the marble burying test and forced swimming test. Acute systemic administration of PAM-4 dose-dependently reversed formalin-induced paw licking behavior and CCI-induced mechanical allodynia without development of any motor impairment. PAM-4 reversed the decreased swimming time and number of buried marbles in CCI-treated mice, suggesting that this ligand attenuates chronic pain-induced depression-like behavior and anxiogenic-like effects. The effects of PAM-4 were inhibited by the α7-selective antagonist methyllycaconitine, indicating molecular mechanism mediated by α7-nAChRs. Indeed, electrophysiological recordings showed the PAM-4 enhances human α7 nAChRs with higher potency and efficacy compared to rat α7 nAChRs. These findings suggest that PAM-4 reduces both sensorial and affective behaviors induced by chronic pain in mice by α7-nAChR potentiation. PAM-4 deserves further investigations for the management of chronic painful conditions with comorbidities.
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Affiliation(s)
- Deniz Bagdas
- Department of Psychiatry, School of Medicine, Yale University, New Haven, USA
| | - Gulce Sevdar
- Department of Pharmacology, Faculty of Medicine, Bursa Uludag University, Bursa, Turkey
| | - Zulfiye Gul
- Department of Pharmacology, Faculty of Medicine, Bahcesehir University, Istanbul, Turkey
| | - Rabha Younis
- Department of Pharmacology and Toxicology, Medical College of Virginia, Virginia Commonwealth University, Richmond, VA, USA
| | - Sinan Cavun
- Department of Pharmacology, Faculty of Medicine, Bursa Uludag University, Bursa, Turkey
| | - Han-Shen Tae
- Illawarra Health and Medical Research Institute (IHMRI), University of Wollongong, Wollongong, Australia
| | - Marcelo O Ortells
- Facultad de Medicina, Universidad de Morón, Morón, and CONICET, Moron, Argentina
| | - Hugo R Arias
- Department of Pharmacology and Physiology, Oklahoma State University College of Osteopathic Medicine, Tahlequah, OK, USA
| | - Mine Sibel Gurun
- Department of Pharmacology, Faculty of Medicine, Bursa Uludag University, Bursa, Turkey
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10
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Malvestio RB, Medeiros P, Negrini-Ferrari SE, Oliveira-Silva M, Medeiros AC, Padovan CM, Luongo L, Maione S, Coimbra NC, de Freitas RL. Cannabidiol in the prelimbic cortex modulates the comorbid condition between the chronic neuropathic pain and depression-like behaviour in rats: The role of medial prefrontal cortex 5-HT 1A and CB 1 receptors. Brain Res Bull 2021; 174:323-338. [PMID: 34192579 DOI: 10.1016/j.brainresbull.2021.06.017] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 05/21/2021] [Accepted: 06/24/2021] [Indexed: 01/06/2023]
Abstract
The prelimbic division (PrL) of the medial prefrontal cortex (mPFC) is a cerebral division that is putatively implicated in the chronic pain and depression. We investigated the activity of PrL cortex neurons in Wistar rats that underwent chronic constriction injury (CCI) of sciatic nerve and were further subjected to the forced swimming (FS) test and mechanical allodynia (by von Frey test). The effect of blockade of synapses with cobalt chloride (CoCl2), and the treatment of the PrL cortex with cannabidiol (CBD), the CB1 receptor antagonist AM251 and the 5-HT1A receptor antagonist WAY-100635 were also investigated. Our results showed that CoCl2 decreased the time spent immobile during the FS test but did not alter mechanical allodynia. CBD (at 15, 30 and 60 nmol) in the PrL cortex also decreased the frequency and duration of immobility; however, only the dose of 30 nmol of CBD attenuated mechanical allodynia in rats with chronic NP. AM251 and WAY-100635 in the PrL cortex attenuated the antidepressive and analgesic effect caused by CBD but did not alter the immobility and the mechanical allodynia when administered alone. These data show that the PrL cortex is part of the neural substrate underlying the comorbidity between NP and depression. Also, the previous blockade of CB1 cannabinoid receptors and 5-HT1A serotonergic receptors in the PrL cortex attenuated the antidepressive and analgesics effect of the CBD. They also suggest that CBD could be a potential medicine for the treatment of depressive and pain symptoms in patients with chronic NP/depression comorbidity.
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Affiliation(s)
- R B Malvestio
- Neuroelectrophysiology Multiuser Centre, Department of Surgery and Anatomy, Ribeirão Preto Medical School of the University of São Paulo (FMRP-USP), Av. Bandeirantes, 3900, Ribeirão Preto, 14049-900, São Paulo, Brazil; Laboratory of Neurosciences of Pain & Emotions, Department of Surgery and Anatomy, FMRP-USP, Av. Bandeirantes, 3900, Ribeirão Preto, 14049-900, São Paulo, Brazil
| | - P Medeiros
- Neuroelectrophysiology Multiuser Centre, Department of Surgery and Anatomy, Ribeirão Preto Medical School of the University of São Paulo (FMRP-USP), Av. Bandeirantes, 3900, Ribeirão Preto, 14049-900, São Paulo, Brazil; Laboratory of Neurosciences of Pain & Emotions, Department of Surgery and Anatomy, FMRP-USP, Av. Bandeirantes, 3900, Ribeirão Preto, 14049-900, São Paulo, Brazil; Laboratory of Neuroanatomy and Neuropsychobiology, Department of Pharmacology, FMRP-USP, Av. Bandeirantes, 3900, Ribeirão Preto, 14049-900, São Paulo, Brazil; Behavioural Neurosciences Institute (INeC), Av. do Café, 2450, Monte Alegre, Ribeirão Preto, 14050-220, São Paulo, Brazil
| | - S E Negrini-Ferrari
- Neuroelectrophysiology Multiuser Centre, Department of Surgery and Anatomy, Ribeirão Preto Medical School of the University of São Paulo (FMRP-USP), Av. Bandeirantes, 3900, Ribeirão Preto, 14049-900, São Paulo, Brazil; Laboratory of Neurosciences of Pain & Emotions, Department of Surgery and Anatomy, FMRP-USP, Av. Bandeirantes, 3900, Ribeirão Preto, 14049-900, São Paulo, Brazil
| | - M Oliveira-Silva
- Neuroelectrophysiology Multiuser Centre, Department of Surgery and Anatomy, Ribeirão Preto Medical School of the University of São Paulo (FMRP-USP), Av. Bandeirantes, 3900, Ribeirão Preto, 14049-900, São Paulo, Brazil; Laboratory of Neurosciences of Pain & Emotions, Department of Surgery and Anatomy, FMRP-USP, Av. Bandeirantes, 3900, Ribeirão Preto, 14049-900, São Paulo, Brazil
| | - A C Medeiros
- Neuroelectrophysiology Multiuser Centre, Department of Surgery and Anatomy, Ribeirão Preto Medical School of the University of São Paulo (FMRP-USP), Av. Bandeirantes, 3900, Ribeirão Preto, 14049-900, São Paulo, Brazil; Laboratory of Neurosciences of Pain & Emotions, Department of Surgery and Anatomy, FMRP-USP, Av. Bandeirantes, 3900, Ribeirão Preto, 14049-900, São Paulo, Brazil; Laboratory of Neuroanatomy and Neuropsychobiology, Department of Pharmacology, FMRP-USP, Av. Bandeirantes, 3900, Ribeirão Preto, 14049-900, São Paulo, Brazil; Behavioural Neurosciences Institute (INeC), Av. do Café, 2450, Monte Alegre, Ribeirão Preto, 14050-220, São Paulo, Brazil
| | - C M Padovan
- Laboratory of Neurobiology of Stress and Depression, Department of Psychology, Ribeirão Preto School of Philosophy, Sciences and Literature of the University of São Paulo (FFCLRP-USP), Ribeirão Preto, 14049-900, São Paulo, Brazil; Behavioural Neurosciences Institute (INeC), Av. do Café, 2450, Monte Alegre, Ribeirão Preto, 14050-220, São Paulo, Brazil
| | - L Luongo
- Department of Experimental Medicine, Division of Pharmacology, Università degli Studi della Campania Luigi Vanvitelli, Naples, Italy; IRCCS Neuromed, 86077, Pozzilli-Caserta, Italy
| | - S Maione
- Department of Experimental Medicine, Division of Pharmacology, Università degli Studi della Campania Luigi Vanvitelli, Naples, Italy; IRCCS Neuromed, 86077, Pozzilli-Caserta, Italy
| | - N C Coimbra
- Neuroelectrophysiology Multiuser Centre, Department of Surgery and Anatomy, Ribeirão Preto Medical School of the University of São Paulo (FMRP-USP), Av. Bandeirantes, 3900, Ribeirão Preto, 14049-900, São Paulo, Brazil; Laboratory of Neuroanatomy and Neuropsychobiology, Department of Pharmacology, FMRP-USP, Av. Bandeirantes, 3900, Ribeirão Preto, 14049-900, São Paulo, Brazil; Behavioural Neurosciences Institute (INeC), Av. do Café, 2450, Monte Alegre, Ribeirão Preto, 14050-220, São Paulo, Brazil
| | - R L de Freitas
- Neuroelectrophysiology Multiuser Centre, Department of Surgery and Anatomy, Ribeirão Preto Medical School of the University of São Paulo (FMRP-USP), Av. Bandeirantes, 3900, Ribeirão Preto, 14049-900, São Paulo, Brazil; Laboratory of Neurosciences of Pain & Emotions, Department of Surgery and Anatomy, FMRP-USP, Av. Bandeirantes, 3900, Ribeirão Preto, 14049-900, São Paulo, Brazil; Laboratory of Neuroanatomy and Neuropsychobiology, Department of Pharmacology, FMRP-USP, Av. Bandeirantes, 3900, Ribeirão Preto, 14049-900, São Paulo, Brazil; Behavioural Neurosciences Institute (INeC), Av. do Café, 2450, Monte Alegre, Ribeirão Preto, 14050-220, São Paulo, Brazil; Biomedical Sciences Institute (ICB), Federal University of Alfenas (UNIFAL-MG), Str. Gabriel Monteiro da Silva, 700, Alfenas, 37130-000, Minas Gerais, Brazil.
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11
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Haddas R, Boah A, Block A. Fear-avoidance and Patients' Reported Outcomes are Strongly Correlated With Biomechanical Gait Parameters in Cervical Spondylotic Myelopathy Patients. Clin Spine Surg 2021; 34:E289-E294. [PMID: 33290329 DOI: 10.1097/bsd.0000000000001111] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 11/07/2020] [Indexed: 11/25/2022]
Abstract
STUDY DESIGN This was a prospective cohort study. OBJECTIVE The aim was to explores whether fear-avoidance is associated with altered gait patterns in cervical spinal myelopathy (CSM) patients. SUMMARY OF BACKGROUND DATA Fear-avoidance is associated with activity restriction and emotional distress in chronic pain patients and with poorer spine surgery outcomes. In adults with spinal deformity, fear and avoidance correlates with gait pattern disruptions. Patients having CSM also display distorted gait. METHODS Ninety CSM patients completed the Tampa Scale for Kinesiophobia (TSK) questionnaire, and the Fear-avoidance Beliefs Questionnaire (FABQ). Each patient performed a series of gait trials. Pearson's product correlation analysis was used to determine the relationship between the self-reported fear of movement measures and the objective gait biomechanical data. RESULTS The TSK total score was correlated with walking speed ( P =0.003), cadence ( P =0.012), stride ( P =0.010) and step ( P =0.036) time, and stride ( P =0.018) and step ( P =0.035) length. The FABQ physical dimension was correlated with walking speed ( P <0.001), cadence ( P <0.001), stride ( P <0.001) and step ( P =0.006) time, stride ( P <0.001) and step ( P <0.001) length, and gait deviation index ( P <0.001). The FABQ work dimension was correlated with walking speed ( P =0.001), cadence ( P =0.001), stride ( P =0.001) and step ( P =0.008) time, and stride ( P =0.014) and step ( P =0.002) length. CONCLUSIONS These results provide a framework for further investigation of the relationship between psychosocial factors and objectively measured function in patients with CSM. This study demonstrates a strong correlation between fear and avoidance of movement, as measured with the TSK and FABQ and multiple biomechanical gait parameters, as measured with gait analysis. The current results may imply that fear and avoidance may compound and worsen functional deficits arising from CSM, and strongly suggest that fear and avoidance beliefs should be included as a component of presurgical diagnostic process for CSM patients.
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Affiliation(s)
- Ram Haddas
- Research Department, Texas Back Institute, Plano
| | - Akwasi Boah
- Research Department, Texas Back Institute, Denton, TX
| | - Andrew Block
- Research Department, Texas Back Institute, Plano
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12
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Medeiros P, Dos Santos IR, Júnior IM, Palazzo E, da Silva JA, Machado HR, Ferreira SH, Maione S, Coimbra NC, de Freitas RL. An Adapted Chronic Constriction Injury of the Sciatic Nerve Produces Sensory, Affective, and Cognitive Impairments: A Peripheral Mononeuropathy Model for the Study of Comorbid Neuropsychiatric Disorders Associated with Neuropathic Pain in Rats. PAIN MEDICINE 2021; 22:338-351. [PMID: 32875331 DOI: 10.1093/pm/pnaa206] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Chronic constriction injury (CCI) is a model of neuropathic pain induced by four loose ligatures around the sciatic nerve. This work aimed to investigate the sensory, affective, cognitive, and motor changes induced by an adaptation of the CCI model by applying a single ligature around the sciatic nerve. METHODS Mechanical allodynia was measured from day 1 to day 28 postsurgery by the von Frey test. The beam walking test (BWT) was conducted weekly until 28 days after surgery. Anxiety- and depression-like behaviors, and cognitive performance were assessed through the open field (OF), forced swimming (FS), and novel object recognition (NOR) tests, respectively, 21 days after surgery. RESULTS The two CCI models, both Bennett and Xie's model (four ligatures of the sciatic nerve) and a modification of it (one ligature), induced mechanical allodynia, increased immobility in the FS, and reduced recognition index in the NOR. The exploratory behavior and time spent in the central part of the arena decreased, while the defensive behavior increased in the OF. The animals subjected to the two CCI models showed motor alterations in the BWT; however, autotomy was observed only in the group with four ligatures and not in the group with a single ligature. CONCLUSIONS Overall these results demonstrate that our adapted CCI model, using a single ligature around the sciatic nerve, induces sensory, affective, cognitive, and motor alterations comparable to the CCI model with four ligatures without generating autotomy. This adaptation to the CCI model may therefore represent an appropriate and more easily performed model for inducing neuropathic pain and study underlying mechanisms and effective treatments.
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Affiliation(s)
- Priscila Medeiros
- Laboratory of Neurosciences of Pain & Emotions and Neuroelectrophysiology Multi-User Centre, Department of Surgery and Anatomy, Ribeirão Preto Medical School of the University of São Paulo (FMRP-USP), Ribeirão Preto, São Paulo, Brazil.,Laboratory of Neuroanatomy and Neuropsychobiology, Department of Pharmacology, Ribeirão Preto Medical School of the University of São Paulo (FMRP-USP), Ribeirão Preto, São Paulo, Brazil.,Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Ieda Regina Dos Santos
- Laboratory of Neuroanatomy and Neuropsychobiology, Department of Pharmacology, Ribeirão Preto Medical School of the University of São Paulo (FMRP-USP), Ribeirão Preto, São Paulo, Brazil
| | - Ivair Matias Júnior
- Laboratory of Pediatric Surgery, Department of Surgery and Anatomy, Ribeirão Preto Medical School of the University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Enza Palazzo
- Division of Pharmacology, Department of Experimental Medicine, University of Campania "L. Vanvitelli," Naples, Italy
| | - José Aparecido da Silva
- Laboratory of Neuroanatomy and Neuropsychobiology, Department of Pharmacology, Ribeirão Preto Medical School of the University of São Paulo (FMRP-USP), Ribeirão Preto, São Paulo, Brazil.,Department of Psychology, Ribeirão Preto School of Philosophy, Sciences and Literature of the University of São Paulo, Ribeirão Preto, São Paulo, Brazil.,Psychology Department, Federal University of Juiz de Fora (UFJF-MG), Juiz de Fora, Minas Gerais, Brazil
| | - Hélio Rubens Machado
- Laboratory of Neurosciences of Pain & Emotions and Neuroelectrophysiology Multi-User Centre, Department of Surgery and Anatomy, Ribeirão Preto Medical School of the University of São Paulo (FMRP-USP), Ribeirão Preto, São Paulo, Brazil.,Laboratory of Pediatric Surgery, Department of Surgery and Anatomy, Ribeirão Preto Medical School of the University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Sérgio Henrique Ferreira
- Laboratory of Neurosciences of Pain & Emotions and Neuroelectrophysiology Multi-User Centre, Department of Surgery and Anatomy, Ribeirão Preto Medical School of the University of São Paulo (FMRP-USP), Ribeirão Preto, São Paulo, Brazil.,Biomedical Sciences Institute, Federal University of Alfenas (UNIFAL-MG), Str. Gabriel Monteiro da Silva, Alfenas, Minas Gerais, Brazil
| | - Sabatino Maione
- Division of Pharmacology, Department of Experimental Medicine, University of Campania "L. Vanvitelli," Naples, Italy.,IRCCS Neuromed, 86077, Pozzilli-Caserta, Italy
| | - Norberto Cysne Coimbra
- Laboratory of Neurosciences of Pain & Emotions and Neuroelectrophysiology Multi-User Centre, Department of Surgery and Anatomy, Ribeirão Preto Medical School of the University of São Paulo (FMRP-USP), Ribeirão Preto, São Paulo, Brazil.,Laboratory of Neuroanatomy and Neuropsychobiology, Department of Pharmacology, Ribeirão Preto Medical School of the University of São Paulo (FMRP-USP), Ribeirão Preto, São Paulo, Brazil.,Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Renato Leonardo de Freitas
- Laboratory of Neurosciences of Pain & Emotions and Neuroelectrophysiology Multi-User Centre, Department of Surgery and Anatomy, Ribeirão Preto Medical School of the University of São Paulo (FMRP-USP), Ribeirão Preto, São Paulo, Brazil.,Laboratory of Neuroanatomy and Neuropsychobiology, Department of Pharmacology, Ribeirão Preto Medical School of the University of São Paulo (FMRP-USP), Ribeirão Preto, São Paulo, Brazil.,Department of Psychology, Ribeirão Preto School of Philosophy, Sciences and Literature of the University of São Paulo, Ribeirão Preto, São Paulo, Brazil.,Biomedical Sciences Institute, Federal University of Alfenas (UNIFAL-MG), Str. Gabriel Monteiro da Silva, Alfenas, Minas Gerais, Brazil
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13
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Alhalal EA, Alhalal IA, Alaida AM, Alhweity SM, Alshojaa AY, Alfaori AT. Effects of chronic pain on sleep quality and depression: A cross-sectional study. Saudi Med J 2021; 42:315-323. [PMID: 33632911 PMCID: PMC7989257 DOI: 10.15537/smj.42.3.20200768] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Accepted: 02/09/2021] [Indexed: 11/16/2022] Open
Abstract
Objectives: To examined the impacts of chronic pain on depression and poor sleep quality dimensions as well as the mediating function of poor sleep quality in the pathway between chronic pain and depression. Methods: Between March 2019 and February 2020, we conducted a cross-sectional study on 233 chronic pain patients in 2 tertiary hospitals in Riyadh, Saudi Arabia. Results: Of the 233 patients, 36% had depression, while 66.1% had poor sleep quality. Chronic pain intensity and pain disability significantly explained 10.9% of depressed affect variance, 4.9% of anhedonia variance, 17.3% of somatic complaint variance, 4.5% of interpersonal difficulty variance, 7.4% of sleep efficiency variance, and 15% of perceived sleep quality variance. The result also showed a positive, direct effect of chronic pain on poor sleep quality, which in turn positively and directly affect depression. However, chronic pain had only indirect effect on depression. Conclusions: Among chronic pain patients, the high rates of poor sleep quality and depression requires a special attention. Chronic pain intensity and disability predict depression and sleep quality dimensions differently. The result underlines the need of managing poor sleep quality to address depression in the context of chronic pain.
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Affiliation(s)
- Eman A. Alhalal
- From the Community and Mental Health Nursing Department (Alhalal, E), Nursing Collage, King Saud University, Riyadh; from the Neurosurgery Department (Alhalal I), Qatif Central Hospital, Eastern Region; from King Fahad General Hospital (Alaida), Ministry of Health, Al-Madinah; from King Fahad Specialist Hospital (Alhweity), Ministry of Health, Tabuk; from Aseer Central Hospital (Alshojaa), Ministry of Health, Abha; and from Rafha Central Hospital (Alfaori), Ministry of Health, Rafha. Kingdom of Saudi Arabia.
- Address correspondence and reprint request to: Eman A. Alhalal, Community and Mental Health Nursing Department, Nursing College, King Saud University, Riyadh, Kingdom of Saudi Arabia. E-mail: ORCID ID: http://orcid.org0000-0001-9892-8509
| | - Ibrahim A. Alhalal
- From the Community and Mental Health Nursing Department (Alhalal, E), Nursing Collage, King Saud University, Riyadh; from the Neurosurgery Department (Alhalal I), Qatif Central Hospital, Eastern Region; from King Fahad General Hospital (Alaida), Ministry of Health, Al-Madinah; from King Fahad Specialist Hospital (Alhweity), Ministry of Health, Tabuk; from Aseer Central Hospital (Alshojaa), Ministry of Health, Abha; and from Rafha Central Hospital (Alfaori), Ministry of Health, Rafha. Kingdom of Saudi Arabia.
| | - Amani M. Alaida
- From the Community and Mental Health Nursing Department (Alhalal, E), Nursing Collage, King Saud University, Riyadh; from the Neurosurgery Department (Alhalal I), Qatif Central Hospital, Eastern Region; from King Fahad General Hospital (Alaida), Ministry of Health, Al-Madinah; from King Fahad Specialist Hospital (Alhweity), Ministry of Health, Tabuk; from Aseer Central Hospital (Alshojaa), Ministry of Health, Abha; and from Rafha Central Hospital (Alfaori), Ministry of Health, Rafha. Kingdom of Saudi Arabia.
| | - Sabreen M. Alhweity
- From the Community and Mental Health Nursing Department (Alhalal, E), Nursing Collage, King Saud University, Riyadh; from the Neurosurgery Department (Alhalal I), Qatif Central Hospital, Eastern Region; from King Fahad General Hospital (Alaida), Ministry of Health, Al-Madinah; from King Fahad Specialist Hospital (Alhweity), Ministry of Health, Tabuk; from Aseer Central Hospital (Alshojaa), Ministry of Health, Abha; and from Rafha Central Hospital (Alfaori), Ministry of Health, Rafha. Kingdom of Saudi Arabia.
| | - Asma Y. Alshojaa
- From the Community and Mental Health Nursing Department (Alhalal, E), Nursing Collage, King Saud University, Riyadh; from the Neurosurgery Department (Alhalal I), Qatif Central Hospital, Eastern Region; from King Fahad General Hospital (Alaida), Ministry of Health, Al-Madinah; from King Fahad Specialist Hospital (Alhweity), Ministry of Health, Tabuk; from Aseer Central Hospital (Alshojaa), Ministry of Health, Abha; and from Rafha Central Hospital (Alfaori), Ministry of Health, Rafha. Kingdom of Saudi Arabia.
| | - Amani T. Alfaori
- From the Community and Mental Health Nursing Department (Alhalal, E), Nursing Collage, King Saud University, Riyadh; from the Neurosurgery Department (Alhalal I), Qatif Central Hospital, Eastern Region; from King Fahad General Hospital (Alaida), Ministry of Health, Al-Madinah; from King Fahad Specialist Hospital (Alhweity), Ministry of Health, Tabuk; from Aseer Central Hospital (Alshojaa), Ministry of Health, Abha; and from Rafha Central Hospital (Alfaori), Ministry of Health, Rafha. Kingdom of Saudi Arabia.
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14
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Medial Prefrontal Transcranial Direct Current Stimulation Aimed to Improve Affective and Attentional Modulation of Pain in Chronic Low Back Pain Patients. J Clin Med 2021; 10:jcm10040889. [PMID: 33671714 PMCID: PMC7926794 DOI: 10.3390/jcm10040889] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 02/09/2021] [Accepted: 02/18/2021] [Indexed: 01/09/2023] Open
Abstract
Chronic low back pain (CLBP) is often without clear underlying pathology. Affective disturbance and dysfunctional pain mechanisms, commonly observed in populations with CLBP, have, therefore, been suggested as potential contributors to CLBP development and maintenance. However, little consensus exists on how these features interact and if they can be targeted using non-invasive brain stimulation. In this pilot trial, 12 participants completed two phases (Active or Sham) of high-definition transcranial direct current stimulation (HD-tDCS) to the medial prefrontal cortex, applied for 20 min on three consecutive days. Clinical pain ratings, questionnaires, and sensitivity to painful cuff pressure were completed at baseline, then 4 trials of conditioned pain modulation (CPM; alone, with distraction using a Flanker task, with positive affect induction, and with negative affect induction using an image slideshow) were performed prior to HD-tDCS on Day 1 and Day 4 (24 h post-HD-tDCS). At baseline, attentional and affective manipulations were effective in inducing the desired state (p < 0.001) but did not significantly change the magnitude of CPM-effect. Active HD-tDCS was unable to significantly alter the magnitude of the shift in valence and arousal due to affective manipulations, nor did it alter the magnitude of CPM under any basal, attentional, or affective manipulation trial significantly on Day 4 compared to sham. The CPM-effect was greater across all manipulations on Day 1 than Day 4 (p < 0.02) but also showed poor reliability across days. Future work is needed to expand upon these findings and better understand how and if HD-tDCS can be used to enhance attentional and affective effects on pain modulation.
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15
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Wang AJ, Eid T, Skavinski K, Sharma AN, Liao S. Intravenous Ketamine Administered as Patient Controlled Analgesia and Continuous Infusion for Central Pain Syndrome. J Pain Palliat Care Pharmacother 2020; 35:38-42. [PMID: 32960657 DOI: 10.1080/15360288.2020.1814480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Treatment of Central Pain Syndrome (CPS) is known to be extremely challenging. Current therapies are unsatisfactory as patients report only mild to moderate pain relief. We report a case of using ketamine as a patient-controlled analgesia (PCA) for the treatment of CPS. A 58-year-old male with CPS presented with severe generalized body pain refractory to multiple pharmacological interventions. He was started on a basal infusion rate at 0.3 mg/kg/h with a ketamine PCA bolus of 10 mg with a 10-minute lockout period. Over the next 7 days, the basal infusion rate was titrated up to 2.1 mg/kg/h relative to the number of times the patient pressed the PCA. At the end of the trial, the patient reported 0/10 pain with lightheadedness on the first day being the only side effect reported. He was discharged home with his regular pain regimen, with significant decrease in pain over the next few months. Rather than trying to establish a "one size fits all" protocol for ketamine infusions, this case illustrates a shift in pain management focus by allowing patients to self-titrate and demonstrates the potential for using ketamine PCA as a treatment option for CPS.
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16
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Arendsen LJ, Henshaw J, Brown CA, Sivan M, Taylor JR, Trujillo-Barreto NJ, Casson AJ, Jones AKP. Entraining Alpha Activity Using Visual Stimulation in Patients With Chronic Musculoskeletal Pain: A Feasibility Study. Front Neurosci 2020; 14:828. [PMID: 32973429 PMCID: PMC7468433 DOI: 10.3389/fnins.2020.00828] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 07/15/2020] [Indexed: 11/13/2022] Open
Abstract
Entraining alpha activity with rhythmic visual, auditory, and electrical stimulation can reduce experimentally induced pain. However, evidence for alpha entrainment and pain reduction in patients with chronic pain is limited. This feasibility study investigated whether visual alpha stimulation can increase alpha power in patients with chronic musculoskeletal pain and, secondarily, if chronic pain was reduced following stimulation. In a within-subject design, 20 patients underwent 4-min periods of stimulation at 10 Hz (alpha), 7 Hz (high-theta, control), and 1 Hz (control) in a pseudo-randomized order. Patients underwent stimulation both sitting and standing and verbally rated their pain before and after each stimulation block on a 0-10 numerical rating scale. Global alpha power was significantly higher during 10 Hz compared to 1 Hz stimulation when patients were standing (t = -6.08, p < 0.001). On a more regional level, a significant increase of alpha power was found for 10 Hz stimulation in the right-middle and left-posterior region when patients were sitting. With respect to our secondary aim, no significant reduction of pain intensity and unpleasantness was found. However, only the alpha stimulation resulted in a minimal clinically important difference in at least 50% of participants for pain intensity (50%) and unpleasantness ratings (65%) in the sitting condition. This study provides initial evidence for the potential of visual stimulation as a means to enhance alpha activity in patients with chronic musculoskeletal pain. The brief period of stimulation was insufficient to reduce chronic pain significantly. This study is the first to provide evidence that a brief period of visual stimulation at alpha frequency can significantly increase alpha power in patients with chronic musculoskeletal pain. A further larger study is warranted to investigate optimal dose and individual stimulation parameters to achieve pain relief in these patients.
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Affiliation(s)
- Laura J. Arendsen
- Division of Functional and Restorative Neurosurgery, Eberhart Karls University of Tübingen, Tübingen, Germany
| | - James Henshaw
- Human Pain Research Group, Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, United Kingdom
| | - Christopher A. Brown
- Human Pain Research Group, Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, United Kingdom
- Department of Psychological Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Manoj Sivan
- Human Pain Research Group, Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, United Kingdom
- Leeds Institute of Rheumatology and Musculoskeletal Medicine, University of Leeds, Leeds, United Kingdom
| | - Jason R. Taylor
- Human Pain Research Group, Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, United Kingdom
| | - Nelson J. Trujillo-Barreto
- Human Pain Research Group, Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, United Kingdom
| | - Alexander J. Casson
- Department of Electrical and Electronic Engineering, University of Manchester, Manchester, United Kingdom
| | - Anthony K. P. Jones
- Human Pain Research Group, Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, United Kingdom
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Clobert M, Sims TL, Yoo J, Miyamoto Y, Markus HR, Karasawa M, Levine CS. Feeling excited or taking a bath: Do distinct pathways underlie the positive affect-health link in the U.S. and Japan? Emotion 2020; 20:164-178. [PMID: 30676038 PMCID: PMC6656630 DOI: 10.1037/emo0000531] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Feeling good is linked to better health in Western contexts. Recent studies show, however, that the affect-health link is not consistent across cultures. We suggest two reasons for such inconsistency. The first follows from research showing that North American (vs. East Asian) cultures tend to value high arousal positive (HAP) states, for example, excited, more than low arousal positive (LAP) states, for example, calm. The second is one we propose for the first time. Positive affective experience is manifest in internal feelings but also in affective practices, such as taking a bath (a highly valued affective experience in Japan) or a fitness workout (a highly valued affective experience in the United States). We hypothesized that the HAP feelings/practices-health link would be stronger in the United States versus Japan, and the LAP feelings/practices-health link would be stronger in Japan versus the United States. Using survey samples from the United States (N = 640) and Japan (N = 382), we examined how health outcomes are shaped by positive affective feelings and practices varying in arousal. In a first set of analyses, HAP feelings predicted better physical and biological health in the United States but not in Japan. No cultural differences were consistently found for the effect of LAP feelings on health. In addition, engaging in HAP practices predicted better physical and biological health in the United States whereas engaging in LAP practices predicted better physical health in Japan but not in the United States. These findings suggest that the pathways underlying the culture-health link are culturally variable. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
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Schrepf A, Naliboff B, Williams DA, Stephens-Shields AJ, Landis JR, Gupta A, Mayer E, Rodriguez LV, Lai H, Luo Y, Bradley C, Kreder K, Lutgendorf SK. Adverse Childhood Experiences and Symptoms of Urologic Chronic Pelvic Pain Syndrome: A Multidisciplinary Approach to the Study of Chronic Pelvic Pain Research Network Study. Ann Behav Med 2019; 52:865-877. [PMID: 30212850 DOI: 10.1093/abm/kax060] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Background Adverse Childhood Experiences (ACEs) such as sexual and physical violence, serious illness, and bereavement have been linked to number of chronic pain conditions in adulthood, and specifically to urologic chronic pelvic pain syndrome (UCPPS). Purpose We sought to characterize the prevalence of ACEs in UCPPS using a large well-characterized cohort in comparison with a group of healthy controls. We also sought to determine the association of ACE severity with psychological factors known to impact pain and to determine whether ACEs are associated with patterns of improvement or worsening of symptom over a year of naturalistic observation. Methods For longitudinal analyses we used functional clusters identifying broad classes of (a) improved, (b) worsened, and (c) stable groups for genitourinary pain and urinary symptoms. We employed a mediation/path analysis framework to determine whether ACEs influenced 1 year outcomes directly, or indirectly through worse perceptions of physical well-being. Results ACE severity was elevated in UCPPS (n = 421) participants compared with healthy controls (n = 414; p < .001), and was most strongly associated with factors associated with complex chronic pain, including more diffuse pain, comorbid functional symptoms/syndromes, and worse perceived physical well-being (all p < .001). Finally, worse physical well-being mediated the relationship between ACE severity and less likelihood of painful symptom improvement (OR = .871, p = .007)) and a greater likelihood of painful symptom worsening (OR = 1.249, p = .003) at 1 year. Conclusions These results confirm the association between ACEs and UCPPS symptoms, and suggest potential targets for therapeutic interventions in UCPPS. Clinical Trial registration NCT01098279.
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Affiliation(s)
- Andrew Schrepf
- Chronic Pain and Fatigue Research Center, Department of Anesthesiology, University of Michigan, Ann Arbor, MI, USA
| | - Bruce Naliboff
- Department of Medicine, University of California, Los Angeles, CA, USA.,Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - David A Williams
- Chronic Pain and Fatigue Research Center, Department of Anesthesiology, University of Michigan, Ann Arbor, MI, USA
| | - Alisa J Stephens-Shields
- Department of Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - J Richard Landis
- Department of Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Arpana Gupta
- Oppenheimer Center for Neurobiology of Stress, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA, USA
| | - Emeran Mayer
- Oppenheimer Center for Neurobiology of Stress, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA, USA
| | - Larissa V Rodriguez
- Department of Urology, University of Southern California, Los Angeles, CA, USA
| | - Henry Lai
- Division of Urologic Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA.,Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Yi Luo
- Department of Urology, University of Iowa, Iowa City, IA, USA
| | - Catherine Bradley
- Department of Urology, University of Iowa, Iowa City, IA, USA.,Department of Obstetrics and Gynecology, University of Iowa, Iowa City, IA, USA
| | - Karl Kreder
- Department of Urology, University of Iowa, Iowa City, IA, USA
| | - Susan K Lutgendorf
- Department of Psychological and Brain Sciences and Urology, University of Iowa, Iowa City, IA, USA
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19
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Medeiros P, de Freitas RL, Boccella S, Iannotta M, Belardo C, Mazzitelli M, Romano R, De Gregorio D, Coimbra NC, Palazzo E, Maione S. Characterization of the sensory, affective, cognitive, biochemical, and neuronal alterations in a modified chronic constriction injury model of neuropathic pain in mice. J Neurosci Res 2019; 98:338-352. [PMID: 31396990 DOI: 10.1002/jnr.24501] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 06/24/2019] [Accepted: 07/08/2019] [Indexed: 12/12/2022]
Abstract
The chronic constriction injury (CCI) of the sciatic nerve is a nerve injury-based model of neuropathic pain (NP). Comorbidities of NP such as depression, anxiety, and cognitive deficits are associated with a functional reorganization of the medial prefrontal cortex (mPFC). Here, we have employed an adapted model of CCI by placing one single loose ligature around the sciatic nerve in mice for investigating the alterations in sensory, motor, affective, and cognitive behavior and in electrophysiological and biochemical properties in the prelimbic division (PrL) of the mPFC. Our adapted model of CCI induced mechanical allodynia, motor, and cognitive impairments and anxiety- and depression-like behavior. In the PrL division of mPFC was observed an increase in GABA and a decrease in d-aspartate levels. Moreover an increase in the activity of neurons responding to mechanical stimulation with an excitation, mPFC (+), and a decrease in those responding with an inhibition, mPFC (-), was found. Altogether these findings demonstrate that a single ligature around the sciatic nerve was able to induce sensory, affective, cognitive, biochemical, and functional alterations already observed in other neuropathic pain models and it may be an appropriate and easily reproducible model for studying neuropathic pain mechanisms and treatments.
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Affiliation(s)
- Priscila Medeiros
- Division of Pharmacology, Department of Experimental Medicine, Università degli Studi della Campania Luigi Vanvitelli, Naples, Italy.,Laboratory of Neurosciences of Pain & Emotions and Multi-User Centre of Neuroelectrophysiology, Department of Surgery and Anatomy, Ribeirão Preto Medical School of the University of São Paulo (FMRP-USP), Ribeirão Preto (SP), Brazil.,Laboratory of Neuroanatomy and Neuropsychobiology, Department of Pharmacology, FMRP-USP, Ribeirão Preto, Brazil.,Behavioural Neurosciences Institute (INeC), Ribeirão Preto, Brazil
| | - Renato Leonardo de Freitas
- Division of Pharmacology, Department of Experimental Medicine, Università degli Studi della Campania Luigi Vanvitelli, Naples, Italy.,Laboratory of Neurosciences of Pain & Emotions and Multi-User Centre of Neuroelectrophysiology, Department of Surgery and Anatomy, Ribeirão Preto Medical School of the University of São Paulo (FMRP-USP), Ribeirão Preto (SP), Brazil.,Laboratory of Neuroanatomy and Neuropsychobiology, Department of Pharmacology, FMRP-USP, Ribeirão Preto, Brazil.,Behavioural Neurosciences Institute (INeC), Ribeirão Preto, Brazil.,Biomedical Sciences Institute, Federal University of Alfenas (UNIFAL), Alfenas (MG), Brazil
| | - Serena Boccella
- Division of Pharmacology, Department of Experimental Medicine, Università degli Studi della Campania Luigi Vanvitelli, Naples, Italy
| | - Monica Iannotta
- Division of Pharmacology, Department of Experimental Medicine, Università degli Studi della Campania Luigi Vanvitelli, Naples, Italy
| | - Carmela Belardo
- Division of Pharmacology, Department of Experimental Medicine, Università degli Studi della Campania Luigi Vanvitelli, Naples, Italy
| | - Mariacristina Mazzitelli
- Division of Pharmacology, Department of Experimental Medicine, Università degli Studi della Campania Luigi Vanvitelli, Naples, Italy
| | - Rosaria Romano
- Division of Pharmacology, Department of Experimental Medicine, Università degli Studi della Campania Luigi Vanvitelli, Naples, Italy
| | - Danilo De Gregorio
- Neurobiological Psychiatry Unit, Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Norberto Cysne Coimbra
- Laboratory of Neurosciences of Pain & Emotions and Multi-User Centre of Neuroelectrophysiology, Department of Surgery and Anatomy, Ribeirão Preto Medical School of the University of São Paulo (FMRP-USP), Ribeirão Preto (SP), Brazil.,Laboratory of Neuroanatomy and Neuropsychobiology, Department of Pharmacology, FMRP-USP, Ribeirão Preto, Brazil.,Behavioural Neurosciences Institute (INeC), Ribeirão Preto, Brazil
| | - Enza Palazzo
- Division of Pharmacology, Department of Experimental Medicine, Università degli Studi della Campania Luigi Vanvitelli, Naples, Italy
| | - Sabatino Maione
- Division of Pharmacology, Department of Experimental Medicine, Università degli Studi della Campania Luigi Vanvitelli, Naples, Italy
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20
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Sørengaard TA, Saksvik-Lehouillier I, Langvik E. Longitudinal and cross-sectional examination of the relationship between personality and fatigue among shift workers. COGENT PSYCHOLOGY 2019. [DOI: 10.1080/23311908.2019.1574095] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Affiliation(s)
| | | | - Eva Langvik
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
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21
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Kirlic N, Aupperle RL, Rhudy JL, Misaki M, Kuplicki R, Sutton A, Alvarez RP. Latent variable analysis of negative affect and its contributions to neural responses during shock anticipation. Neuropsychopharmacology 2019; 44:695-702. [PMID: 30181595 PMCID: PMC6372706 DOI: 10.1038/s41386-018-0187-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 07/11/2018] [Accepted: 08/14/2018] [Indexed: 01/04/2023]
Abstract
Negative affect is considered an important factor in the etiology of depression and anxiety, and is highly related to pain. However, negative affect is not a unitary construct. To identify specific targets for treatment development, we aimed to derive latent variables of negative affect and test their unique contributions to affective processing during anticipation of unpredictable, painful shock. Eighty-three subjects (43 with depression and anxiety spectrum disorders and 40 healthy controls) completed self-report measures of negative valence and underwent neuroimaging while exploring computer-simulated contexts with and without the threat of a painful, but tolerable, shock. Principal component analysis (PCA) extracted distinct components of general negative affect (GNA) and pain-related negative affect (PNA). While elevated GNA and PNA were both indicative of depression and anxiety disorders, greater PNA was more strongly related to task-specific anxious reactivity during shock anticipation. GNA was associated with increased precuneus and middle frontal gyrus activity, whereas PNA was related to increased bilateral anterior insula activity. Anterior insula activity mediated the relationship between PNA and task-specific anxious reactivity. In conclusion, GNA and PNA have distinct neural signatures and uniquely contribute to anxious anticipation. PNA, via insula activity, may relate to arousal in ways that could contribute to affective dysregulation, and thus may be an important treatment target.
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Affiliation(s)
- Namik Kirlic
- Laureate Institute for Brain Research, Tulsa, OK, USA.
| | - Robin L. Aupperle
- 0000 0004 0512 8863grid.417423.7Laureate Institute for Brain Research, Tulsa, OK USA ,0000 0001 2160 264Xgrid.267360.6School of Community Medicine, University of Tulsa, Tulsa, OK USA
| | - Jamie L. Rhudy
- 0000 0001 2160 264Xgrid.267360.6Department of Psychology, University of Tulsa, Tulsa, OK USA
| | - Masaya Misaki
- 0000 0004 0512 8863grid.417423.7Laureate Institute for Brain Research, Tulsa, OK USA
| | - Rayus Kuplicki
- 0000 0004 0512 8863grid.417423.7Laureate Institute for Brain Research, Tulsa, OK USA
| | - Anne Sutton
- 0000 0004 0512 8863grid.417423.7Laureate Institute for Brain Research, Tulsa, OK USA
| | - Ruben P. Alvarez
- 0000 0004 0512 8863grid.417423.7Laureate Institute for Brain Research, Tulsa, OK USA
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22
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Cunningham NR, Fussner LM, Moorman E, Avar Aydin PO, Brunner HI, Kashikar-Zuck S. Development and pilot testing of the treatment and education approach for childhood-onset lupus (TEACH): a cognitive behavioral treatment. Pediatr Rheumatol Online J 2019; 17:9. [PMID: 30777090 PMCID: PMC6380024 DOI: 10.1186/s12969-019-0307-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 01/30/2019] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND To develop and test the feasibility and initial effectiveness of the Treatment and Education Approach for Childhood-onset Lupus (TEACH) protocol, a 6-session cognitive behavioral therapy (CBT) intervention for adolescents and young adults (AYA) with childhood-onset systemic lupus erythematosus (cSLE). METHODS Females with cSLE (n = 14; ages 13-19 years, M = 16.21 years) presenting to a pediatric rheumatology clinic subsequently completed the protocol, which was iteratively modified based on participant/interventionist feedback. Upon intervention completion, participants provided qualitative data on feasibility, acceptability, potential modifications, and perceived effectiveness of the program via a semi-structured interview, which was analyzed for shared themes. Participants also completed measures of fatigue, psychological distress, and pain intensity before and after the intervention. Nonparametric statistics were conducted to examine changes in outcome measures following the intervention. RESULTS During the study, several protocol modifications were employed to better address the unique needs of individuals with cSLE (e.g., separate content for adolescents versus young adults). Results suggest that TEACH is feasible, acceptable, and potentially effective in the management of cSLE symptoms. Following the intervention, there was a statistically significant reduction in fatigue (Z = - 2.81, p < .01) and depressive symptoms (Z = - 2.69, p < .01). Reductions in pain and anxiety symptoms were marginal. CONCLUSIONS TEACH, a tailored CBT protocol for AYA with cSLE, is a feasible and potentially effective intervention for the management of fatigue and depressive symptoms. Future directions include testing the protocol in a larger controlled study.
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Affiliation(s)
- Natoshia R. Cunningham
- University of Cincinnati College of Medicine, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH 45229 USA
- Division of Behavioral Medicine and Clinical Psychology, MLC 7039, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH 45229 USA
| | - Lauren M. Fussner
- Division of Behavioral Medicine and Clinical Psychology, MLC 7039, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH 45229 USA
| | - Erin Moorman
- Division of Behavioral Medicine and Clinical Psychology, MLC 7039, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH 45229 USA
| | - Pinar O. Avar Aydin
- University of Cincinnati College of Medicine, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH 45229 USA
- Division of Rheumatology, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH 45229 USA
| | - Hermine I. Brunner
- University of Cincinnati College of Medicine, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH 45229 USA
- Division of Rheumatology, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH 45229 USA
| | - Susmita Kashikar-Zuck
- University of Cincinnati College of Medicine, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH 45229 USA
- Division of Behavioral Medicine and Clinical Psychology, MLC 7039, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH 45229 USA
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23
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Clauw DJ, Essex MN, Pitman V, Jones KD. Reframing chronic pain as a disease, not a symptom: rationale and implications for pain management. Postgrad Med 2019; 131:185-198. [DOI: 10.1080/00325481.2019.1574403] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Daniel J. Clauw
- Department of Anesthesiology, University of Michigan, Ann Arbor, MI, USA
| | | | - Verne Pitman
- Global Medical Affairs, US Medical Affairs, Pfizer Inc, New York, NY, USA
| | - Kim D. Jones
- School of Nursing, Linfield College, Portland, OR, USA
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24
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Ommerborn MA, Depprich RA, Schneider C, Giraki M, Franz M, Raab WHM, Schäfer R. Pain perception and functional/occlusal parameters in sleep bruxism subjects following a therapeutic intervention. Head Face Med 2019; 15:4. [PMID: 30696443 PMCID: PMC6350301 DOI: 10.1186/s13005-019-0188-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 01/14/2019] [Indexed: 12/02/2022] Open
Abstract
Background This study was conducted to assess the individual pain perception in sleep bruxism (SB) subjects. Moreover, the effects of a cognitive behavioural therapy (CBT) compared to an occlusal appliance (OA) on pain perception and a possible continuative impact on several functional parameters were investigated. Methods A total of 57 SB subjects participated in this investigation. The diagnosis of SB was based on the clinical criteria of the American Academy of Sleep Medicine (AASM). Twenty-eight SB subjects were randomly allocated to the CBT group and 29 to the OA group. The therapeutic intervention took place over a period of 12 weeks, whereby both groups were examined at baseline, immediately after termination of the intervention, and at a 6-month follow-up for pain perception and functional parameters. At each of the three measurement periods, participants completed the pain perception scale and ten functional/occlusal parameters were recorded. Results Of the 12 parameters recorded, statistically significant main effects were found for the affective pain perception (p < 0.05) and for the three functional variables. Interestingly, the values obtained for the affective pain perception were considerably below that of a reference group. Apart from the determined statistically significant results, the values recorded for all functional/occlusal variables as well as those obtained for the sensory pain perception were clearly located within normative ranges. Conclusions Within the limitations of this study, it might be concluded that the significantly reduced affective pain perception in SB subjects is the expression of an adaptation mechanism.
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Affiliation(s)
- Michelle Alicia Ommerborn
- Department of Operative Dentistry, Periodontics, and Endodontics, Faculty of Medicine, Heinrich-Heine-University, Moorenstr. 5, 40225, Düsseldorf, Germany.
| | - Rita Antonia Depprich
- Department of Cranio- and Maxillofacial Surgery, Faculty of Medicine, Heinrich-Heine-University, Düsseldorf, Germany
| | - Christine Schneider
- Clinical Institute of Psychosomatic Medicine and Psychotherapy, Faculty of Medicine, Heinrich-Heine-University, Düsseldorf, Germany
| | - Maria Giraki
- Department of Operative Dentistry, Periodontics, and Endodontics, Faculty of Medicine, Heinrich-Heine-University, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Matthias Franz
- Clinical Institute of Psychosomatic Medicine and Psychotherapy, Faculty of Medicine, Heinrich-Heine-University, Düsseldorf, Germany
| | - Wolfgang Hans-Michael Raab
- Department of Operative Dentistry, Periodontics, and Endodontics, Faculty of Medicine, Heinrich-Heine-University, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Ralf Schäfer
- Clinical Institute of Psychosomatic Medicine and Psychotherapy, Faculty of Medicine, Heinrich-Heine-University, Düsseldorf, Germany
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25
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Chang SS, Chou T. A Dynamical Bifurcation Model of Bipolar Disorder Based on Learned Expectation and Asymmetry in Mood Sensitivity. COMPUTATIONAL PSYCHIATRY 2018; 2:205-222. [PMID: 30627671 PMCID: PMC6317753 DOI: 10.1162/cpsy_a_00021] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 09/17/2018] [Indexed: 11/16/2022]
Abstract
Bipolar disorder is a common psychiatric dysfunction characterized by recurring episodes of mania and depression. Despite its prevalence, the causes and mechanisms of bipolar disorder remain largely unknown. Recently, theories focusing on the interaction between emotion and behavior, including those based on dysregulation of the so-called behavioral approach system (BAS), have gained popularity. Mathematical models built on this principle predict bistability in mood and do not invoke intrinsic biological rhythms that may arise from interactions between mood and expectation. Here we develop and analyze a model with clinically meaningful and modifiable parameters that incorporates the interaction between mood and expectation. Our nonlinear model exhibits a transition to limit cycle behavior when a mood-sensitivity parameter exceeds a threshold value, signaling a transition to a bipolar state. The model also predicts that asymmetry in response to positive and negative events can induce unipolar depression/mania, consistent with clinical observations. We analyze the model with asymmetric mood sensitivities and show that large unidirectional mood sensitivity can lead to bipolar disorder. Finally, we show how observed effects of lithium- and antidepressant-induced mania can be explained within the framework of our proposed model.
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Affiliation(s)
- Shyr-Shea Chang
- Department of Mathematics, University of California, Los Angeles, Los Angeles, California, USA
| | - Tom Chou
- Department of Mathematics, University of California, Los Angeles, Los Angeles, California, USA
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26
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Braun Y, Mellema JJ, Peters RM, Curley S, Burchill G, Ring D. The relationship between therapist-rated function and patient-reported outcome measures. J Hand Ther 2018; 30:516-521. [PMID: 27912920 DOI: 10.1016/j.jht.2016.02.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Revised: 12/12/2015] [Accepted: 02/18/2016] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN Prospective cohort study. INTRODUCTION Some third-party payers require hand therapists to rate patient's functional disability based on patient self-rating using patient-reported outcome measures (PROMs), objective measurements of impairment, and observation of functional tasks-hand therapist-rated function (HTRF). PURPOSE OF THE STUDY To test the correlation between HTRF and PROMs (upper limb functional index [ULFI] and Patient-Reported Outcomes Measurement Information System upper extremity [PROMIS UE]) and its association with psychological factors. METHODS In 2014, 100 new patients with upper extremity illness presenting to hand therapists were asked to participate in an observational cross-sectional study. Demographic-, condition-related, and psychological factors were obtained in addition to PROMs and HTRF. RESULTS HTRF correlated moderately with PROMIS UE (r = -0.49, P < .001) and ULFI (r = -0.56, P < .001). Correlation between PROMIS UE and ULFI was strong (r = 0.78, P < .001). Psychological factors explained most of the variations in both HTRF and PROMs. CONCLUSIONS Hand therapists' ratings of patient function correlate less strongly with PROMs than PROMs correlate with one other. The discrepancy between HTRF and PROMs may offer an opportunity to address stress, distress, or ineffective coping strategies that can interfere with recovery-an opportunity for therapists and patients to collaborate and develop goals and for future research to develop effective and feasible strategies for hand therapists. LEVEL OF EVIDENCE Level II, diagnostic study.
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Affiliation(s)
- Yvonne Braun
- Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital - Harvard Medical School, Boston, MA, USA
| | - Jos J Mellema
- Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital - Harvard Medical School, Boston, MA, USA
| | - Rinne M Peters
- Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital - Harvard Medical School, Boston, MA, USA
| | - Suzanne Curley
- Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital - Harvard Medical School, Boston, MA, USA
| | - Gae Burchill
- Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital - Harvard Medical School, Boston, MA, USA
| | - David Ring
- Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, TX.
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Milanovic M, Holshausen K, Milev R, Bowie CR. Functional competence in major depressive disorder: Objective performance and subjective perceptions. J Affect Disord 2018. [PMID: 29518625 DOI: 10.1016/j.jad.2018.02.094] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Major depressive disorder (MDD) is increasingly recognized as a disorder of everyday functioning. Multi-level approaches to investigating functioning have been employed in other conditions whereby competence (ability to perform living skills) is distinguished from real-world functioning, but not yet in MDD. We used a multidimensional (adaptive and interpersonal), multi-level (competence and performance) approach to investigate differences between those with MDD and healthy comparisons (HC) on measures of competence, functional disability, and self-perceived competence. METHODS Between-group analysis of variance identified differences between MDD (n = 42) and HC (n = 24). Moderation analysis determined whether the strength of the relationship between competence accuracy and self-perception of performance was related to group membership. RESULTS In adaptive and interpersonal domains, the MDD group performed significantly lower on competence tasks, endorsed greater functional disability, and reported lower self-perception of competence. Group membership did not moderate the relationship between competence and self-perceived competence in the adaptive domain. Significant moderation was observed in the interpersonal domain such that competence and self-perception of abilities converged in the HC, but not MDD, group. LIMITATIONS A cross-sectional design precluded the ability to interpret causality of results. Functional disability was measured by interview, thereby susceptible to biases in self-report. CONCLUSIONS A multi-level approach to assessing functioning in MDD was supported. Performance-based measures of functional competence are sensitive to MDD and useful for research trials and clinical work to objectively track everyday living skills. Objective measurement is further supported, as those with depression are less likely to accurately evaluate their own abilities, even after demonstrating skills.
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Affiliation(s)
| | | | - Roumen Milev
- Department of Psychiatry, Queen's University & Providence Care Hospital, Kingston.
| | - Christopher R Bowie
- Department of Psychology, Queen's University, Kingston; Department of Psychiatry, Queen's University & Providence Care Hospital, Kingston; Department of Psychology, Queen's University & Centre for Addiction and Mental Health, Toronto.
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28
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Paulus DJ, Garey L, Gallagher MW, Derrick JL, Jardin C, Langdon K, Ditre JW, Zvolensky MJ. Pain severity as a predictor of negative affect following a self-guided quit attempt: An ecological momentary assessment study. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2018; 44:543-550. [PMID: 29846094 PMCID: PMC6234120 DOI: 10.1080/00952990.2018.1467432] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2017] [Revised: 01/25/2018] [Accepted: 04/17/2018] [Indexed: 10/16/2022]
Abstract
BACKGROUND Past work has documented bidirectional associations between pain and cigarette smoking behaviors such that those who smoke evidence greater pain, and those in pain tend to smoke more. However, such work has not focused on the role of pain in relation to negative affect, which plays an important role during cessation attempts. OBJECTIVE The current study evaluated pain as a predictor of negative affect as well as level of interference associated with negative affect among individuals undergoing a self-guided quit attempt. METHODS Study variables were assessed via ecological momentary assessment (EMA) during the 2 weeks following a self-guided quit attempt. Participants included 54 daily smokers (33.3% female; Mage = 34.7, SD = 13.9). RESULTS There were statistically significant within-person associations of pain ratings with negative affect and interference due to negative affect, such that greater pain was associated with higher levels of each dependent variable. Additionally, there was a within-person effect of smoking status (i.e., smoking vs. abstinence, measured via EMA) on negative affect, but not ratings of interference; smoking was associated with greater negative affect. CONCLUSION These findings highlight the importance of bodily pain in relation to negative mood following a quit attempt. Clinically, the results suggest a greater focus on the experience of pain during quit attempts may be warranted.
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Affiliation(s)
- Daniel J. Paulus
- University of Houston, Department of Psychology (Houston, Texas)
| | - Lorra Garey
- University of Houston, Department of Psychology (Houston, Texas)
| | - Matthew W. Gallagher
- University of Houston, Department of Psychology (Houston, Texas)
- University of Houston, Texas Institute for Measurement, Evaluation, and Statistics (Houston, Texas)
| | - Jaye L. Derrick
- University of Houston, Department of Psychology (Houston, Texas)
| | - Charles Jardin
- University of Houston, Department of Psychology (Houston, Texas)
| | - Kirsten Langdon
- Rhode Island Hospital, Department of Psychiatry (Providence, Rhode Island)
- Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior (Providence, Rhode Island)
| | - Joseph W. Ditre
- Syracuse University, Department of Psychology (Syracuse, New York)
| | - Michael J. Zvolensky
- University of Houston, Department of Psychology (Houston, Texas)
- The University of Texas MD Anderson Cancer Center, Department of Behavioral Science (Houston, Texas)
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Abstract
We investigated the discrepancy between competence and real-world performance in major depressive disorder (MDD) for adaptive and interpersonal behaviors, determining whether self-efficacy significantly predicts this discrepancy, after considering depressive symptoms. Forty-two participants (Mage = 37.64, 66.67% female) with MDD were recruited from mental health clinics. Competence, self-efficacy, and real-world functioning were evaluated in adaptive and interpersonal domains; depressive symptoms were assessed with the Beck Depression Inventory II. Hierarchical regression analysis identified predictors of functional disability and the discrepancy between competence and real-world functioning. Self-efficacy significantly predicted functioning in the adaptive and interpersonal domains over and above depressive symptoms. Interpersonal self-efficacy accounted for significant variance in the discrepancy between interpersonal competence and functioning beyond symptoms. Using a multilevel, multidimensional approach, we provide the first data regarding relationships among competence, functioning, and self-efficacy in MDD. Self-efficacy plays an important role in deployment of functional skills in everyday life for individuals with MDD.
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Brienza A, Gianforcaro A, Suffoletto B, Callaway CW, Pacella ML. The utility of assessing for pain interference and psychological factors among emergency department patients who present with pain. Gen Hosp Psychiatry 2018. [PMID: 29518742 DOI: 10.1016/j.genhosppsych.2018.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Ashley Brienza
- Department of Emergency Medicine, University of Pittsburgh, Iroquois Building, Suite 400A, 3600 Forbes Ave, Pittsburgh, PA 15261, United States.
| | - Alexandro Gianforcaro
- Department of Emergency Medicine, University of Pittsburgh, Iroquois Building, Suite 400A, 3600 Forbes Ave, Pittsburgh, PA 15261, United States.
| | - Brian Suffoletto
- Department of Emergency Medicine, University of Pittsburgh, Iroquois Building, Suite 400A, 3600 Forbes Ave, Pittsburgh, PA 15261, United States.
| | - Clifton W Callaway
- Department of Emergency Medicine, University of Pittsburgh, Iroquois Building, Suite 400A, 3600 Forbes Ave, Pittsburgh, PA 15261, United States.
| | - Maria L Pacella
- Department of Emergency Medicine, University of Pittsburgh, Iroquois Building, Suite 400A, 3600 Forbes Ave, Pittsburgh, PA 15261, United States.
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Geva N, Defrin R. Opposite Effects of Stress on Pain Modulation Depend on the Magnitude of Individual Stress Response. THE JOURNAL OF PAIN 2018; 19:360-371. [DOI: 10.1016/j.jpain.2017.11.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2017] [Revised: 10/17/2017] [Accepted: 11/14/2017] [Indexed: 12/29/2022]
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Hassett AL, Goesling J, Mathur SN, Moser SE, Brummett CM, Sibille KT. Affect and Low Back Pain: More to Consider Than the Influence of Negative Affect Alone. Clin J Pain 2017; 32:907-14. [PMID: 26889620 DOI: 10.1097/ajp.0000000000000350] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVES Affect balance style, a measure of trait positive affect (PA) and negative affect (NA), is predictive of pain and functioning in fibromyalgia and healthy individuals. The purpose of this study was to evaluate the distribution of affect balance styles and the relationship between these styles and clinical factors in low back pain. METHODS In this cross-sectional study, patients with low back pain (N=443) completed questionnaires and were categorized as having 1 of 4 distinct affect balance styles: Healthy (high levels of PA and low levels of NA), Low (low PA/low NA), Reactive (high PA/high NA), and Depressive (low PA/high NA). Comparisons between groups were made in regard to pain, functioning, and psychiatric comorbidity. RESULTS High NA was observed in 63% (n=281), whereas low PA was present in 81% (n=359). We found that having a Depressive style was associated with greater pain severity, increased odds for comorbid fibromyalgia, and worse functioning compared with having a Healthy or Low style. Yet, those with a Low style were at increased risk for depression compared with a Healthy style, whereas patients with a Reactive style had similar levels of pain, functioning, and depression as those with a Healthy affective style. CONCLUSIONS Our study revealed that there are important differences between trait affect balance styles in regard to pain, mood, and functioning in low back pain. Findings related to Reactive and Low affective styles suggest that relationships between affect, pain, and disability in low back pain extend beyond considering NA alone.
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Affiliation(s)
- Afton L Hassett
- *Department of Anesthesiology, Chronic Pain & Fatigue Research Center, University of Michigan, Ann Arbor, MI †NeuroSpinecare Inc., Cleveland, OH ‡Department of Aging & Geriatric Research, University of Florida, Gainesville, FL
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Mela M, Baetz M, Marcoux G, Delury D, Cooper B, Sajobi TT. The influence of a learning to forgive programme on negative affect among mentally disordered offenders. CRIMINAL BEHAVIOUR AND MENTAL HEALTH : CBMH 2017; 27:162-175. [PMID: 26833928 DOI: 10.1002/cbm.1991] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Revised: 07/18/2014] [Accepted: 11/17/2015] [Indexed: 06/05/2023]
Abstract
BACKGROUND Clinical trials and meta-analyses provide some evidence for effectiveness of forgiveness therapy delivered individually or in groups. To date, however, forgiveness therapy has not been evaluated with mentally disordered offenders. Given the high prevalence of experienced and perpetrated trauma among such people, this population may particularly benefit from such an intervention. AIM The aim of this study is to test the feasibility and impact of a 'learn to forgive' group programme among mentally disordered offenders on a specialist secure hospital setting. METHODS We conducted a non-randomised trial with 36 offenders with mental disorders and 29 comparison patients. The intervention group engaged in a six-week manual-based 'learn to forgive' treatment programme, while the comparison group watched a 90-minute video on forgiveness. Both groups completed measures of anger, depression, stress, forgiveness and satisfaction with life at baseline and then 6 and 18 weeks later. A repeated measures mixed-effects model was used to investigate the association between affective outcomes and type of intervention received, after adjusting for baseline characteristics. RESULTS The group completion rate was over 90%. The treatment and comparison groups were similar on baseline demographic and criminological measures, but the treatment group had higher baseline anger and depression scores. While both groups showed improved capacity to forgive and reduced negative affect over time, those in the 'learn to forgive' programme showed significantly more improvement in forgiveness and on anger measures. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Forgiveness training can be delivered effectively to offenders with mental disorders in clinical settings. Its range of benefits, including reduction I in anger as well as improved capacity to forgive, suggest that it may have longer term implications for personal safety and reintegration into mainstream societal settings. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Mansfield Mela
- Department of Psychiatry, University of Saskatchewan, Saskatoon, Canada
| | - Marilyn Baetz
- Department of Psychiatry, University of Saskatchewan, Saskatoon, Canada
| | - Gene Marcoux
- Department of Psychiatry, University of Saskatchewan, Saskatoon, Canada
| | - Daniel Delury
- Department of Psychiatry, University of Saskatchewan, Saskatoon, Canada
| | | | - Tolulope T Sajobi
- Department of Community Health Sciences & O'Brien Institute for Public Health, University of Calgary, Calgary, Canada
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Results from 10 Years of a CBT Pain Self-Management Outpatient Program for Complex Chronic Conditions. Pain Res Manag 2016; 2016:4678083. [PMID: 27891062 PMCID: PMC5116337 DOI: 10.1155/2016/4678083] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 08/30/2016] [Accepted: 08/31/2016] [Indexed: 01/22/2023]
Abstract
Background. Traditional unimodal interventions may be insufficient for treating complex pain, as they do not address cognitive and behavioural contributors to pain. Cognitive Behavioural Therapy (CBT) and physical exercise (PE) are empirically supported treatments that can reduce pain and improve quality of life. Objectives. To examine the outcomes of a pain self-management outpatient program based on CBT and PE at a rehabilitation hospital in Toronto, Ontario. Methods. The pain management group (PMG) consisted of 20 sessions over 10 weeks. The intervention consisted of four components: education, cognitive behavioural skills, exercise, and self-management strategies. Outcome measures included the sensory, affective, and intensity of pain experience, depression, anxiety, pain disability, active and passive coping style, and general health functioning. Results. From 2002 to 2011, 36 PMGs were run. In total, 311 patients entered the program and 214 completed it. Paired t-tests showed significant pre- to posttreatment improvements in all outcomes measured. Patient outcomes did not differ according to the number or type of diagnoses. Both before and after treatment, women reported more active coping than men. Discussion. The PMGs improved pain self-management for patients with complex pain. Future research should use a randomized controlled design to better understand the outcomes of PMGs.
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Sleep Problems are Associated With Chronic Pain Over and Above Mutual Associations With Depression and Catastrophizing. Clin J Pain 2016; 32:792-9. [DOI: 10.1097/ajp.0000000000000329] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Zeng F, Sun X, Yang B, Fu X. Life events, anxiety, social support, personality, and alexithymia in female patients with chronic pain: A path analysis. Asia Pac Psychiatry 2016; 8:44-50. [PMID: 26568558 PMCID: PMC5063115 DOI: 10.1111/appy.12222] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Accepted: 10/06/2015] [Indexed: 02/05/2023]
Abstract
INTRODUCTION This study sought to identify a model that explains the relationship between psychosocial factors and chronic pain in female patients, and to explore all of these constructs in a single study and provide a more holistic examination of the overall psychosocial factors that female patients with chronic pain encounter. METHODS Female patients with chronic pain (n = 147), aged 20-65 (M = 34.9 years, SD = 11.25), from an outpatient pain clinic completed a cross-sectional self-report questionnaire on anxiety, life events, personality, social support, and alexithymia. Data were analyzed by means of path analysis. RESULTS The direct effect of anxiety on female patients with chronic pain was greatest among all the paths. Personality and alexithymia led to chronic pain in female patients only indirectly, mediated by life events. The personality factors of neuroticism and extraversion were associated positively with social support, which had an indirect effect on the influence of life events on chronic pain. However, alexithymia was associated negatively with social support, which had an indirect effect on the influence of life events on chronic pain. DISCUSSION Our findings provide evidence that life events are a mediator in the relationship between personality, social support, alexithymia, and chronic pain in female patients.
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Affiliation(s)
- Fanmin Zeng
- Department of Psychiatry, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xueli Sun
- Department of Psychiatry, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Bangxiang Yang
- Department of Pain Management, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xiaoqian Fu
- Department of Psychiatry, Suzhou Psychiatry Hospital, Suzhou, China
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Subedi A, Chaudakshetrin P, Chotisukarat H, Mandee S. Effect of Co-Morbid Conditions on Persistent Neuropathic Pain after Brachial Plexus Injury in Adult Patients. J Clin Neurol 2016; 12:489-494. [PMID: 27819420 PMCID: PMC5063877 DOI: 10.3988/jcn.2016.12.4.489] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 05/05/2016] [Accepted: 05/09/2016] [Indexed: 02/06/2023] Open
Abstract
Background and Purpose Neuropathic pain (NeuP) associated with traumatic brachial plexus injury (BPI) can be severe, persistent, and resistant to treatment. Moreover, comorbidity associated with NeuP may worsen the pain and quality of life. This study compared persistent NeuP after BPI between patients with and without co-morbid conditions (psychiatric dysfunction and other painful conditions) and tramadol usage as a second-line agent in combination with an antiepileptic and/or antidepressant during a 2-year follow-up. Methods The medical records of patients diagnosed with BPI referred to a pain center between 2006 and 2010 were reviewed for 2 years retrospectively. Data regarding patient demographics, injury and surgical profiles, characteristics of NeuP and its severity, and treatment received were compared between patients with and without manifesting co-morbid conditions. The NeuP and pain intensity assessments were based on the DN4 questionnaire and a numerical rating scale, respectively. Results Of the 45 patients studied, 24 patients presented with one of the following co-morbid conditions: myofascial pain (21%), psychiatric disorder (17%), phantom limb pain (4%), complex regional pain syndrome (21%), and insomnia (37%). Tramadol was required by 20 patients with co-morbidity and, 9 patients without co-morbidity (p<0.001). The mean pain score after 2 years was higher in patients with co-morbidity than in those without co-morbidity (p<0.05). Conclusions Persistent pain following BPI was more common in patients manifesting other painful conditions or psychiatric co-morbidity. A higher proportion of the patients in the co-morbid group required tramadol as a second-line of agent for pain relief.
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Affiliation(s)
- Asish Subedi
- Department of Anesthesiology, BPKIHS, Dharan, Nepal.
| | | | | | - Sahatsa Mandee
- Department of Anesthesiology, Siriraj Hospital, Bangkok, Thailand
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Liu Y, Yang L, Yu J, Zhang YQ. Persistent, comorbid pain and anxiety can be uncoupled in a mouse model. Physiol Behav 2015; 151:55-63. [DOI: 10.1016/j.physbeh.2015.07.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Revised: 07/03/2015] [Accepted: 07/05/2015] [Indexed: 01/26/2023]
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Abstract
OBJECTIVE This narrative review summarizes and integrates the available literature on positive affect (PA) and pain to: (1) provide a brief overview of PA and summarize the key findings that have emerged in the study of PA and pain; (2) provide a theoretical foundation from which to understand how PA operates in the context of chronic pain (CP); and (3) highlight how the prevailing psychosocial treatments for CP address PA in the therapeutic context, and offer suggestions for how future treatment development research can maximize the benefit of PA for patients with CP. RESULTS In experimental studies, the evidence suggests PA is analgesic. In clinical studies, the association of PA and pain is dynamic, time variant, and may be best considered in context of its interacting role with negative affect. DISCUSSION We offer an "upward spiral" model of PA, resilience and pain self-management, which makes specific predictions that PA will buffer maladaptive cognitive and affective responses to pain, and promote active engagement in valued goals that enhance CP self-management.
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Day MA, Jensen MP, Ehde DM, Thorn BE. Toward a theoretical model for mindfulness-based pain management. THE JOURNAL OF PAIN 2015; 15:691-703. [PMID: 24985483 DOI: 10.1016/j.jpain.2014.03.003] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Revised: 02/04/2014] [Accepted: 03/17/2014] [Indexed: 11/24/2022]
Abstract
UNLABELLED Mindfulness, as both a process and a practice, has received substantial research attention across a range of health conditions, including chronic pain. Previously proposed mechanisms underlying the potential health-related benefits of mindfulness and mindfulness-based interventions (MBIs) are based on a strong theoretical background. However, to date, an empirically grounded, integrated theoretical model of the mechanisms of MBIs within the context of chronic pain has yet to be proposed. This is a surprising gap in the literature given the exponential growth of studies reporting on the benefits of MBIs for heterogeneous chronic pain conditions. Moreover, given the importance of determining how, and for whom, psychological interventions for pain management are effective, it is imperative that this gap in the literature be addressed. The overarching aim of the current theoretical paper was to propose an initial integrated, theoretically driven, and empirically based model of the mechanisms of MBIs for chronic pain management. Theoretical and research implications of the model are discussed. The theoretical considerations proposed herein can be used to help organize and guide future research that will identify the mechanisms underlying the benefits of mindfulness-based treatments, and perhaps psychosocial treatments more broadly, for chronic pain management. PERSPECTIVE This focus article presents an initial framework for an empirically based, theoretical model of the mechanisms of MBIs for chronic pain management. Implications of the framework for refining theory and for future research are addressed.
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Affiliation(s)
- Melissa A Day
- Department of Rehabilitation Medicine, University of Washington, University of Washington School of Medicine, Seattle, Washington.
| | - Mark P Jensen
- Department of Rehabilitation Medicine, University of Washington, University of Washington School of Medicine, Seattle, Washington
| | - Dawn M Ehde
- Department of Rehabilitation Medicine, University of Washington, University of Washington School of Medicine, Seattle, Washington
| | - Beverly E Thorn
- Department of Psychology, University of Alabama, Tuscaloosa, Alabama
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Emmert K, Breimhorst M, Bauermann T, Birklein F, Van De Ville D, Haller S. Comparison of anterior cingulate vs. insular cortex as targets for real-time fMRI regulation during pain stimulation. Front Behav Neurosci 2014; 8:350. [PMID: 25346666 PMCID: PMC4191436 DOI: 10.3389/fnbeh.2014.00350] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Accepted: 09/18/2014] [Indexed: 11/24/2022] Open
Abstract
Real-time functional magnetic resonance imaging (rt-fMRI) neurofeedback allows learning voluntary control over specific brain areas by means of operant conditioning and has been shown to decrease pain perception. To further increase the effect of rt-fMRI neurofeedback on pain, we directly compared two different target regions of the pain network, notably the anterior insular cortex (AIC) and the anterior cingulate cortex (ACC). Participants for this prospective study were randomly assigned to two age-matched groups of 14 participants each (7 females per group) for AIC and ACC feedback. First, a functional localizer using block-design heat pain stimulation was performed to define the pain-sensitive target region within the AIC or ACC. Second, subjects were asked to down-regulate the BOLD activation in four neurofeedback runs during identical pain stimulation. Data analysis included task-related and functional connectivity analysis. At the behavioral level, pain ratings significantly decreased during feedback vs. localizer runs, but there was no difference between AIC and ACC groups. Concerning neuroimaging, ACC and AIC showed consistent involvement of the caudate nucleus for subjects that learned down-regulation (17/28) in both task-related and functional connectivity analysis. The functional connectivity toward the caudate nucleus is stronger for the ACC while the AIC is more heavily connected to the ventrolateral prefrontal cortex. Consequently, the ACC and AIC are suitable targets for real-time fMRI neurofeedback during pain perception as they both affect the caudate nucleus, although functional connectivity indicates that the direct connection seems to be stronger with the ACC. Additionally, the caudate, an important area involved in pain perception and suppression, could be a good rt-fMRI target itself. Future studies are needed to identify parameters characterizing successful regulators and to assess the effect of repeated rt-fMRI neurofeedback on pain perception.
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Affiliation(s)
- Kirsten Emmert
- Department of Radiology and Medical Informatics, University of Geneva Geneva, Switzerland ; Medical Image Processing Laboratory, Institute of Bioengineering, Ecole Polytechnique Fédérale de Lausanne Lausanne, Switzerland
| | - Markus Breimhorst
- Department of Neurology, University Medical Center of the Johannes Gutenberg-University Mainz Mainz, Germany
| | - Thomas Bauermann
- Institute of Neuroradiology, University Medical Center of the Johannes Gutenberg-University Mainz Mainz, Germany
| | - Frank Birklein
- Department of Neurology, University Medical Center of the Johannes Gutenberg-University Mainz Mainz, Germany
| | - Dimitri Van De Ville
- Department of Radiology and Medical Informatics, University of Geneva Geneva, Switzerland ; Medical Image Processing Laboratory, Institute of Bioengineering, Ecole Polytechnique Fédérale de Lausanne Lausanne, Switzerland
| | - Sven Haller
- Department of Radiology and Medical Informatics, University of Geneva Geneva, Switzerland
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Sleigh J, Harvey M, Voss L, Denny B. Ketamine – More mechanisms of action than just NMDA blockade. TRENDS IN ANAESTHESIA AND CRITICAL CARE 2014. [DOI: 10.1016/j.tacc.2014.03.002] [Citation(s) in RCA: 93] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Hoffelt C, Zwack A. Assessment and management of chronic pain in patients with depression and anxiety. Ment Health Clin 2014. [DOI: 10.9740/mhc.n198935] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This article will review the role of the pharmacist in the management of chronic pain in patients with comorbid mood disorders.
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Slepian P, Bernier E, Scott W, Niederstrasser NG, Wideman T, Sullivan M. Changes in pain catastrophizing following physical therapy for musculoskeletal injury: the influence of depressive and post-traumatic stress symptoms. JOURNAL OF OCCUPATIONAL REHABILITATION 2014; 24:22-31. [PMID: 23529509 DOI: 10.1007/s10926-013-9432-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
PURPOSE The aim of the present study was to investigate the factors that influence the change in pain catastrophizing during the course of a physical therapy intervention for musculoskeletal injury. METHODS 187 clients enrolled in a 7-week physical therapy intervention were divided into four mutually exclusive groups on the basis of a pre-treatment assessment: (1) clients whose pre-treatment catastrophizing scores and measures of mental health problems were below clinical threshold, (2) clients whose pre-treatment catastrophizing scores were above clinical threshold but who scores on measures of mental health problems were below clinical threshold, (3) clients whose pre-treatment catastrophizing scores were above clinical threshold and whose scores on measures of mental health problems were also above clinical threshold, and (4) clients whose pre-treatment catastrophizing scores were below clinical threshold but whose scores on measures of mental health problems were above clinical threshold. RESULTS The most prevalent risk profile consisted of clients with high levels of pain catastrophizing and high mental health problems (37 %), followed by the low catastrophizing and low mental health problems profile (35 %), the high catastrophizing and low mental health problems profile (16 %), and low catastrophizing and high mental health problems profile (10 %). Clients were considered non-responders if their post-treatment catastrophizing score remained above clinical threshold following treatment. Chi square analyses revealed a significantly higher proportion of non-responders in the high catastrophizing and mental health problem group than in any other group. CONCLUSIONS The presence of mental health symptoms markedly reduces the effectiveness of physical therapy for reducing catastrophizing scores. The 'risk value' of high catastrophizing scores thus appears to vary as a function of the presence or absence of mental health symptoms. The findings argue for the inclusion of measures of mental health problems in the routine screening of individuals treated in physical therapy.
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Affiliation(s)
- Peter Slepian
- Department of Psychology, McGill University, 1205 Docteur Penfield, Montreal, QC, H3A 1B1, Canada
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Emery PC, Wilson KG, Kowal J. Major depressive disorder and sleep disturbance in patients with chronic pain. Pain Res Manag 2014; 19:35-41. [PMID: 24367795 PMCID: PMC3938341 DOI: 10.1155/2014/480859] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Disturbed sleep is a common problem in both chronic pain and major depressive disorder (MDD). Moreover, many patients with chronic pain are depressed. OBJECTIVES To examine the effects of depression on the sleep behaviour of chronic pain patients by comparing patients who did or did not meet diagnostic criteria for MDD. METHODS A total of 60 patients with chronic musculoskeletal pain underwent structured diagnostic interviews for MDD and insomnia, and completed questionnaires assessing pain severity, disability, sleep quality, beliefs and attitudes about sleep, and sleep hygiene. For four consecutive days, they also completed a sleep diary, and reported on sleep hygiene practices and presleep arousal. RESULTS Thirty-three patients (55%) met diagnostic criteria for MDD, most of whom (n=32 [97%]) also fulfilled criteria for insomnia disorder. Insomnia was also common among patients without MDD (21 of 27 [78%]). Participants with MDD had higher self-reports of pain, disability, dysfunctional beliefs about sleep, and, on a prospective basis, greater presleep arousal and poorer sleep hygiene. However, diary assessments of specific sleep parameters (eg, sleep onset latency, total sleep time, sleep efficiency) did not differ between the groups. DISCUSSION Chronic pain patients with comorbid MDD exhibited more dysfunctional beliefs about sleep, poorer sleep hygiene practices and greater presleep arousal; however, diary-recorded sleep characteristics may not differ from those of patients without MDD. Chronic pain itself may disturb sleep so extensively that MDD introduces little additive effect. CONCLUSION MDD in chronic pain may be related to the cognitive and behavioural aspects of insomnia, rather than to an incremental disturbance in the initiation or maintenance of sleep.
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Affiliation(s)
| | - Keith G Wilson
- School of Psychology
- Department of Medicine, University of Ottawa
- Department of Psychology, The Ottawa Hospital Rehabilitation Centre
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario
| | - John Kowal
- School of Psychology
- Department of Psychology, The Ottawa Hospital Rehabilitation Centre
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario
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Geva N, Defrin R. Enhanced pain modulation among triathletes: A possible explanation for their exceptional capabilities. Pain 2013; 154:2317-2323. [DOI: 10.1016/j.pain.2013.06.031] [Citation(s) in RCA: 104] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2013] [Revised: 06/10/2013] [Accepted: 06/17/2013] [Indexed: 10/26/2022]
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Karp JF, Yu L, Friedly J, Amtmann D, Pilkonis PA. Negative affect and sleep disturbance may be associated with response to epidural steroid injections for spine-related pain. Arch Phys Med Rehabil 2013; 95:309-15. [PMID: 24060493 DOI: 10.1016/j.apmr.2013.09.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2013] [Revised: 09/11/2013] [Accepted: 09/12/2013] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To describe whether negative affect and sleep impairment are associated with the clinical effect of epidural steroid injections (ESIs) for low back pain. DESIGN Observational study; patients were evaluated before ESI and 1 and 3 months after ESI. SETTING Spine center and related treatment sites. PARTICIPANTS Participants (N=158) seeking treatment for low back pain with or without radiculopathy. INTERVENTION ESI for low back pain with or without radiculopathy. MAIN OUTCOME MEASURES We assessed the dependent (global pain severity for back and leg pain, pain behavior, pain interference) and independent variables (depression, sleep disturbance, and covariates of back pain response) with the Patient-Reported Outcome Measurement Information System (PROMIS) and legacy measures. Outcome was assessed cross-sectionally using multiple regression and longitudinally with path analysis. RESULTS After 1 month, sleep disturbance was the only predictor for the global ratings of improvement in back pain (R(2)=16.8%) and leg pain (R(2)=11.4%). The proportions of variance explained by sleep disturbance and negative affect for all dependent variables were greater at 3 months than 1 month. Mediation analysis was significant for negative affect for the 3-month outcomes on PROMIS pain behavior (β=.87, P<.01) and pain interference (β=.37, P<.01). There was no evidence of mediation by sleep disturbance for any outcome. CONCLUSIONS Negative affect and sleep disturbance are associated with worse outcomes after ESI. Further research is needed to determine if treatment of negative affect and sleep disturbance prior to or concurrently with ESI will improve outcomes.
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Affiliation(s)
- Jordan F Karp
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA; Department of Anesthesiology, University of Pittsburgh School of Medicine, Pittsburgh, PA.
| | - Lan Yu
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Janna Friedly
- Department of Rehabilitation, University of Washington, Seattle, WA
| | - Dagmar Amtmann
- Department of Rehabilitation, University of Washington, Seattle, WA
| | - Paul A Pilkonis
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
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Torres X, Collado A, Gómez E, Arias A, Cabrera-Villalba S, Messina OD, Vidal LF, Clark P, Ríos C, Salomón PA. The Spanish version of the Fibromyalgia Rapid Screening Tool: translation, validity and reliability. Rheumatology (Oxford) 2013; 52:2283-91. [DOI: 10.1093/rheumatology/ket308] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
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Jacobs MS. Psychological Factors Influencing Chronic Pain and the Impact of Litigation. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2013. [DOI: 10.1007/s40141-013-0015-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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