Alexithymia and pain experience in depressive patients

2011 ◽  
Vol 26 (S2) ◽  
pp. 643-643
Author(s):  
K. Sokolowska ◽  
E. Gorniak ◽  
A. Kowalska ◽  
K. Wydra ◽  
K. Krysta ◽  
...  
Keyword(s):  
Pain Intensity ◽  
Pain Control ◽  
Control Group ◽  
Psychosomatic Illness ◽  
Great Intensity ◽  
Pain Experience ◽  
Intensity Range ◽  
Depressive Patients ◽  
Healthy Persons

IntroductionAlexithymia appears as an inhibition of recognizing and describing the mental conditions. It is often connected with psychosomatic illness or depression.AimsThe aim of this study was to compare depressive patients with healthy persons in terms of the prevelence and level of the alexithymia and pain feeling.MethodsThe examined group (E) consists of 16 patients with diagnosed depression (11 women, 44,6±11,6 year old).The control group (C) consists of 14 randomly chosen persons (10 women, 40,0+/-15,3 year old) who achieved < 11 points in the Beck's Depression Inventory (BDI).The alexithymia level was examined with TAS - 26 questionnaire (difficulty of recognizing the feelings and somatic senses (ODR), concrete thinking (MK), difficulty of expressing the feelings (TRW) and the lack of imagination (U)). The intensity of pain was examined with the questionnaire SF-MPQ. The scale BPCQ was used to examine beliefs about pain control.ResultsNo statistical differences about age, sex, the U feature in TAS-26 scale and the results of BPCQ test were shown. The differences beetween groups E and C appeared in the alexithymia intensity range (75,3 ± 14,4 v.62,4 ± 8,2pts, p = 007), the ODR feature (23,7 ± 6,7 v. 13,0 ± 4,1pts, p< 0,001), MK (18,9 ± 4 v.23,1 ± 5,3pts, p = 0,036) and TRW (13,4 ± 2,6 v. 9,6 ± 2,8pts, p = 0,001). The E group featured significantly higher pain intensity(p = 0,012).ConclusionsThe patients with depression suffer from alexithymia very often. The prevalence of upper difficulties and great intensity of pain could suggest a psychotomatic component of pain affections.

Effects of prolonged-release oxycodone/naloxone on pain control, bowel function and quality of life: A prospective observational study

2014 ◽  
Vol 5 (2) ◽  
pp. 75-81 ◽  
Author(s):  
Sabine Hesselbarth ◽  
Oliver Löwenstein ◽  
Thomas Cegla
Keyword(s):  
Pain Intensity ◽  
Functional Impairment ◽  
Pain Control ◽  
Bowel Function ◽  
Control Group ◽  
Prolonged Release ◽  
Data Set ◽  
Strong Opioids ◽  
Higher Doses

AbstractBackground and aimStrong opioids including oxycodone are amongst the most effective analgesics to combat moderate to severe pain of various aetiologies, but opioid-induced bowel dysfunction (OIBD) represents a relevant problem. The rationale for development of a prolonged-release (PR) fixed combination of oxycodone and naloxone was to counteract OIBD. Due to its negligible oral bioavailability, the μ-opioid receptor antagonist naloxone is able to selectively displace opioids from local μ-receptors in the gastrointestinal tract without affecting central opioid binding sites. Pivotal trials of PR oxycodone/naloxone not only demonstrated improved bowel function but also equivalent analgesic efficacy compared to PR oxycodone alone. Controlled clinical trials comparing PR oxycodone/naloxone with strong opioids other than oxycodone are not available. The present study is the first data set aimed at comparing pain control, bowel function, and quality of life (QoL) in patients newly treated with or switched to PR oxycodone/naloxone or other strong opioids during routine clinical practice.MethodsIn this three-arm, prospective observational study, 588 patients with moderate to severe pain of varying aetiologies received either PR oxycodone/naloxone (OXN group and OXN 40/20 group with indicated use of the 40 mg/20 mg dose strength at baseline) or other strong opioids (control group), dosed according to pain severity, for 4–6 weeks. Data documented include pain intensity (NRS), bowel function (Bowel Function Index, BFI), pain-related functional impairment (BPI-SF), QoL (EuroQol EQ-5D-3L), and a global assessment of treatment.ResultsPatients receiving PR oxycodone/naloxone experienced a clinically important reduction in pain intensity and pain-related functional impairment of approximately 40%. The reductions of pain intensity (−2.9 ± 2.3) and pain-related functional impairment (−2.4 ± 2.3) in the OXN group were significantly more pronounced than in the control group (−2.1 ± 2.1 and −1.8 ± 1.7). In the control group, mean reductions in pain intensity did not reach the threshold of ≥30% for at least moderate clinically important differences, although patients were prescribed higher doses of morphine equivalents than OXN group patients. Improvements in bowel function (OXN: −16.0 ± 27.6; control: 3.1 ± 24.4) and QoL (OXN: 20.8 ± 24.2; control: 13.2 ± 23.1) were also significantly more pronounced in the OXN group, with BFI scores reduced to a level that reflects normal bowel function. Results for the OXN 40/20 group receiving higher doses of PR oxycodone/naloxone were in line with those for the OXN group. In the control group, more frequent gastrointestinal adverse events and less favourable ratings of tolerability resulted in a higher rate of treatment discontinuations due to adverse events.ConclusionsIn patients receiving PR oxycodone/naloxone, more favourable outcomes compared with other strong opioids regarding pain control, bowel function, and QoL were observed.ImplicationsThe present findings underline the value of PR oxycodone/naloxone in the management of patients with moderate to severe chronic pain. The data set further adds to our understanding of the benefits and risks of opioid treatment in routine clinical practice.

Pain Education for Underserved Minority Cancer Patients: A Randomized Controlled Trial

2004 ◽  
Vol 22 (24) ◽  
pp. 4918-4925 ◽  
Author(s):  
Karen O. Anderson ◽  
Tito R. Mendoza ◽  
Richard Payne ◽  
Vicente Valero ◽  
Guadalupe R. Palos ◽  
...  
Keyword(s):  
Quality Of Life ◽  
African American ◽  
Pain Management ◽  
Pain Intensity ◽  
Cancer Patients ◽  
Pain Control ◽  
Control Group ◽  
Pain Education ◽  
Perceived Pain

Purpose Previous studies found that African American and Hispanic cancer patients are at risk for undertreatment of pain. We evaluated the efficacy of a pain education intervention for underserved minority patients. Patients and Methods Ninety-seven underserved African American and Hispanic outpatients with cancer-related pain were enrolled onto a randomized clinical trial of pain management education. The patients in the education group received a culture-specific video and booklet on pain management. The control group received a video and booklet on nutrition. A research nurse met with each patient to review the materials. We measured changes in pain intensity and pain-related interference 2 to 10 weeks after the intervention, as well as changes in quality of life, perceived pain control, functional status, analgesics, and physician pain assessments. Results Physicians underestimated baseline pain intensity and provided inadequate analgesics for more than 50% of the sample. Although the ratings for pain intensity and pain interference decreased over time for both groups, there was no statistically significant difference between groups. Pain education did not affect quality of life, perceived pain control, or functional status. African American patients in the education but not the control group reported a significant decrease in pain worst ratings from baseline to first follow-up (P < .01), although this decrease was not maintained at subsequent assessments. Conclusion Brief education had limited impact on pain outcomes for underserved minority patients, suggesting that more intensive education for patients and interventions for physicians are needed.

scholarly journals COPAHS Study: protocol of a randomised experimental study comparing the effects of hypnosis, mindfulness meditation, and spiritual practices on experimental pain in healthy adults

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e040068
Author(s):  
Alexandra Ferreira-Valente ◽  
Filipa Pimenta ◽  
Rui M. Costa ◽  
Melissa A. Day ◽  
José Pais-Ribeiro ◽  
...  
Keyword(s):  
Pain Intensity ◽  
Mindfulness Meditation ◽  
Pain Tolerance ◽  
Healthy Adults ◽  
Spiritual Practices ◽  
Control Group ◽  
Audio Recording ◽  
Pain Experience ◽  
Painful Stimulation ◽  
Related Stress

BackgroundThere has been an increasing interest in studying the potential benefits of so-called complementary and alternative approaches for pain management, such as hypnosis and mindfulness-based interventions. More recently, researchers have been interested in studying the effects of spiritual practices on pain experience as well. These practices may increase pain tolerance, result in a positive re-appraisal of pain and influence other psychological variables that are known to be associated with pain experience. The purpose of this study is to evaluate and compare the immediate effects of self-hypnosis, mindfulness meditation, and a spiritual intervention relative to a control condition for increasing pain tolerance and reducing pain intensity and pain-related stress, in response to experimental painful stimulation.Methods and analysisRecruitment is anticipated to start in November 2020. This is a randomised quantitative experimental mixed-design repeated-measures study with three assessment points: baseline (T0), pre-test (T1) and post-test (T2). Eligible healthy adults will be randomised to one of the four study conditions. Interventions will be a 20-minute audio-guided practice of either self-hypnosis, mindfulness meditation, or Christian prayer. Participants in the control group will not be instructed to use any specific strategy during the painful stimulation. Participants will be submitted to a first cycle of Cold Pressor Arm Wrap. They will then listen to a 20-minute audio recording inducing one of the three interventions, or, in the case of the control group, to a 20-minute audio recording of text from a natural history textbook. Primary outcomes are pain intensity and pain tolerance. Pain-related stress as measured by salivary cortisol level and heart rate variability are secondary outcomes.Ethics and disseminationThis study was approved by ISPA—University Institute’s internal Ethics Committee for Research on 3rd December 2018 (reference I/010/12/2018). Findings will be published in peer-reviewed indexed journals and presented at conferences.Trial registration numberClinicalTrials.gov registry (NCT04491630). Stage: pre-results.

Design and Evaluation of a Modulated TENS Stimulation in Medical Pain Therapy

2019 ◽  
Vol 14 (1) ◽  
pp. 75-83
Author(s):  
L. Bouafif ◽  
N. Ellouze
Keyword(s):  
Pain Intensity ◽  
Nerve Stimulation ◽  
Transcutaneous Electrical Nerve Stimulation ◽  
Pain Therapy ◽  
Subjective Evaluation ◽  
Large Population ◽  
Electrical Current ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Electrical Nerve Stimulation

Background: Transcutaneous Electrical Nerve Stimulation (TENS) is a non-invasive pain therapy that uses the sensory effects of an electrical current applied to the skin. Some clinical studies demonstrated that this treatment helps to reduce acute and chronic pains, while others gave sometimes contradictory or uncertain conclusions about the performances of this strategy according to pathology classification. The purpose of this study is the development and evaluation of a new modulated version of transcutaneous electrical nerve stimulation called PWM-TENS. The principle is based on an automatic variation of the stimulation parameters (frequency, amplitude, duration, shape, cyclic ratio) according to the pain evolution. Methods: The study was a controlled clinical trial involving 15 participants, divided into 2 groups. The first experimental group performed modulated PWM-TENS electro-stimulation sessions applied to the painful areas 3 to 4 times a day, for one month. The second control group did parallel treatments by Placebo. The evaluation of the pain intensity is done with the Visual Analog Scale (EVA), the DN4 and SF36 questionnaires. Results: The tests and measurements with our embedded PWM-TENS technique demonstrated that we succeeded to increase the analgesic effect after stopping the stimulation and reduced the pain sensation by about 60%. An improvement in pain intensity scores and questionnaires (EVA, DN4), as well as the quality of life score (SF36), was observed. Also, a reduction of the treatment period from 3 to 1 month was also obtained. Conclusion: The first results clinically observed in the PWM-TENS technique are encouraging. The findings of this study confirm that this noninvasive strategy is suitable and useful for acute pains coming from the nociceptive, neuropathic and musculoskeletal origin. However, its efficiency is moderated and less adapted for low back pain. The experiments make it possible to estimate whether this modulated TENS method could improve existing anti-pain therapies, taking into account objective and subjective evaluation criteria. But this study must be followed by large population samples to answer all the problems of acute and chronic pains.

scholarly journals Efficacy and safety of duloxetine for postoperative pain after total knee arthroplasty in centrally sensitized patients: study protocol for a randomized controlled trial

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Shicheng Wang ◽  
Wensheng Wang ◽  
Long Shao ◽  
Jing Ling
Keyword(s):  
Clinical Trial ◽  
Total Knee Arthroplasty ◽  
Randomized Controlled Trial ◽  
Pain Control ◽  
Controlled Trial ◽  
Control Group ◽  
Efficacy And Safety ◽  
Randomized Controlled ◽  
Total Knee ◽  
Postoperative Residual

Abstract Background Postoperative residual knee pain after total knee arthroplasty (TKA) is a significant factor that contributes to patient dissatisfaction. Patients with preoperative central sensitization (CS) may be more susceptible to unexplained chronic pain after TKA, and duloxetine has been reported to be effective in post-TKA pain control in patients with CS. However, there remains limited evidence to support this off-label use in routine clinical practice. Hence, we designed this randomized, placebo-controlled, triple-blind clinical trial to evaluate the effects of preoperative screening and targeted duloxetine treatment of CS on postoperative residual pain compared with the care-as-usual control group. Methods This randomized controlled trial includes patients with knee osteoarthritis on a waiting list for primary unilateral TKA. Patients with preoperative CS will be randomly allocated to the perioperative duloxetine treatment group (duloxetine group) or the care-as-usual control group (placebo group). Patients in the duloxetine group will receive a half-dose of preemptive duloxetine (30 mg/day) for a week before surgery and a full-dose of duloxetine (60 mg/day) for six weeks after surgery. The primary outcome is the intensity of residual pain at six months after TKA, including the visual analogue scale, 11-point numeric rating scale, the sensory dimension of the brief pain inventory, and the pain subscale of the Knee injury and Osteoarthritis Outcome Score. The secondary outcome measures will include the pain and function related outcomes. All of the patients will be followed up at one, three, and six months after surgery. All adverse events will be recorded and immediately reported to the primary investigator and ethics committee to decide if the patient needs to drop out from the trial. Discussion This clinical trial will convey the latest evidence of the efficacy and safety of the application of duloxetine in postoperative pain control in CS patients who are scheduled for TKA. The study results will be disseminated at national and international conferences and published in peer-reviewed journals. Trial registration Chinese Clinical Trial Registry (http://www.chictr.org.cn) registration number: ChiCTR2000031674. Registered 07 April 2020.

scholarly journals Repetitive transcranial magnetic stimulation as a prophylactic treatment in migraine

2021 ◽  
Vol 57 (1) ◽  
Author(s):  
Azza B. Hammad ◽  
Rasha E. Elsharkawy ◽  
Ghada S. Abdel Azim
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Serum Level ◽  
Pain Intensity ◽  
Magnetic Stimulation ◽  
Prophylactic Treatment ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Low Frequency ◽  
Control Group ◽  
Neurokinin A ◽  
Abortive Treatment

Abstract Background Clinical applications of transcranial magnetic stimulation (TMS) have shown promising results in the treatment of headache disorders, with migraine being one of the most encountered. Objective To assess the role of low-frequency repetitive transcranial magnetic stimulation as a preventive treatment of migraine (with and without aura) and correlate the results with the serum level of the inflammatory biomarker (neurokinin A). Methods Forty patients, with age ranging from 15 to 55 years, diagnosed with migraine (30 migraine without aura and 10 with aura) and 20 apparently healthy individuals, who were age and sex matched with the patient group, were included in this study. A low-frequency (1 Hz) rTMS protocol was applied for all patients for five consecutive days interictally. Assessment of pain intensity using visual analogue scale and frequency and duration of attacks as well as number of pills taken by patients as an abortive treatment according to the Basic Diagnostic Headache Diary for 4 weeks before and 4 weeks after TMS sessions was done. In addition, the Migraine Disability Assessment scale (MIDAS) was applied to assess the severity and degree of disability caused by migraine. Measurement of neurokinin A serum level was done by using ELISA for all patients before and after TMS and for control group once. Results There was a significant reduction in pain intensity, frequency and duration of migraine attacks, migraine disability scores, and number of pills taken as abortive treatment for attacks after rTMS (P < 0.001). Also, serum level of neurokinin A in the patients was significantly reduced after rTMS (P < 0.001). Conclusion Low-frequency rTMS is an effective prophylactic treatment for migraine with and without aura.

scholarly journals Virtual Reality Analgesia for Children With Large Severe Burn Wounds During Burn Wound Debridement

2020 ◽  
Vol 1 ◽  
Author(s):  
Hunter G. Hoffman ◽  
David R. Patterson ◽  
Robert A. Rodriguez ◽  
Raquel Peña ◽  
Wanda Beck ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Pain Intensity ◽  
Wound Care ◽  
Primary Outcome Measure ◽  
Control Group ◽  
Severe Burn ◽  
Burn Wound ◽  
Absolute Change ◽  
Wound Debridement ◽  
Pain Medications

The objective of this study was to compare the effect of adjunctive virtual reality vs. standard analgesic pain medications during burn wound cleaning/debridement. Participants were predominantly Hispanic children aged 6–17 years of age, with large severe burn injuries (TBSA = 44%) reporting moderate or higher baseline pain during burn wound care. Using a randomized between-groups design, participants were randomly assigned to one of two groups, (a) the Control Group = pain medications only or (b) the VR Group = pain medications + virtual reality. A total of 50 children (88% Hispanic) with large severe burns (mean TBSA &gt; 10%) received severe burn wound cleaning sessions. For the primary outcome measure of worst pain (intensity) on Study Day 1, using a between groups ANOVA, burn injured children in the group that received virtual reality during wound care showed significantly less pain intensity than the No VR control group, [mean worst pain ratings for the No VR group = 7.46 (SD = 2.93) vs. 5.54 (SD = 3.56), F(1,48) = 4.29, &lt; 0.05, MSE = 46.00]. Similarly, one of the secondary pain measures, “lowest pain during wound care” was significantly lower in the VR group, No VR = 4.29 (SD = 3.75) vs. 1.68 (2.04) for the VR group, F(1,47) = 9.29, &lt;0.005, MSE = 83.52 for Study Day 1. The other secondary pain measures showed the predicted pattern on Study Day 1, but were non-significant. Regarding whether VR reduced pain beyond Study Day 1, absolute change in pain intensity (analgesia = baseline pain minus the mean of the worst pain scores on Study days 1–10) was significantly greater for the VR group, F(1,48) = 4.88, p &lt; 0.05, MSE = 34.26, partial eta squared = 0.09, but contrary to predictions, absolute change scores were non-significant for all secondary measures.

EFFICACY OF PRESSURE-BIOFEEDBACK GUIDED DEEP CERVICAL FLEXOR TRAINING ON NECK PAIN AND MUSCLE PERFORMANCE IN VISUAL DISPLAY TERMINAL OPERATORS

2013 ◽  
Vol 16 (03) ◽  
pp. 1350011 ◽  
Author(s):  
Md. Nezamuddin ◽  
Shahnawaz Anwer ◽  
Sohrab Ahmad Khan ◽  
Ameed Equebal
Keyword(s):  
Neck Pain ◽  
Pain Intensity ◽  
Exercise Program ◽  
Visual Display ◽  
Muscle Performance ◽  
Control Group ◽  
Women Patients ◽  
Flexor Muscle ◽  
Visual Display Terminal ◽  
Pressure Biofeedback

Purpose: This randomized trial study compared the efficacy of pressure-biofeedback guided deep cervical flexor training as an adjunct with conventional exercise on pain and muscle performance in visually displayed terminal operators. Methods: A total of 50 (22 men and 28 women) patients with neck pain participated in the study. Patients were randomly placed into two groups: a biofeedback group (n = 25) and a control group (n = 25). The biofeedback group received pressure-biofeedback guided deep cervical flexor training program for 5 days a week for 6 weeks, whereas the control group received an exercise program only. Results: On intergroup comparisons, the deep cervical flexor performance in biofeedback group, at the end of 6th week was significantly higher than those of control group (p < 0.01). Pain intensity was also significantly reduced in biofeedback group when compared to control group at the end of trial (p < 0.004). Conclusion: The addition of pressure-biofeedback to a 6-week conventional program appeared to increase deep cervical flexor muscle performance, compared to the exercise program alone for people with reduced muscle performance.

Self-esteem in Recovered Bipolar and Unipolar Out-patients

1993 ◽  
Vol 163 (6) ◽  
pp. 755-762 ◽  
Author(s):  
D. Pardoen ◽  
F. Bauwens ◽  
A. Tracy ◽  
F. Martin ◽  
J. Mendlewicz
Keyword(s):  
Social Adjustment ◽  
Clinical Characteristics ◽  
Self Esteem ◽  
Normal Control Group ◽  
Basic Component ◽  
Control Group ◽  
Bipolar Patients ◽  
The Relationship ◽  
Depressive Patients

The hypothesis of a low self-esteem in depressive patients was tested using the Rosenberg Self-Esteem Scale in 24 recovered unipolar and 27 recovered bipolar patients, compared with a normal control group of 26 subjects matched for age and sex. The hypothesis was confirmed only for unipolars; bipolar patients presented a self-esteem score not significantly different from normal scores. Self-esteem was not related to clinical characteristics of the affective disorder, suggesting that low self-esteem may be a basic component of a depression-prone personality. The investigation of the relationship between self-esteem and social adjustment confirmed the presence of social conformism in bipolar patients and rigidly set low self-esteem in unipolar patients. These results should stimulate the evaluation of different psychotherapeutic treatments in the long-term psychosocial management of affectively ill patients.

scholarly journals Cognitive errors assessed by observer ratings in bipolar affective disorder: relationship with symptoms and therapeutic alliance

2009 ◽  
Vol 2 (2) ◽  
pp. 92-105 ◽  
Author(s):  
Ueli Kramer ◽  
Guy Bodenmann ◽  
Martin Drapeau
Keyword(s):  
Cognitive Therapy ◽  
Affective Disorder ◽  
Mood Disorders ◽  
Bipolar Affective Disorder ◽  
Cognitive Model ◽  
Control Group ◽  
Cognitive Errors ◽  
Manic Symptoms ◽  
Observer Ratings ◽  
Depressive Patients

AbstractThe construct of cognitive errors is clinically relevant for cognitive therapy of mood disorders. Beck's universality hypothesis postulates the relevance of negative cognitions in all subtypes of mood disorders, as well as positive cognitions for manic states. This hypothesis has rarely been empirically addressed for patients presenting bipolar affective disorder (BD). In-patients (n= 30) presenting with BD were interviewed, as were 30 participants of a matched control group. Valid and reliable observer-rater methodology for cognitive errors was applied to the session transcripts. Overall, patients make more cognitive errors than controls. When manic and depressive patients were compared, parts of the universality hypothesis were confirmed. Manic symptoms are related to positive and negative cognitive errors. These results are discussed with regard to the main assumptions of the cognitive model for depression; thus adding an argument for extending it to the BD diagnostic group, taking into consideration specificities in terms of cognitive errors. Clinical implications for cognitive therapy of BD are suggested.

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