A Multidisciplinary Approach to the Expression of Pain in Psychic Depression

1978 ◽  
Vol 47 (2) ◽  
pp. 379-390 ◽  
Author(s):  
Judith R. Ganchrow ◽  
Jacob E. Steiner ◽  
Murray Kleiner ◽  
Eliezer L. Edelstein

The expression of cold pressor pain was measured by recording simultaneously verbal magnitude estimates, heart rates, and facial displays of 16 recently hospitalized depressed patients, and 16 nondepressed adults. Independence of the two groups for the depression factor was verified using the Hamilton Scale for Depression and the 100-mm line self-rating scale. Verbal responses and amount of time the ice bath was tolerated, as well as heart-rate measures, indicated that depressed individuals were significantly more sensitive to the pain stimulus. However, this elevated intolerance to pain was not reflected by marked changes of facial display. Reasons for this discrepancy are discussed. Nondepressed subjects, although clearly able to verbalize intensity of pain, were much less reactive to the pain along all dimensions.

2019 ◽  
Author(s):  
Richard Stephens ◽  
Olly May Robertson

Background: This pre-registered study extends previous findings that swearing alleviates pain tolerance by assessing the effects of a conventional swear word (“fuck”) and two new “swear” words, “fouch” and “twizpipe”.Method: A mixed sex group of participants (N = 92) completed a repeated measures experimental design augmented by mediation analysis. The independent variable was Word with the levels, “fuck” v. “fouch” v. “twizpipe” v. a neutral word. The dependent variables were emotion rating, humour rating, distraction rating, cold pressor pain threshold, cold pressor pain tolerance, pain perception score and change from resting heart rate. Possible mediation effects were assessed for emotion, humour and distraction ratings. Results: For conventional swearing (“fuck”), confirmatory analyses found a 32% increase in pain threshold and a 33% increase in pain tolerance, accompanied by increased ratings for emotion, humour and distraction, relative to the neutral word condition. The new “swear” words, “fouch” and “twizpipe” were rated higher than the neutral word for emotion and humour although these words did not affect pain threshold or tolerance. Changes in heart rate, pain perception and were absent, as were mediation effects.Conclusions: Our data replicate previous findings that repeating a swear word at a steady pace and volume benefits pain tolerance, extending this finding to pain threshold. Our data cannot explain how such effects are manifest, although distraction appears to be of little importance, and emotion is worthy of future study. The new “swear” words did not alleviate pain even though participants rated them as emotion evoking and humorous.


1984 ◽  
Vol 9 (1) ◽  
pp. 55-75 ◽  
Author(s):  
Kenneth L. Subotnik ◽  
David Shapiro

1982 ◽  
Vol 19 (4) ◽  
pp. 393-403 ◽  
Author(s):  
John L. Reeves ◽  
David Shapiro

2016 ◽  
Vol 124 (2) ◽  
pp. 453-463 ◽  
Author(s):  
Eckhard Mauermann ◽  
Joerg Filitz ◽  
Patrick Dolder ◽  
Katharina M. Rentsch ◽  
Oliver Bandschapp ◽  
...  

Abstract Background Although opioids in general and remifentanil in particular have been shown to induce hyperalgesia, data regarding fentanyl are scarce. Thus, the authors investigated the effect of fentanyl dosing on pain perception and central sensitization in healthy volunteers using established pain models. Methods Twenty-one healthy, male volunteers were included in this randomized, double-blind, crossover study and received either intravenous low-dose (1 μg/kg) or high-dose (10 μg/kg) fentanyl. Pain intensities and hyperalgesia were assessed by intracutaneous electrical stimulation, and cold pressor pain was used as an additional measure of acute pain. The primary outcome was hyperalgesia from 4.5 to 6.5 h after fentanyl administration. Results A higher dose of fentanyl led to significantly decreased pain scores as measured by the numeric rating scale (0.83 units lower [95% CI, 0.63 to 1.02]; P < 0.001) but increased areas of hyperalgesia (+30.5% [95% CI, 16.6 to 44.4%]; P < 0.001) from 4.5 to 6.5 h after fentanyl administration. Allodynia did not differ between groups (+4.0% [95% CI, −15.4 to 23.5%]; P = 0.682).The high dose also led to both increased cold pressor pain threshold (+43.0% [95% CI, 29.7 to 56.3%]; P < 0.001) and tolerance (+32.5% [95% CI, 21.7 to 43.4%]; P < 0.001) at 4.5 to 6.5h. In the high-dose group, 19 volunteers (90%) required reminders to breathe, 8 (38%) required supplemental oxygen, and 12 (57%) experienced nausea. Conclusions A higher dose of fentanyl increased hyperalgesia from 4.5 to 6.5 h in healthy volunteers while simultaneously decreasing pain scores.


1991 ◽  
Vol 100 (2) ◽  
pp. 223-226 ◽  
Author(s):  
Mary F. Miller ◽  
Arreed F. Barabasz ◽  
Marianne Barabasz

2021 ◽  
pp. 1-7
Author(s):  
Anna Sandmeir ◽  
Désirée Schoenherr ◽  
Uwe Altmann ◽  
Christoph Nikendei ◽  
Henning Schauenburg ◽  
...  

Psychomotor retardation is a well-known clinical phenomenon in depressed patients that can be measured in various ways. This study aimed to investigate objectively measured gross body movement (GBM) during a semi-structured clinical interview in patients with a depressive disorder and its relation with depression severity. A total of 41 patients with a diagnosis of depressive disorder were assessed both with a clinician-rated interview (Hamilton Depression Rating Scale) and a self-rating questionnaire (Beck Depression Inventory-II) for depression severity. Motion energy analysis (MEA) was applied on videos of additional semi-structured clinical interviews. We considered (partial) correlations between patients’ GBM and depression scales. There was a significant, moderate negative correlation between both measures for depression severity (total scores) and GBM during the diagnostic interview. However, there was no significant correlation between the respective items assessing motor symptoms in the clinician-rated and the patient-rated depression severity scale and GBM. Findings imply that neither clinician ratings nor self-ratings of psychomotor symptoms in depressed patients are correlated with objectively measured GBM. MEA thus offers a unique insight into the embodied symptoms of depression that are not available via patients’ self-ratings or clinician ratings.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kilin Shi ◽  
Tobias Steigleder ◽  
Sven Schellenberger ◽  
Fabian Michler ◽  
Anke Malessa ◽  
...  

AbstractContactless measurement of heart rate variability (HRV), which reflects changes of the autonomic nervous system (ANS) and provides crucial information on the health status of a person, would provide great benefits for both patients and doctors during prevention and aftercare. However, gold standard devices to record the HRV, such as the electrocardiograph, have the common disadvantage that they need permanent skin contact with the patient. Being connected to a monitoring device by cable reduces the mobility, comfort, and compliance by patients. Here, we present a contactless approach using a 24 GHz Six-Port-based radar system and an LSTM network for radar heart sound segmentation. The best scores are obtained using a two-layer bidirectional LSTM architecture. To verify the performance of the proposed system not only in a static measurement scenario but also during a dynamic change of HRV parameters, a stimulation of the ANS through a cold pressor test is integrated in the study design. A total of 638 minutes of data is gathered from 25 test subjects and is analysed extensively. High F-scores of over 95% are achieved for heartbeat detection. HRV indices such as HF norm are extracted with relative errors around 5%. Our proposed approach is capable to perform contactless and convenient HRV monitoring and is therefore suitable for long-term recordings in clinical environments and home-care scenarios.


2019 ◽  
Vol 7 (1) ◽  
Author(s):  
Maximilian Pilhatsch ◽  
Thomas J Stamm ◽  
Petra Stahl ◽  
Ute Lewitzka ◽  
Anne Berghöfer ◽  
...  

Abstract Background Symptoms of anxiety co-occur in a variety of disorders including in depressive episodes of bipolar disorder and in patients with thyrotoxicosis. Treatment of refractory bipolar disorder with supraphysiologic doses of levothyroxine (L-T4) has been shown to improve the phenotypic expression of the disorder and is associated with an increase of circulating thyroid hormones. However, it might be associated with somatic and mental adverse effects. Here we report the investigation of the influence of treatment with supraphysiologic doses of L-T4 on symptoms of anxiety in patients with refractory bipolar depression. Methods Post-hoc analysis from a 6-week, multi-center, randomized, double-blind, placebo-controlled study of the effects of supraphysiologic L-T4 treatment on anxiety symptoms in bipolar depression. Anxiety symptoms were measured weekly with the Hamilton anxiety/somatization factor (HASF) score of the Hamilton Depression Rating Scale (HAMD) and the State- and Trait Anxiety Inventory (STAI). Results Treatment of both groups was associated with a significant reduction in anxiety symptoms (p < 0.001) with no statistical difference between groups (LT-4: from 5.9 (SD = 2.0) at baseline to 3.7 (SD = 2.4) at study end; placebo: from 6.1 (SD = 2.4) at baseline to 4.4 (SD = 2.8) at study end; p = 0.717). Severity of anxiety at baseline did not show a statistically significant correlation to the antidepressive effect of treatment with supraphysiologic doses of L-T4 (p = 0.811). Gender did not show an influence on the reduction of anxiety symptoms (females: from 5.6 (SD = 1.7) at baseline to 3.5 (SD = 2.4) at study end; males: from 6.1 (SD = 2.3) at baseline to 4.0 (SD = 2.4) at study end; p = 0.877). Conclusions This study failed to detect a difference in change of anxiety between bipolar depressed patients treated with supraphysiologic doses of L-T4 or placebo. Comorbid anxiety symptoms should not be considered a limitation for the administration of supraphysiologic doses of L-T4 refractory bipolar depressed patients. Trial registration ClinicalTrials, ClinicalTrials.gov identifier: NCT01528839. Registered 2 June 2012—Retrospectively registered, https://clinicaltrials.gov/ct2/show/study/NCT01528839


Sign in / Sign up

Export Citation Format

Share Document