scholarly journals Postconcussion Symptoms in Patients with Injury-Related Chronic Pain

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Britt Marie Stålnacke

Background. Postconcussion symptoms (PCSs)—such as fatigue, headache, irritability, dizziness, and impaired memory—are commonly reported in patients who have mild traumatic brain injuries (MTBIs). Evaluation of PCS after MTBI is proposed to have a diagnostic value although it is unclear whether PCS are specific to MTBI. After whiplash injuries, patients most often complain of headaches and neck pain; the other PCS are not as closely evaluated. In patients with chronic pain because of other injuries, the presence of PCS is unclear. This study aimed to describe the frequency of PCS in patients with injury-related pain and to examine the relationships between PCS, pain, and psychological factors.Methods. This study collected data using questionnaires addressing PCS (Rivermead Postconcussion Questionnaire, RPQ), pain intensity (Visual Analogue Scale), depression, anxiety (Hospital, Anxiety, and Depression Scale), and posttraumatic stress (Impact of Event Scale).Results. Fatigue (90.7%), sleep disturbance (84.9%), headache (73.5%), poor concentration (88.2%), and poor memory (67.1%) were some of the most commonly reported PCS. Significant relationships were found between PCS and posttraumatic stress, depression, and anxiety.Conclusion. To optimize treatment, it is important to assess each patient’s PCS, the mechanism of injury, and factors such as posttraumatic stress and depression.

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Britt-Marie Stålnacke

Background. Chronic injury-related pain could be influenced by psychological symptoms such as depression, anxiety, and stress that also affect daily life. Methods. Patients with chronic pain caused by an injury () aged 18–65 years referred to the Pain Rehabilitation Clinic at the Umeå University Hospital answered a set of questionnaires to assess pain intensity, depression, anxiety, posttraumatic stress, sleep disturbance, and fatigue. Results. A significantly higher proportion of women (47.5%) reported depression (Hospital Anxiety and Depression Scale (HAD)) than men (22.2%). In all patients anxiety (HAD) was reported by 39.5% and moderate/severe posttraumatic stress (Impact of Event Scale) by 30.2%. A majority reported sleep disturbance (84.9%) and fatigue (90.7%). Significant relationships were found between posttraumatic stress and depression and anxiety. Conclusion. These findings indicate the importance of assessing and treating psychological symptoms associated with chronic pain as the result of trauma.


2020 ◽  
Vol 4 ◽  
pp. 247054702098167
Author(s):  
Alisher R. Dadabayev ◽  
Sonalee A. Joshi ◽  
Mariam H. Reda ◽  
Tamar Lake ◽  
Mark S. Hausman ◽  
...  

Objective To date, treatment options (i.e. psychotherapy, antidepressant medications) for patients with posttraumatic stress disorder (PTSD), are relatively few, and considering their limited efficacy, novel therapies have gained interest among researchers and treatment providers alike. Among patients with chronic pain (CP) about one third experience comorbid PTSD, which further complicates their already challenging pharmacological regimens. Low dose ketamine infusion has shown promise in PTSD, and in treatment of CP, however they have not been studied in comorbid population and under rigorous control conditions. Methods We compared the effects of a single dose of either ketamine (0.5 mg/kg) or ketorolac (15 mg) over a 40-minute of IV infusion in CP patients with and without PTSD, in double blind, randomized study. Measures were collected before, during, one day and seven days after the infusion. A planned sample size of 40 patients randomly assigned to treatment order was estimated to provide 80% power to detect a hypothesized treatment difference after the infusion. Main Outcome and Measures: The primary outcome measures were change in PTSD symptom severity assessed with the Impact of Event Scale–Revised (IES-R) and Visual Analogue Scale (VAS) for pain administered by a study clinician 24 hours post infusion. Secondary outcome measures included Impact of Event Scale–Revised (IES-R), VAS and Brief Pain Inventory (Short Form) for pain 1 week after the infusion. Results Both treatments offered comparable improvement of PTSD and CP symptoms that persisted for 7 days after the infusion. Patients with comorbid PTSD and CP experienced less dissociative side effects compared to the CP group. Surprisingly, ketorolac infusion resulted in dissociative symptoms in CP patients only. Conclusions This first prospective study comparing effects of subanesthetic ketamine versus ketorolac infusions for comorbid PTSD and CP, suggests that both ketamine and ketorolac might offer meaningful and durable response for both PTSD and CP symptoms.


2012 ◽  
Vol 4 (2) ◽  
pp. 59-65 ◽  
Author(s):  
Monica Blanaru ◽  
Boaz Bloch ◽  
Limor Vadas ◽  
Zahi Arnon ◽  
Naomi Ziv ◽  
...  

Posttraumatic stress disorder (PTSD), an anxiety disorder with lifetime prevalence of 7.8%, is characterized by symptoms that develop following exposure to traumatic life events and that cause an immediate experience of intense fear, helplessness or horror. PTSD is marked by recurrent nightmares typified by the recall of intrusive experiences and by extended disturbance throughout sleep. Individuals with PTSD respond poorly to drug treatments for insomnia. The disadvantages of drug treatment for insomnia underline the importance of non-pharmacological alternatives. Thus, the present study had three aims: first, to compare the efficiency of two relaxation techniques (muscular relaxation and progressive music relaxation) in alleviating insomnia among individuals with PTSD using both objective and subjective measures of sleep quality; second, to examine whether these two techniques have different effects on psychological indicators of PTSD, such as depression and anxiety; and finally, to examine how initial PTSD symptom severity and baseline emotional measures are related to the efficiency of these two relaxation methods. Thirteen PTSD patients with no other major psychiatric or neurological disorders participated in the study. The study comprised one seven-day running-in, no-treatment period, followed by two seven-day experimental periods. The treatments constituted either music relaxation or muscle relaxation techniques at desired bedtime. These treatments were randomly assigned. During each of these three experimental periods, subjects' sleep was continuously monitored with a wrist actigraph (Ambulatory Monitoring, Inc.), and subjects were asked to fill out several questionnaires concerned with a wide spectrum of issues, such as sleep, depression, and anxiety. Analyses revealed a significant increase in objective and subjective sleep efficiency and a significant reduction in depression level following music relaxation. Moreover, following music relaxation, a highly significant negative correlation was found between improvement in objective sleep efficiency and reduction in depression scale. The study‘s findings provide evidence that music relaxation at bedtime can be used as treatment for insomnia among individuals with PTSD.


2009 ◽  
Vol 67 (1) ◽  
pp. 25-28 ◽  
Author(s):  
Martha M.C. Castro ◽  
Carla Daltro

BACKGROUND: Sleep disturbances and symptoms of anxiety and depression have been shown to be involved in the genesis and perpetuation of chronic pain. OBJECTIVE: To evaluate sleep patterns and the prevalence of symptoms of anxiety and depression in patients with chronic pain. METHOD: Four hundred consecutive patients referred to a chronic pain outpatient clinic were investigated using patient charts, the numerical Visual Analogue Scale for the evaluation of pain, the Hospital Anxiety and Depression scale and the Mini-Sleep Questionnaire. RESULTS: The mean age of patients was 45.6±11.4 years. The most frequent medical diagnosis was myofascial pain followed by neuropathic pain. The prevalence of symptoms of anxiety was 72.8%, depression 93% and altered sleep patterns 93%. CONCLUSION: This study revealed a high prevalence of symptoms of depression and anxiety and alterations in sleep patterns in patients with chronic pain, justifying investigation into these disturbances in this group of patients.


Psichologija ◽  
2007 ◽  
Vol 35 ◽  
pp. 7-18
Author(s):  
Evaldas Kazlauskas ◽  
Irma Šimėnaitė ◽  
Danutė Gailienė

Potrauminis augimas yra teigiami psichologiniai padariniai po traumos, kurie pasireiškia savęs suvokimo, požiūrio į pasaulį ir tarpasmeninių santykių pokyčiais (Tedeschi and Calhoun, 1996). Pozityvūs procesai po traumos dar tik pradedami tyrinėti, todėl nėra žinoma, kokios yra potrauminio augimo (PTA), trauminio įvykio intensyvumo ir potrauminio streso sutrikimo (PTSS) sąsajos. Siekiant įvertinti ryšius tarp trauminės patirties ir PTSS bei PTA, buvo ištirti 104 studentiško amžiaus jaunuoliai, per savo gyvenimą patyrę bent vieną trauminį įvykį. Tako analizės modelis parodė, kad subjektyvus trauminės patirties intensyvumasyra veiksnys, reikšmingai prognozuojantis tiek PTSS, tiek PTA. Kuo reakcija į trauminį įvykį yra stipresnė, tuo labiau išreikšti PTSS ir PTA požymiai. Nustatytas nestiprus teigiamas ryšys tarp PTSS ir PTA parodė, kad, norėdami geriau suprasti, kaip jaučiasi asmenys po traumos, turime atsižvelgti ir į teigiamus (PTA), ir į neigiamus (PTSS) traumos padarinius. Pagrindiniai žodžiai: trauma, potrauminis stresas, potrauminis augimas.RELATIONSHIP BETWEEN TRAUMA EXPOSURE, POSTTRAUMATIC GROWTH AND POSTTRAUMATIC STRESS DISORDEREvaldas Kazlauskas, Irma Šimėnaitė, Danutė Gailienė SummaryObjectives: The notion that traumatic experiences may have an impact on human mind is very old. Recent developments in psychotraumatology shifted the approach to a trauma from a purely negative to a more positive perspective. Research confirmed that traumatic events may lead not only to posttraumatic stress or other disorders, but also to positive changes. The present research was based on the concept of Posttraumatic Growth developed by Calhoun and Tedeschi (1996), which is widely known in the field of traumatic stress. Although the number of Posttraumatic Growth (PTG) research is growing rapidly, little is known about Posttraumatic Growth predictors. The present research was designed to find out the links between Posttraumatic Growth, Posttraumatic Stress and initial reactions to the traumatic event. We set up two goals of the study: 1) evaluation of how initial traumatic reactions predict PTG, and 2) assessment of links between PTG and PTSD.Methods: A group of 104 university students exposed to at least one life-time traumatic event participated in the study. The average time gap between exposure to a traumatic event and the time of research was 43 months. The intensity of initial reactions to a traumatic event was measured using a 10-item selfrating inventory developed by the authors of the present study. The Subjective Traumatic Experience (STE) inventory consisted of items covering cognitive, emotional and physiological reactions to a traumatic event. Posttraumatic Growth was measured using the Posttraumatic Growth Inventory (PGI) developed by Tedeschi and Calhoun (1996). Previous research showed satisfactory psychometric properties of the Lithuanian version of PGI (Gailienë & Kazlauskas, 2005). Posttraumatic Stress Disorder was measured using the Lithuanian version of Impact of Event Scale – Revised (IES-R). A recent validation of the IES-R on Lithuanian population showed its good psychometric properties (Kazlauskas et al., 2006).


2008 ◽  
Vol 17 (6) ◽  
pp. 534-543 ◽  
Author(s):  
Karen Wallen ◽  
Wendy Chaboyer ◽  
Lukman Thalib ◽  
Debra K. Creedy

Background Admission to intensive care is often a sudden and unexpected event precipitated by a life-threatening condition, 2 determinants thought to influence the development of posttraumatic stress disorder. Objectives To identify the frequency of acute symptoms of posttraumatic stress disorder and to describe factors predictive of these symptoms in patients 1 month after discharge from intensive care. Methods In this prospective cohort study, all patients meeting the inclusion criteria during the study period were invited to participate. Participants completed the Impact of Event Scale-Revised, and demographic and clinical data were accessed from an intensive care unit database. Results During a 9-month period, 114 of 137 patients who met the inclusion criteria consented to participate in the study, and 100 (88%) completed it. The mean total score on the Impact of Event Scale-Revised was 17.8 (SD, 13.4; possible range, 0–88). A total of 13 participants (13%) scored higher than the cutoff score for clinical posttraumatic stress disorder. Neither sex nor length of stay was predictive of acute symptoms of post-traumatic stress disorder. In multivariate analysis, the only independent predictor of symptoms was age. Patients younger than 65 years were 5.6 times (95% confidence interval, 1.17–26.89) more likely than those 65 years and older to report symptoms. Conclusion The rate of symptoms of posttraumatic stress disorder 1 month after discharge from intensive care was relatively low. Consistent with findings of previous research, being younger than 65 years was the only independent predictor of symptoms.


2009 ◽  
Vol 45 (3) ◽  
pp. 405-412 ◽  
Author(s):  
Siri Thoresen ◽  
Kristian Tambs ◽  
Ajmal Hussain ◽  
Trond Heir ◽  
Venke A. Johansen ◽  
...  

1996 ◽  
Vol 169 (4) ◽  
pp. 430-433 ◽  
Author(s):  
Helen L. Chubb ◽  
Jonathan I. Bisson

BackgroundThe impact of major trauma on individuals with pre-existing and enduring mental health difficulties is poorly understood.MethodTwenty individuals with pre-existing and enduring mental health difficulties were assessed with the Clinician Administered Post Traumatic Stress Disorder Scale, the 28-item version of the GHQ, the Hospital Anxiety and Depression Scale, and the Impact of Event Scale between four and eight weeks after their involvement in a major coach accident.ResultsTen (50%) individuals satisfied the full DSM–IV criteria for a diagnosis of PTSD. The questionnaire scores indicated a high level of psychological suffering among the group. On dividing the sample into those individuals with previous diagnoses of anxiety or depressive disorders and those with a previous diagnosis of chronic schizophrenia, the schizophrenia group displayed less marked psychological sequelae on all measures.ConclusionThere was a high incidence of early psychological sequelae among the group as a whole. Some diagnoses (e.g. depression and anxiety) may predispose to psychological sequelae while others (e.g. chronic schizophrenia) may not.


2020 ◽  
Vol 12 (3) ◽  
pp. 115-123
Author(s):  
Jonas Osmann ◽  
Abdul Mujeeb Khalvatgar ◽  
Anthony Feinstein

Purpose Afghanistan is one of the world’s most dangerous places for journalists. There are, however, no data on the mental health of Afghan journalists covering conflict in their country. The study aims to determine the degree to which Afghan journalists are exposed to traumatic events, their perceptions of organizational support, their rates of symptoms of posttraumatic stress disorder (PTSD) and depression, their utilization of mental health services and the effectiveness of the treatment received. Design/methodology/approach The entire study was undertaken in Dari (Farsi). Five major Afghan news organizations representing 104 journalists took part of whom 71 (68%) completed a simple eleven-point analog scale rating perceptions of organizational support. Symptoms of PTSD and depression were recorded with the Impact of Event Scale – Revised (IES-R) and the Centre for Epidemiologic Studies Depression Scale (CES-D), respectively. Behavioral comparisons were undertaken between those journalists who had and had not received mental health therapy. Findings The majority of journalists exceeded cutoff scores for PTSD and major depression and reported high rates for exposure to traumatic events. There were no significant differences in IES-R and CES-D scores between journalists who had and had not received mental health therapy. Most journalists did not view their employers as supportive. Originality/value To the best of authors’ knowledge, this is the first study to collect empirical data on the mental health of Afghan journalists. The results highlight the extreme stressors confronted by them, their correspondingly high levels of psychopathology and the relative ineffectiveness of mental health therapy given to a minority of those in distress. The implications of these findings are discussed.


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