Efficacy of a transdiagnostic emotion–focused exposure treatment for chronic pain patients with comorbid anxiety and depression

Background and Objectives: Musculoskeletal dysfunction can induce several types of chronic pain syndromes. It is of particular interest to elucidate the pathomechanism of different forms of chronic pain. It is possible that patients who have developed chronic widespread pain (CWP) may endure different pathomechanisms as compared to those who suffer from local pain (osteoarthritis, OA) and regional pain (chronic low back pain, cLBP), especially with regard to pain regulation and its related biomediators. The aim of this study was to determine the differences in pathomechanisms among these patients by measuring pain-related biomediators, particularly brain-derived neurotrophic factor (BDNF). Additionally, subpopulations of immune cells were determined in parallel. Materials and Methods: Patients and healthy subjects (HSs) were recruited (age and gender-matched). BDNF was measured from serum samples of patients and HSs and the data of body composition parameters were recorded. Additionally, both patients and HSs were asked to fill in questionnaires related to pain intensity, anxiety, and depression. Results: Our results highlight that the levels of both free and total BDNF are significantly lower in pain patients compared to HSs, with p values of 0.041 and 0.024, respectively. The number of CD3− CD56bright natural killer (NK) cells shows significant differences between the groups. Comparing all chronic pain patients with HSs reveals a significantly lower number of CD4+ CD8+ T cells (p = 0.031), CD3− CD56bright NK cells (p = 0.049) and CD20+ CD3− cells (p = 0.007). Conclusions: To conclude, it seems that a general conformity between the pathomechanisms of different chronic pain diseases exists, although there are unique findings only in specific chronic pain patients.

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Validating the German version of the Revised Children's Anxiety and Depression Scale in a sample of pediatric chronic pain patients

Journal of Psychosomatic Research ◽

10.1016/j.jpsychores.2019.109786 ◽

2019 ◽

Vol 124 ◽

pp. 109786 ◽

Cited By ~ 1

Author(s):

Lorin Stahlschmidt ◽

Bruce F. Chorpita ◽

Julia Wager

Keyword(s):

Chronic Pain ◽

Depression Scale ◽

Anxiety And Depression ◽

German Version ◽

Pediatric Chronic Pain ◽

Chronic Pain Patients ◽

Children’S Anxiety ◽

Pain Patients

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CB7-04: Generalized Anxiety and Depression Among Chronic Pain Patients on Opioid Therapy are Associated With Higher Pain Impairment, Increased Service Utilization and Poorer Health Status

Clinical Medicine & Research ◽

10.3121/cmr.2012.1100.cb7-04 ◽

2012 ◽

Vol 10 (3) ◽

pp. 183-183 ◽

Cited By ~ 2

Author(s):

J. Boscarino ◽

S. Hoffman ◽

G. Gerhard ◽

J. Han ◽

M. Rukstalis ◽

...

Keyword(s):

Chronic Pain ◽

Health Status ◽

Service Utilization ◽

Opioid Therapy ◽

Anxiety And Depression ◽

Generalized Anxiety ◽

Chronic Pain Patients ◽

Pain Patients

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Observing the Effects of Mindfulness-Based Meditation on Anxiety and Depression in Chronic Pain Patients

Abnormal and Behavioural Psychology ◽

10.4172/2472-0496.1000111 ◽

2016 ◽

Vol 02 (01) ◽

Author(s):

Kim R

Keyword(s):

Chronic Pain ◽

Anxiety And Depression ◽

Chronic Pain Patients ◽

Pain Patients

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Pain Acceptance Creates an Emotional Context That Protects against the Misuse of Prescription Opioids: A Study in a Sample of Patients with Chronic Noncancer Pain

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18063054 ◽

2021 ◽

Vol 18 (6) ◽

pp. 3054

Author(s):

Rosa Esteve ◽

Estefanía Marcos ◽

Ángela Reyes-Pérez ◽

Alicia E. López-Martínez ◽

Carmen Ramírez-Maestre

Keyword(s):

Chronic Pain ◽

Structural Equation ◽

Opioid Analgesics ◽

Anxiety And Depression ◽

Opioid Misuse ◽

Chronic Noncancer Pain ◽

Pain Acceptance ◽

Emotional Context ◽

Chronic Pain Patients ◽

Pain Patients

There is solid evidence of an association between several psychological flexibility processes, particularly pain acceptance, and adaptation to chronic pain. However, there are relatively few studies on the relationship between pain acceptance and opioid misuse in chronic pain patients. Thus, the aim of the present study was to test a hypothetical model in which pain acceptance would regulate pain sensations and pain-related thoughts and emotions, which would be related to opioid misuse. The sample comprised 140 chronic pain patients attending two hospitals. All patients were receiving pharmacological treatment, including opioid analgesics. Structural equation modelling analyses showed a significant association between higher pain acceptance and lower pain intensity and catastrophizing, and lower levels of anxiety and depression. Only higher anxiety and depression were significantly associated with increased opioid misuse. The results suggest that levels of anxiety, depression, and pain acceptance must be assessed before opioids are prescribed. Pain acceptance implies a relationship with internal events that protects against anxiety and depression and thus against opioid misuse. Acceptance and Commitment Therapy appears to be particularly appropriate for these patients.

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Sleep Quality in Chronic Pain Patients

The Canadian Journal of Psychiatry ◽

10.1177/070674370204700905 ◽

2002 ◽

Vol 47 (9) ◽

pp. 844-848 ◽

Cited By ~ 71

Author(s):

Kemal Sayar ◽

Meltem Arikan ◽

Tulin Yontem

Keyword(s):

Chronic Pain ◽

Sleep Quality ◽

Pain Intensity ◽

Anxiety And Depression ◽

Poor Sleep ◽

Poor Sleep Quality ◽

Control Subjects ◽

Chronic Pain Patients ◽

Healthy Control ◽

Pain Patients

Objective: Chronic pain patients have been reported to complain about poor sleep quality. Research aimed at delineating the predictors of poor sleep has produced conflicting results. Depressive mood and pain severity are the most frequently encountered predictors. This study aimed to find out whether chronic pain patients differed from healthy control subjects who had no pain on subjective sleep quality measures and, if so, which factors contributed most to poorer sleep quality. Method: We compared 40 patients with chronic pain who met inclusion criteria with 40 healthy control subjects on the measures of sleep quality, anxiety, and depression. The predictors of sleep quality were investigated with multiple regression in the pain group. Results: Chronic pain patients had higher scores than did healthy control subjects on the Beck Anxiety Scale, the Beck Depression Inventory (BDI), and the Pittsburgh Sleep Quality Index (PSQI). At the bivariate level, pain intensity, anxiety, and depression correlated significantly with poorer sleep quality. At the multivariate level, depression was found to be the only significant factor correlating with the quality of sleep, and the model explained 34% of the variance. Conclusions: Chronic pain patients suffer from poor sleep quality—a function of depressed mood rather than pain intensity, duration, or anxiety. However, it is difficult to draw a causal relation in this relatively small sample size. Besides, our study sample comprised a mostly psychiatric population and may not represent the general group of patients with chronic pain.

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Age-Dependent Opioid Escalation in Chronic Pain Patients

Yearbook of Anesthesiology and Pain Management ◽

10.1016/s1073-5437(08)70477-7 ◽

2006 ◽

Vol 2006 ◽

pp. 233

Author(s):

S.E. Abram

Keyword(s):

Chronic Pain ◽

Chronic Pain Patients ◽

Age Dependent ◽

Pain Patients

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Pain Influences Several Levels of Attention

Zeitschrift für Neuropsychologie ◽

10.1024/1016-264x.16.4.235 ◽

2005 ◽

Vol 16 (4) ◽

pp. 235-242 ◽

Cited By ~ 4

Author(s):

Astrid von Bueren Jarchow ◽

Bogdan P. Radanov ◽

Lutz Jäncke

Keyword(s):

Chronic Pain ◽

Divided Attention ◽

Covert Attention ◽

Attention Task ◽

Attentional Deficits ◽

Control Subjects ◽

Chronic Pain Patients ◽

Divided Attention Task ◽

Pain Stimuli ◽

Pain Patients

Abstract: The aim of the present study was to examine to what extent chronic pain has an impact on various attentional processes. To measure these attention processes a set of experimental standard tests of the “Testbatterie zur Aufmerksamkeitsprüfung” (TAP), a neuropsychological battery testing different levels of attention, were used: alertness, divided attention, covert attention, vigilance, visual search, and Go-NoGo tasks. 24 chronic outpatients and 24 well-matched healthy control subjects were tested. The control subjects were matched for age, gender, and education. The group of chronic pain patients exhibited marked deficiencies in all attentional functions except for the divided attention task. Thus, the data supports the notion that chronic pain negatively influences attention because pain patients` attention is strongly captivated by the internal pain stimuli. Only the more demanding divided attention task has the capability to distract the focus of attention to the pain stimuli. Therefore, the pain patients are capable of performing within normal limits. Based on these findings chronic pain patients' attentional deficits should be appropriately evaluated and considered for insurance and work related matters. The effect of a successful distraction away from the pain in the divided attention task can also open new therapeutic aspects.

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