Psychological approach in headache patients with pain medication misuse in an outpatient center for drug treatment in Barcelona

2017 ◽  
Vol 41 (S1) ◽  
pp. s876-s876
Author(s):  
E. Ros-Cucurull ◽  
M. Perea ◽  
D. Romero ◽  
R.F. Palma-Álvarez ◽  
P. Pozo-Rosich ◽  
...  
Keyword(s):  
Depressive Symptomatology ◽  
Psychiatric Symptoms ◽  
Bodily Pain ◽  
Pain Medication ◽  
Drug Misuse ◽  
Cognitive Behavior ◽  
Group Interventions ◽  
Addictive Disorders ◽  
Medication Misuse ◽  
Headache Patients

IntroductionPain medication misuse is commonly found in patients under headache treatment and may produce co-morbid anxiety and depressive symptomatology. Management of this issue requires a comprehensive and integrative treatment including psychotherapy. Group interventions have been scarcely studied in addictive disorders, those interventions aims to decrease drug misuse and improve related psychiatric symptoms.AimTo study the efficacy of group interventions base on cognitive-behavior approach in patients with pain medication misuse.MethodPatients with pain medication misuse were included and were evaluated with BDI, STAI, SF36 and HIT scales (basal and at the end of treatment sessions). Patients were recruited from headache outpatient unit. Twelve sessions of one hour were performed with a cognitive-behavior approach (weekly).ResultsWe present preliminary results about the efficacy of group interventions in patients with pain medication misuse. Descriptive results pre- and post- treatment were analyzed in depressive symptoms (M = 20.14, SD = 12.25; M = 14.67, SD = 19.50) and in areas of quality of life: physical functioning (M = 48.75, SD = 31.13; M = 60.50, SD = 41.68), bodily pain (M = 12, SD = 9.25; M = 42.75, SD = 34.09), general health perceptions (M = 25.75, SD = 16.96; M = 44.25, SD = 22.33), vitality (M = 33.75, SD = 13.82; M = 48, SD = 34.82).ConclusionsPain medication misuse is commonly found in chronic headache patients, consequently worst outcomes for both pathologies. Group interventions may be useful in management of pain, anxiety and other comorbidities. Furthermore, it may favor drug use decrease and even abstinence.Disclosure of interestThe authors have not supplied their declaration of competing interest.

The Growing Role of Cognitive Behavior Therapy in the Treatment of Parkinson’s Disease

2021 ◽  
Vol 34 (4) ◽  
pp. 310-320 ◽  
Author(s):  
Sneha R. Lopes ◽  
Sunna Khan ◽  
Suma Chand
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Behavior Therapy ◽  
Cognitive Behavior Therapy ◽  
Pharmacological Treatment ◽  
Impulse Control ◽  
Psychiatric Symptoms ◽  
Neuropsychiatric Symptoms ◽  
Cognitive Behavior ◽  
Sufficient Power

Neuropsychiatric symptoms occur frequently in Parkinson’s disease (PD) patients. Pharmacological treatment of the psychiatric symptoms has been found to be inadequate. Cognitive behavior therapy (CBT) is an evidence based form of psychotherapy that is effective in treating a number of psychiatric disorders. In this article we examine the evidence of CBT in treating common psychiatric symptoms seen in PD patients, namely depression, anxiety, insomnia and impulse control behaviors. Most of the studies adapted CBT to address PD related concerns. Caregivers were frequently part of the CBT programs. Among the studies reviewed, randomized controlled trials showed significant effects in treating depression with CBT in PD patients. Studies have also provided preliminary data for effects of CBT on anxiety, impulse-control behaviors and insomnia. There is a need for more well designed studies with sufficient power for CBT to be established as a useful non-pharmacological treatment for psychiatric symptoms in PD.

scholarly journals Pain and its impact on functioning and disability in manual wheelchair users with spinal cord injury: a protocol for a mixed-methods study

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e044152
Author(s):  
Mokgadi Kholofelo Mashola ◽  
Elzette Korkie ◽  
Diphale Joyce Mothabeng
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
South African ◽  
Phase 1 ◽  
Pain Medication ◽  
Self Management ◽  
Medication Misuse ◽  
Wheelchair Users ◽  
Manual Wheelchair ◽  
Cord Injury

IntroductionApproximately 80% of people with spinal cord injury experience clinically significant chronic pain. Pain (whether musculoskeletal or neuropathic) is consistently rated as one of the most difficult problems to manage and negatively affects the individual’s physical, psychological and social functioning and increases the risk of pain medication misuse and poor mental health. The aim of this study is to therefore determine the presence of pain and its impact on functioning and disability as well as to develop a framework for self-management of pain for South African manual wheelchair users with spinal cord injury.Methods and analysisCommunity-dwelling participants with spinal cord injury will be invited to participate in this three-phase study. Phase 1 will use a quantitative, correlational design to determine factors related to pain such as pectoralis minor length, scapular dyskinesis, wheelchair functioning, physical quality of life, community reintegration and pain medication misuse. Demographic determinants of pain such as age, gender, type of occupation, completeness of injury and neurological level of injury will also be investigated. Participants with pain identified in phase 1 will be invited to partake in a qualitative descriptive and contextually designed phase 2 to explore their lived experience of pain through in-depth interviews. The results of phases 1 and 2 will then be used with the assistance from experts to develop a framework for self-management of pain using a modified Delphi study. Data analysis will include descriptive and inferential statistics (quantitative data) and thematic content analysis (qualitative data).Ethics and disseminationApproval for this study is granted by the Faculty of Health Sciences Research Ethics Committee of the University of the Pretoria (approval number 125/2018). This study is registered with the South African National Health Research Database (reference GP201806005). This study’s findings will be shared in academic conferences and published in scientific peer-reviewed journals.

Anxiety and depression in patients with hepatic versus cardiac disease

2016 ◽  
Vol 33 (S1) ◽  
pp. S409-S409
Author(s):  
A. Dolfi ◽  
A. Anton ◽  
V. Marinescu
Keyword(s):  
Cardiac Failure ◽  
Cardiac Disease ◽  
Hepatic Failure ◽  
Depressive Symptomatology ◽  
Psychiatric Symptoms ◽  
Depression Score ◽  
Hepatic Disease ◽  
Anxiety And Depression ◽  
Good Reliability ◽  
Severity Scores

BackgroundIn both hepatic and cardiac disease, a bidirectional relationship exists between somatic and psychiatric symptoms: is anxiety/depression caused by the somatic burden of the symptoms or the psychiatric symptoms and stress are an important pathophysiologic factor for the somatic disease?ObjectiveThe objectives of our observational study were to see if any differences exist regarding the anxiety level in patients with hepatic versus cardiac disease and if the depressive symptomatology differs between the two groups of patients.Materials and methods: We conceived a 2X2 study model by including two independent variables (the somatic pathology, hepatic and cardiac) and two dependent variables (anxiety and depression) which included 66 patients (35 with hepatic and 31 with cardiac pathology) who completed both STAI X1 scale for anxiety and BECK scale for depression with good reliability for both scales (Cronbach's alpha value of 0.74 for STAI X1 and 0.76 for BECK), data analyzed with SPSS 17.ResultsWe obtained a low level for anxiety (mean = 17.76) and a medium level for depression (mean = 49), both anxiety and depression level being higher in the patients with hepatic disease versus cardiac patients (P > 0.05). The patients with hepatic failure had a higher medium anxiety score (54.66) vs cardiac failure patients (42.61). The depression score was 19.71 in patients with hepatic failure and 15.55 in patients with cardiac failure.ConclusionBoth anxiety and depression severity scores were increased in patients with hepatic disease vs patients with cardiac disease in the studied groups.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Les manifestations psychiatriques dans la démence: perspective phénoménologique

1993 ◽  
Vol 38 (10) ◽  
pp. 671-677 ◽  
Author(s):  
Isabelle Paquette
Keyword(s):  
Major Depression ◽  
Cognitive Deficits ◽  
Clinical Characteristics ◽  
Depressive Symptomatology ◽  
Psychiatric Symptoms ◽  
Memory Loss ◽  
Psychotic Symptoms ◽  
Neuropsychological Evaluations ◽  
Operational Criteria ◽  
Psychiatric Manifestations

The study of psychiatric manifestations in dementia has long been overshadowed by the more classical manifestations of the disease, such as memory loss and other cognitive deficits. In recent years, however, psychiatric symptoms as part of the demential process have attracted interest and research has become more specific. Clinicians are faced with diagnostic, treatment and management difficulties related to affective or psychotic symptoms, which account for much distress and morbidity. Several studies indicate that the prevalence of psychiatric manifestations in clinical populations of patients suffering from dementia is high: 15% to 30% for hallucinations, 15% to 30% for delusions, ten percent to 20% for major depression and 40% to 50% for depressed mood. These figures tend to confirm the hypothesis that psychiatric features in dementia are neither infrequent nor atypical. Thus, researchers have sought to link psychotic or depressive symptomatology with several clinical characteristics of dementia, namely stage, severity, prognosis or cognitive dysfunction. Some recent studies involving extensive neuropsychological evaluations indicate that subgroups of patients can be defined according to psychiatric criteria, as well as cognitive or neurological criteria. Unfortunately, results are inconsistent. Some of the contradictions in the literature are related to poorly defined terms and symptoms, a lack of reliable operational criteria, absence of validation of instruments and scales and heterogeneity of the populations studied. Ambiguous syndromes, such as pseudodementia, while illustrative of certain clinical situations, have not been helpful in categorizing demented patients. The author suggests that research focused on specific and clearly defined psychiatric symptoms in dementia will better serve our comprehension of mixed syndromes.

Abuse of Opioids and Prescription Medications

2016 ◽  
Author(s):  
Isis Burgos-Chapman ◽  
Louis A. Trevisan ◽  
Kevin Sevarino
Keyword(s):  
Pain Treatment ◽  
The Elderly ◽  
Pain Medication ◽  
Opioid Use Disorder ◽  
Prescription Medications ◽  
Opioid Use ◽  
Opioid Medication ◽  
Medication Misuse ◽  
Chronic Pain Treatment

This chapter reviews an under-recognized aspect of geriatrics. The elderly population is growing in number, as is the proportion of aging baby-boomers at high risk for pain medication misuse and opioid use disorders. Given the widespread use of opioids in pain management, one can expect that problems with opioid use will increase among the elderly in the coming years. We describe the magnitude of the problem and discuss the importance of risk-stratification to identify which older patients are at elevated risk to develop problems with opioids. We examine the role of opioids in chronic pain treatment and the pitfalls of their use in the elderly. Finally, we provide general guidelines for the treatment of pain medication misuse and/or an opioid use disorder in the elderly. Opioid medication misuse and use disorders should be on every practitioner’s radar as a possible reason for problems surfacing in the elderly patient.

scholarly journals The Ineffectiveness of Group Interventions for Female Turkish Migrants with Recurrent Depression

2011 ◽  
Vol 39 (9) ◽  
pp. 1217-1234 ◽  
Author(s):  
Walter Renner ◽  
John W. Berry
Keyword(s):  
Migration Background ◽  
Traumatic Experiences ◽  
Individual Treatment ◽  
Cognitive Behavior ◽  
Group Interventions ◽  
Recurrent Depression ◽  
Younger Women ◽  
Symptoms Of Depression ◽  
Self Help ◽  
Self Help Groups

We tested group interventions for women with a Turkish migration background living in Austria and suffering from recurrent depression. Sixty-six participants were randomized to: (1) self-help groups (SHG), (2) cognitive behavior therapy (CBT) groups, or (3) a wait-list (WL) control condition. Neither SHG nor CBT were superior to WL. On an individual basis, approximately one third of the participants showed significant improvements with respect to symptoms of depression. Younger women, women who had lived in Austria for longer, and those who had encountered a higher number of traumatic experiences, showed increased improvement of depressive symptoms. The results suggest that individual treatment by ethnic, female psychotherapists should be used instead of group interventions.

Psychiatric symptoms are not an independent mortality risk factor in community-living elderly people

2014 ◽  
Vol 26 (6) ◽  
pp. 911-920 ◽  
Author(s):  
Sergio Benabarre ◽  
Javier Olivera ◽  
Teófilo Lorente ◽  
Mariano Rodriguez ◽  
Alfonso Barros-Loscertales ◽  
...  
Keyword(s):  
Risk Factor ◽  
Elderly People ◽  
Mortality Risk ◽  
Depressive Symptomatology ◽  
Psychiatric Symptoms ◽  
The Elderly ◽  
Physical Illness ◽  
Research Interest ◽  
Psychiatric Disease ◽  
Prospective Longitudinal

ABSTRACTBackground:Mortality risk factors have attracted great research interest in recent years. Physical illness is strongly associated with mortality risk in elderly people. Furthermore, a relationship between mortality risk and psychiatric disease in the elderly has gained research interest.Methods:This is a prospective longitudinal multicenter study. A sample of 324 participants was selected as a representative sample of community members aged 65 years and older and living in Huesca (Spain). The following information was collected: affiliation data, severity of physical illness, psychosocial, and psychiatric factors. Statistical analyses were completed with a multivariate analysis in order to control possible confounding variables related to mortality.Results:Of the initially selected sample, 293 participants were assessed. Sixty-four participants died (21.8%, 95% CI [16.9%, 26.7%]), 5.3% annual rate, and 46.1% showed symptomatology of mental disorders. Older people have eight times greater risk of mortality. The risk increased 53 times in patients affected by several physical illness. No relationship between cognitive dysfunction and depressive symptomatology was observed. In fact, physical condition was associated with depression, and the percentage of participants with depressive symptoms increased according to the severity of physical illness.Conclusions:Severity of physical illness and age are independently and directly associated with mortality in the elderly people. Therefore, severity of physical illness seems to be a crucial factor in the bi-directional association between mortality and depression, acting as a risk factor independently for both. So the relationship between depression and mortality can be affected by the severity of physical illness.

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