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Wang H, Kwok WH, Yao LQ, Liu XL, Bressington D, Chen ML, Huang HQ, Wang T, Tan JYB. An evidence-based breathing exercise intervention for chronic pain management in breast cancer survivors: A phase II randomized controlled trial. Eur J Oncol Nurs 2024; 71:102625. [PMID: 38897104 DOI: 10.1016/j.ejon.2024.102625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 05/17/2024] [Accepted: 05/26/2024] [Indexed: 06/21/2024]
Abstract
OBJECTIVE Explore the preliminary effects of a breathing exercise (BE) intervention on chronic pain among breast cancer survivors. METHODS This two-parallel-arm, open-label pilot randomized controlled trial recruited 72 breast cancer survivors who were randomly allocated to either the control or intervention group (n = 36 each). Both groups received usual care and a pain information booklet, while the intervention group received 4 weeks of additional BE. The primary clinical outcome was measured using the Brief Pain Inventory (BPI), with secondary clinical outcomes measured by the Hospital Anxiety and Depression Scale (HADS), Quality of Life Patient/Cancer Survivor Version in Chinese (QOLCSV-C), and Functional Assessment of Cancer Therapy- Breast (FACT-B) immediately post-intervention and at 4-week follow-up. Both adjusted and unadjusted Generalized Estimating Equation models were utilized to assess the BE's potential effects, with safety assessed through participant self-report. RESULTS Sixty-eight participants completed the study. Statistical significance was observed in BPI in both adjusted and unadjusted models at post-intervention and follow-up (p < 0.05). BE demonstrated positive effects on anxiety, depression and quality of life improvement across all measures and timepoints in both adjusted and unadjusted models (p < 0.05). The effect sizes were smaller in the adjusted model. Three mild transient discomforts were reported associated with BE practice including dizziness, tiredness and yawning, without requirement of medical treatment. No severe adverse events occurred. CONCLUSION This BE intervention appears effective in alleviating chronic pain, anxiety and depression, and improving quality of life for breast cancer survivors. Fully powered large-scale studies are required to confirm its effects.
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Affiliation(s)
- Haiying Wang
- School of Nursing (Brisbane Centre), Faculty of Health, Charles Darwin University, Brisbane, QLD, Australia; School of Nursing and Midwifery & Centre for Health Research, University of Southern Queensland, Ipswich, QLD, Australia
| | - Wai Hang Kwok
- School of Nursing and Midwifery, Edith Cowan University, WA, Australia; School of Nursing, Faculty of Health, Charles Darwin University, Ellengowan Drive, Casuarina, NT, Australia
| | - Li-Qun Yao
- College of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou City, Fujian Province, China
| | - Xian-Liang Liu
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Homantin, Kowloon, Hong Kong SAR, China
| | - Daniel Bressington
- School of Nursing, Faculty of Health, Charles Darwin University, Ellengowan Drive, Casuarina, NT, Australia; Faculty of Nursing, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Meng-Ling Chen
- Affiliated Hospital of Southwest Medical University, Luzhou City, Sichuan Province, China
| | - Hou-Qiang Huang
- Affiliated Hospital of Southwest Medical University, Luzhou City, Sichuan Province, China
| | - Tao Wang
- School of Nursing (Brisbane Centre), Faculty of Health, Charles Darwin University, Brisbane, QLD, Australia.
| | - Jing-Yu Benjamin Tan
- School of Nursing and Midwifery & Centre for Health Research, University of Southern Queensland, Ipswich, QLD, Australia
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Guo H, Hu WC, Xian H, Shi YX, Liu YY, Ma SB, Pan KQ, Wu SX, Xu LY, Luo C, Xie RG. CCL2 Potentiates Inflammation Pain and Related Anxiety-Like Behavior Through NMDA Signaling in Anterior Cingulate Cortex. Mol Neurobiol 2024; 61:4976-4991. [PMID: 38157119 DOI: 10.1007/s12035-023-03881-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 12/06/2023] [Indexed: 01/03/2024]
Abstract
Previous studies have shown that the C-C motif chemokine ligand 2 (CCL2) is widely expressed in the nervous system and involved in regulating the development of chronic pain and related anxiety-like behaviors, but its precise mechanism is still unclear. This paper provides an in-depth examination of the involvement of CCL2-CCR2 signaling in the anterior cingulate cortex (ACC) in intraplantar injection of complete Freund's adjuvant (CFA) leading to inflammatory pain and its concomitant anxiety-like behaviors by modulation of glutamatergic N-methyl-D-aspartate receptor (NMDAR). Our findings suggest that local bilateral injection of CCR2 antagonist in the ACC inhibits CFA-induced inflammatory pain and anxiety-like behavior. Meanwhile, the expression of CCR2 and CCL2 was significantly increased in ACC after 14 days of intraplantar injection of CFA, and CCR2 was mainly expressed in excitatory neurons. Whole-cell patch-clamp recordings showed that the CCR2 inhibitor RS504393 reduced the frequency of miniature excitatory postsynaptic currents (mEPSC) in ACC, and CCL2 was involved in the regulation of NMDAR-induced current in ACC neurons in the pathological state. In addition, local injection of the NR2B inhibitor of NMDAR subunits, Ro 25-6981, attenuated the effects of CCL2-induced hyperalgesia and anxiety-like behavior in the ACC. In summary, CCL2 acts on CCR2 in ACC excitatory neurons and participates in the regulation of CFA-induced pain and related anxiety-like behaviors through upregulation of NR2B. CCR2 in the ACC neuron may be a potential target for the treatment of chronic inflammatory pain and pain-related anxiety.
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Affiliation(s)
- Huan Guo
- Department of Basic Medical Sciences, Shantou University Medical College, No.22, Xinling Road, Shantou, 515041, China
- Department of Neurobiology, School of Basic Medicine, Fourth Military Medical University, Xi'an, 710032, China
| | - Wen-Chao Hu
- Department of Neurobiology, School of Basic Medicine, Fourth Military Medical University, Xi'an, 710032, China
| | - Hang Xian
- Department of Orthopedics, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, China
| | - Yun-Xin Shi
- Department of Neurobiology, School of Basic Medicine, Fourth Military Medical University, Xi'an, 710032, China
- School of Life Science & Research Center for Resource Peptide Drugs, Shaanxi Engineering & Technological Research Center for Conversation & Utilization of Regional Biological Resources, Yanan University, Yanan, 716000, China
| | - Yuan-Ying Liu
- Department of Neurobiology, School of Basic Medicine, Fourth Military Medical University, Xi'an, 710032, China
- School of Life Science & Research Center for Resource Peptide Drugs, Shaanxi Engineering & Technological Research Center for Conversation & Utilization of Regional Biological Resources, Yanan University, Yanan, 716000, China
| | - Sui-Bin Ma
- State Key Laboratory of Cellular Stress Biology, School of Life Sciences, Xiamen University, Xiamen, 361102, China
| | - Kun-Qing Pan
- No.19 Cadet Regiment, School of Basic Medical Sciences, Fourth Military Medical University, Xi'an, 710032, China
| | - Sheng-Xi Wu
- Department of Neurobiology, School of Basic Medicine, Fourth Military Medical University, Xi'an, 710032, China
| | - Li-Yan Xu
- Department of Basic Medical Sciences, Shantou University Medical College, No.22, Xinling Road, Shantou, 515041, China.
| | - Ceng Luo
- Department of Neurobiology, School of Basic Medicine, Fourth Military Medical University, Xi'an, 710032, China.
| | - Rou-Gang Xie
- Department of Neurobiology, School of Basic Medicine, Fourth Military Medical University, Xi'an, 710032, China.
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Gnall KE, Sinnott SM, Laumann LE, Park CL, David A, Emrich M. Changes in Interoception in Mind-body Therapies for Chronic Pain: A Systematic Review and Meta-Analysis. Int J Behav Med 2024:10.1007/s12529-023-10249-z. [PMID: 38169051 DOI: 10.1007/s12529-023-10249-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/07/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND Emerging literature has demonstrated deficits in interoception (i.e., the perception of physical sensations from inside the body) in individuals with chronic pain conditions. Mind-body therapies (MBTs) are purported to improve chronic pain in part through improving or restoring interoceptive abilities. The present systematic review and meta-analysis aimed to examine changes in interoception in MBTs for chronic pain conditions. METHODS A systematic search of PubMed, PsycINFO, Scopus, CINAHL, and ProQuest Dissertation and Theses was conducted from database inception to February 2023. English language intervention studies evaluating the effect of MBTs on interoception in adults with chronic pain conditions were examined. Changes in pain (severity and interference) following treatment were examined as secondary outcomes. RESULTS A total of 11 studies (10 unique samples) were identified. Meta-analytic results reveal significant improvements in total interoceptive awareness (Becker's d = 1.168, p < .01) as well as improvements in seven of eight subdomains of interoceptive awareness (ds = 0.28 to 0.81). MBTs were also associated with reductions in both pain intensity (d = -1.46, p = .01) and pain interference (d = -1.07, p < .001). CONCLUSIONS Preliminary research suggests that MBTs demonstrate improvements in interoceptive awareness and reduce pain in adults with chronic pain. Literature on changes in other domains of interoception, such as interoceptive accuracy, following MBTs is severely lacking. Although more rigorous studies are needed to corroborate results, the present findings lay an important foundation for future research to examine interoception as a possible underlying mechanism of MBTs to improve pain outcomes.
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Affiliation(s)
- Katherine E Gnall
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, 06269, USA.
| | - Sinead M Sinnott
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, 06269, USA
| | - Laura E Laumann
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, 06269, USA
| | - Crystal L Park
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, 06269, USA
| | - Adam David
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, 06269, USA
| | - Mariel Emrich
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, 06269, USA
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Development and Validation of an Evidence-Based Breathing Exercise Intervention Protocol for Chronic Pain Management in Breast Cancer Survivors. Pain Manag Nurs 2022; 24:357-364. [DOI: 10.1016/j.pmn.2022.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 08/16/2022] [Accepted: 09/24/2022] [Indexed: 11/17/2022]
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Mann EG, VanDenKerkhof EG, Johnson A, Gilron I. Help-seeking behavior among community-dwelling adults with chronic pain. Can J Pain 2019; 3:8-19. [PMID: 35005390 PMCID: PMC8730570 DOI: 10.1080/24740527.2019.1570095] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2018] [Accepted: 12/29/2018] [Indexed: 10/27/2022]
Abstract
Background: Some individuals with chronic pain do not seek care. This decision may be due to characteristics of the individual, pain, and/or their health professional(s). Aims: This study aimed to identify and compare features of individuals with chronic pain, their pain and general health, and their health care professional between community-dwelling adults who did and did not seek care. Methods: Randomly selected adults were mailed a study questionnaire that screened for chronic pain (pain persisting ≥3 months) and asked about their general well-being (Short Form [SF]-36), pain location (body diagram), pain intensity and characteristics (Leeds Assessment of Neuropathic Symptoms and Signs), experiences with health care professionals (Chronic Illness Resources Survey), and visits made to health professionals over the past year. Respondents were categorized as help-seeking (≥1 visit in the past year) and non-help-seeking (zero visits in the past year). Results: Six percent of respondents (44/696) were non-help-seeking. These respondents differed in individual, pain, and health care professional characteristics when compared to those who did seek care. Specifically, when other variables were controlled, non-help-seeking individuals were less likely to be male (relative risk [RR] = 0.39, 95% confidence interval [CI], 0.18-0.86), report comorbid conditions (RR = 0.46, 95% CI, 0.22-0.98), report being treated as an equal partner in decision making (RR = 0.40, 95% CI, 0.18-0.93), and rate their health care professional as important to their pain management (RR = 0.39, 95% CI, 0.18-0.85). They were more likely to use over-the-counter medication to manage their pain (RR = 2.52, 95% CI, 1.14-5.58). Conclusions: Experiences with health professionals play a role in determining whether an individual manages his or her pain independently. Future research should explore the safety of those who do not seek care.
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Affiliation(s)
- Elizabeth G. Mann
- School of Rehabilitation Therapy, Queen’s University, Kingston, Ontario, Canada
| | - Elizabeth G. VanDenKerkhof
- School of Nursing and Department of Anesthesiology and Perioperative Medicine, Queen’s University, Kingston, Ontario, Canada
| | - Ana Johnson
- Department of Public Health Sciences, Queen’s University, Kingston, Ontario, Canada
| | - Ian Gilron
- Departments of Anesthesiology & Perioperative Medicine and Biomedical & Molecular Sciences, Kingston General Hospital, Kingston, Ontario, Canada
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Shim M, Goodill S, Bradt J. Mechanisms of Dance/Movement Therapy for Building Resilience in People Experiencing Chronic Pain. AMERICAN JOURNAL OF DANCE THERAPY 2019. [DOI: 10.1007/s10465-019-09294-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Interdisciplinary Cognitive-Behavioral Therapy as Part of Lumbar Spinal Fusion Surgery Rehabilitation: Experience of Patients With Chronic Low Back Pain. Orthop Nurs 2018; 35:238-47. [PMID: 27441878 PMCID: PMC4957958 DOI: 10.1097/nor.0000000000000259] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Supplemental Digital Content is Available in the Text. BACKGROUND: Patients receiving lumbar spinal fusion surgery often have persisting postoperative pain negatively affecting their daily life. These patients may be helped by interdisciplinary cognitive-behavioral therapy which is recognized as an effective intervention for improving beneficial pain coping behavior, thereby facilitating the rehabilitation process of patients with chronic pain. PURPOSE: The purpose of this study was to describe the lived experience of patients recovering from lumbar spinal fusion surgery and to explore potential similarities and disparities in pain coping behavior between receivers and nonreceivers of interdisciplinary cognitive-behavioral group therapy. METHODS: We conducted semistructured interviews with 10 patients; 5 receiving cognitive-behavioral therapy in connection with their lumbar spinal fusion surgery and 5 receiving usual care. We conducted a phenomenological analysis to reach our first aim and then conducted a comparative content analysis to reach our second aim. RESULTS: Patients' postoperative experience was characterized by the need to adapt to the limitations imposed by back discomfort (coexisting with the back), need for recognition and support from others regarding their pain, a relatively long rehabilitation period during which they “awaited the result of surgery”, and ambivalence toward analgesics. The patients in both groups had similar negative perception of analgesics and tended to abstain from them to avoid addiction. Coping behavior apparently differed among receivers and nonreceivers of interdisciplinary cognitive-behavioral group therapy. Receivers prevented or minimized pain by resting before pain onset, whereas nonreceivers awaited pain onset before resting. CONCLUSION: The postoperative experience entailed ambivalence, causing uncertainty, worry and insecurity. This ambivalence was relieved when others recognized the patient's pain and offered support. Cognitive-behavioral therapy as part of rehabilitation may have encouraged beneficial pain coping behavior by altering patients' pain perception and coping behavior, thereby reducing adverse effects of pain.
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Ruest M, Bourque M, Laroche S, Harvey MP, Martel M, Bergeron-Vézina K, Apinis C, Proulx D, Hadjistavropoulos T, Tousignant-Laflamme Y, Léonard G. Can We Quickly and Thoroughly Assess Pain with the PACSLAC-II? A Convergent Validity Study in Long-Term Care Residents Suffering from Dementia. Pain Manag Nurs 2017; 18:410-417. [DOI: 10.1016/j.pmn.2017.05.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Revised: 05/31/2017] [Accepted: 05/31/2017] [Indexed: 10/19/2022]
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Yu L, Hua L, Chen ZY, Hua R, Zhang YM. Effect of functional chronic visceral pain caused by neonatal colorectal distension on depression-like behavior and expression of CRH in the paraventricular nucleus of adult male rats. Shijie Huaren Xiaohua Zazhi 2014; 22:2091-2099. [DOI: 10.11569/wcjd.v22.i15.2091] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate the effect of functional chronic visceral pain caused by neonatal colorectal distension (CRD) on depression-like behavior and expression of corticotropin releasing hormone (CRH) in the paraventricular nucleus (PVN) of adult male rats, and to explore the underlying mechanism.
METHODS: Neonatal male rats were randomly divided into two groups (n = 10 for each), a sham operation group and a CRD group. The CRD group was given colorectal distension twice daily on postnatal days 8, 10, and 12. Abdominal withdrawal reflex (AWR) scores, pain threshold, and external oblique discharge amplitude were used to test visceral hypersensitivity during postnatal weeks 8-10. Open field test, sucrose preference test and forced swim test were used to test depression-like behavior during postnatal weeks 10-12. After behavior tests, HE staining was used to detect pathological changes of the colorectal tissue. Immunofluorescence was used to detect the expression of CRH in the PVN. Radioimmunoassay was used to detect the level of cortisol in blood.
RESULTS: Colorectal distension resulted in chronic visceral hypersensitivity without pathological changes in the colorectal tissue. Rats with functional chronic visceral pain caused by early-life stress exhibited depression-like behavior. The expression of CRH in the PVN and the level of CORT in blood of CRD rats increased compared with control rats.
CONCLUSION: Rats with functional chronic visceral pain caused by early-life stress show depression-like behavior, and the underlying mechanism may be related to increased expression of CRH in the PVN and dysfunction of the HPA axis.
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Sui GY, Hu S, Sun W, Wang Y, Liu L, Yang XS, Wang L. Prevalence and associated factors of depressive symptoms among Chinese male correctional officers. Int Arch Occup Environ Health 2013; 87:387-95. [PMID: 23609322 DOI: 10.1007/s00420-013-0877-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2012] [Accepted: 04/10/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVES Chinese correctional officers (COs) consist of frontline COs in direct contact with the prisoners and non-frontline COs (including administrative staff and professionals). Male COs compose the majority of Chinese COs, especially for frontline COs. Although they are quite susceptible to depressive symptoms due to highly risky and stressful working environment, few studies focus on this issue. This study aimed to evaluate the prevalence of depressive symptoms and to explore its associated factors among Chinese male frontline and non-frontline COs. METHODS This cross-sectional study was performed during the period of March/April 2011. The study population comprised of 1,900 male COs in four male prisons in a province of northeast China. A questionnaire including the Center for Epidemiological Studies Depression Scale, demographic factors, work conditions, effort-reward imbalance questionnaire was distributed to these COs. A total of 1,494 effective respondents became our subjects (981 frontline COs and 513 non-frontline COs). Frontline and non-frontline COs were analyzed separately. RESULTS Approximately 61.4% of Chinese male COs had depressive symptoms (63.5% in frontline COs and 57.3% in non-frontline COs). Multivariate logistic analyses showed that effort-reward ratio, overcommitment, chronic disease, and threat perception were associated with depressive symptoms in frontline and non-frontline COs, whereas weekly work time had an effect only in frontline COs. CONCLUSIONS Chinese male COs, especially frontline COs, might have high-level prevalence of depressive symptoms. Moreover, this study had identified important risk factors that might be important in planning strategies for prevention and intervention of depressive symptoms for Chinese male COs.
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Affiliation(s)
- Guo-Yuan Sui
- Department of Social Medicine, School of Public Health, China Medical University, No. 92 Beier Road, Heping District, Shenyang, 110001, Liaoning, People's Republic of China
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Ben-Shoshan M, Blinderman I, Raz A. Psychosocial factors and chronic spontaneous urticaria: a systematic review. Allergy 2013; 68:131-41. [PMID: 23157275 DOI: 10.1111/all.12068] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/05/2012] [Indexed: 11/27/2022]
Abstract
BACKGROUND Chronic spontaneous urticaria (CSU) is one of the most costly allergic conditions challenging physicians as well as patients and their families. Despite evident lacunae in the understanding of the pathogenesis, at least some findings suggest that psychosocial factors likely contribute to the development and exacerbation of CSU. We aim to assess the contribution of psychological factors to CSU. METHODS Systematic search of PubMed and OVID/Medline databases was conducted from 1 January 1935 to 1 January 2012. Studies selected include original research in English, Spanish and French exploring the association between CSU and psychosocial factors. Two investigators independently reviewed all titles and abstracts to identify potentially relevant articles and resolved discrepancies by repeated review and discussion and arbitration of a third reviewer. Quality of systematic reviews and meta-analyses was assessed using a measure based on the Newcastle-Ottawa Scale and psychological conditions of CSU patients. RESULTS We identified 114 eligible studies spanning 77 years and featuring 17 reviews, 67 studies related to neither CSU nor psychosocial factors, and eight studies that provided either no prevalence estimates or insufficient sample size. Pooling effect sizes using random effects, analyses revealed that, despite large heterogeneity (I(2) of 97.60%), psychosocial factors had a prevalence of 46.09% (95% confidence interval, 44.01%, 48.08%). CONCLUSION Future research needs to better establish the contribution of psychosocial factors to the pathogenesis and exacerbation of CSU, and explore the possible benefit of behavioural interventions to the development of new management strategies.
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Affiliation(s)
- M. Ben-Shoshan
- Division of Paediatric Allergy and Clinical Immunology, Department of Paediatrics; McGill University Health Center; Montreal; Quebec; Canada
| | - I. Blinderman
- Department of Psychiatry; Lady Davis Institute for Medical Research and Jewish General Hospital, McGill University; Montreal; Quebec; Canada
| | - A. Raz
- Departments of Psychiatry, Neurology and Neurosurgery, and Psychology; Lady Davis Institute for Medical Research and Jewish General Hospital, McGill University; Montreal; Quebec; Canada
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