scholarly journals Prevalence of unrecognized depression in patients with chronic pain without a history of psychiatric diseases

2018 ◽  
Vol 31 (2) ◽  
pp. 116 ◽  
Author(s):  
Ho-Jin Lee ◽  
Eun Joo Choi ◽  
Francis Sahngun Nahm ◽  
In Young Yoon ◽  
Pyung Bok Lee
Keyword(s):  
Chronic Pain ◽  
Psychiatric Diseases ◽  
History Of

scholarly journals Clinical characteristics and sociodemographic features of psychotic major depression

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Meng-qi Wang ◽  
Ran-ran Wang ◽  
Yu Hao ◽  
Wei-feng Xiong ◽  
Ling Han ◽  
...  
Keyword(s):  
Family History ◽  
Major Depression ◽  
Clinical Characteristics ◽  
Missing Values ◽  
Psychotic Disorders ◽  
Mental Health Center ◽  
Psychiatric Diseases ◽  
First Onset ◽  
History Of ◽  
Psychotic Major Depression

Abstract Background Psychotic major depression (PMD) is a subtype of depression with a poor prognosis. Previous studies have failed to find many differences between patients with PMD and those with non-psychotic major depression (NMD) or schizophrenia (SZ). We compared sociodemographic factors (including season of conception) and clinical characteristics between patients with PMD, NMD, and schizophrenia. Our aim was to provide data to help inform clinical diagnoses and future etiology research. Methods This study used data of all patients admitted to Shandong Mental Health Center from June 1, 2016 to December 31, 2017. We analyzed cases who had experienced an episode of PMD (International Classification of Diseases, Tenth Revision codes F32.3, F33.3), NMD (F32.0–2/9, F33.0–2/9), and SZ (F20–20.9). Data on sex, main discharge diagnosis, date of birth, ethnicity, family history of psychiatric diseases, marital status, age at first onset, education, allergy history, and presence of trigger events were collected. Odds ratios (OR) were calculated using logistic regression analyses. Missing values were filled using the k-nearest neighbor method. Results PMD patients were more likely to have a family history of psychiatric diseases in their first-, second-, and third-degree relatives ([OR] 1.701, 95% confidence interval [CI] 1.019–2.804) and to have obtained a higher level of education (OR 1.451, 95% CI 1.168–1.808) compared with depression patients without psychotic features. Compared to PMD patients, schizophrenia patients had lower education (OR 0.604, 95% CI 0.492–0.741), were more often divorced (OR 3.087, 95% CI 1.168–10.096), had a younger age of onset (OR 0.934, 95% CI 0.914–0.954), less likely to have a history of allergies (OR 0.604, 95% CI 0.492–0.741), and less likely to have experienced a trigger event 1 year before first onset (OR 0.420, 95% CI 0.267–0.661). Season of conception, ethnicity, and sex did not differ significantly between PMD and NMD or schizophrenia and PMD. Conclusions PMD patients have more similarities with NMD patients than SZ patients in terms of demographic and clinical characteristics. The differences found between PMD and SZ, and PMD and NMD correlated with specificity of the diseases. Furthermore, allergy history should be considered in future epidemiological studies of psychotic disorders.

scholarly journals Intravascular Glomus Tumor of the Forearm Causing Chronic Pain and Focal Tenderness

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Sang Ki Lee ◽  
Dae Geon Song ◽  
Won Sik Choy
Keyword(s):  
Chronic Pain ◽  
Glomus Tumor ◽  
Rare Condition ◽  
Surgical Excision ◽  
Vascular Tumor ◽  
Glomus Tumors ◽  
Contrast Magnetic Resonance ◽  
History Of ◽  
Subcutaneous Layer ◽  
Magnetic Resonance Imaging Mri

Introduction. A glomus tumor is a benign vascular tumor derived from glomus cells and occurs mainly in the subcutaneous layer of the subungual or digital pulp. Extradigital glomus tumors have been reported within the palm, wrist, forearm, foot, bone, stomach, colon, cervix, and mesentery. Glomus tumors can originate from the intraosseous, intramuscular, periosteal, intravascular, and intraneural layers. However, a glomus tumor originating from the intravascular layer of the forearm is a rare condition.Case Report. A 44-year-old woman had a 7-year history of chronic pain and focal tenderness of the forearm. No hypersensitivity or sensory alterations were observed. Contrast magnetic resonance imaging (MRI) showed a mass measuring 5 × 3 × 2 mm leading to a vein. Surgical excision was performed, and the tumor was completely resected. Finding of gross examination revealed a dark-red, well-defined soft tissue tumor, and histologic examination confirmed that the mass was a glomus tumor. The patient’s symptoms were completely resolved postoperatively.Conclusion. Intravascular glomus tumors rarely occur in the forearm; therefore, a thorough physical exam, comprehensive medical history, in-depth imaging, and early surgical excision upon clinical suspicion may be helpful to prevent a delayed or incorrect diagnosis.

Sex, Race, Insurance, and Pain: Do Patient Sociodemographics Influence Postoperative Opioid Prescriptions Among Hand Surgeons?

Hand ◽  
2021 ◽  
pp. 155894472199802
Author(s):  
Connor J. Peck ◽  
Martin Carney ◽  
Alexander Chiu ◽  
Kitae E. Park ◽  
Alexandre Prassinos ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Medical Center ◽  
Carpal Tunnel Release ◽  
Private Insurance ◽  
Academic Medical Center ◽  
Age Groups ◽  
Postoperative Pain Management ◽  
Patient Treatment ◽  
Opioid Prescription ◽  
History Of

Background: Social and demographic factors may influence patient treatment by physicians. This study analyzes the influence of patient sociodemographics on prescription practices among hand surgeons. Methods: We performed a retrospective analysis of all hand surgeries (N = 5278) at a single academic medical center from January 2016 to September 2018. The average morphine milligram equivalent (MME) prescribed following each surgery was calculated and then classified by age, race, sex, type of insurance, and history of substance use or chronic pain. Multivariate linear regression was used to compare MME among groups. Results: Overall, patients with a history of substance abuse were prescribed 31.2 MME more than those without ( P < .0001), and patients with a history of chronic pain were prescribed 36.7 MME more than those without ( P < .0001). After adjusting for these variables and the type of procedure performed, women were prescribed 11.2 MME less than men ( P = .0048), and Hispanics were prescribed 16.6 MME more than whites ( P = .0091) overall. Both Hispanic and black patients were also prescribed more than whites following carpal tunnel release (+19.0 and + 20.0 MME, respectively; P < .001). Patients with private insurance were prescribed 24.5 MME more than those with Medicare ( P < .0001), but 25.0 MME less than those with Medicaid ( P < .0001). There were no differences across age groups. Conclusions: Numerous sociodemographic factors influenced postoperative opioid prescription among hand surgeons at our institution. These findings highlight the importance of establishing more uniform, evidence-based guidelines for postoperative pain management, which may help minimize subjectivity and prevent the overtreatment or undertreatment of pain in certain patient populations.

The changing face of acute pain services

2017 ◽  
Vol 16 (1) ◽  
pp. 204-210 ◽  
Author(s):  
Adriana Miclescu ◽  
Stephen Butler ◽  
Rolf Karlsten
Keyword(s):  
Chronic Pain ◽  
Pain Intensity ◽  
Acute Pain ◽  
Severe Pain ◽  
Care Hospital ◽  
Opioid Dependency ◽  
Number Of Patients ◽  
History Of ◽  
Number Of Visits ◽  
Pain Services

AbstractBackground and AimsAcute Pain Services have been implemented initially to treat inadequate postoperative pain. This study was undertaken to prospectively review the current challenges of the APS team in an academic hospital assessing the effects of its activity on both surgical and medical pain intensity. It also define the characteristics of the patients and the risk factors influencing the multiple visits from the APS team.MethodThis prospective cohort study was conducted at Uppsala University Hospital (a Swedish tertiary and quaternary care hospital) during one year. All the patients referred to the APS team were enrolled. A standardized data collection template of demographic data, medical history, pain diagnosis, associated diseases, duration of treatment, number of visits by the APS team and type of treatment was employed. The primary outcomes were pain scores before, after treatment and the number of follow-ups. The patients were visited by APS at regular intervals and divided by the number of visits by APS team into several groups: group 1 (one visit and up to 2 follow ups); group 2 (3 to 4 follow-ups); group 3 (5 to 9 follow-ups); group 4 (10 to 19 follow-ups); group 5 (>20 followups). The difference between groups were analyzed with ordinal logistic regression analyses.ResultsPatients (n = 730) (mean age 56±4, female 58%, men 42%) were distributed by service to medical (41%) and surgical (58%). Of these, 48% of patients reported a pain score of moderate to severe pain and 27% reported severe pain on the first assessment. On the last examination before discharge, they reported 25–30% less pain (P = 0.002). The median NRS (numerical rating scores) decreased significantly from 9.6 (95% confidence interval, 8.7–9.9) to 6.3 (6.1–7.4) for the severe pain (P < 0.0001), from 3.8 (3.2–4.3) to 2.4 (1.8–2.9) for the moderate pain. The odds ratio for frequent follow-ups of the patients between 18 and 85 years (n = 609) was 2.33 (95% CI: 1.35–4.02) if the patient had a history of chronic neuropathic pain, 1.80(1.25–2.60) in case the patient had a history of chronic nociceptive pain, 2.06(1.30–3.26) if he had mental diseases, and 3.35(2.21–5.08) if he had opioid dependency at the time of consultation from APS. Strong predictors of frequent visits included female gender (P = 0.04).ConclusionsBeside the benefits of APS in reducing pain intensity, this study demonstrates that the focus of APS has been shifted from the traditional treatment of acute surgical pain to the clinical challenges of treating hospitalized patients with a high comorbidity of psychiatric diseases, opioid dependency and chronic pain.ImplicationsThe concept of an APS will ultimately be redefined according to the new clinical variables. In the light of the increasing number of patients with complex pain states and chronic pain, opioid dependency and psychiatric comorbidities it is mandatory that the interdisciplinary APS team should include other specialties besides the “classical interdisciplinary APS team”, as psychiatry, psychology, rehabilitation and physiotherapy with experience in treating chronic pain patients.

Introduction

2018 ◽  
Author(s):  
Edward Shorter ◽  
Max Fink
Keyword(s):  
Psychiatric Diseases ◽  
The Public ◽  
Life Threatening ◽  
History Of

Catatonia is a syndrome that is identifiable, verifiable, and eminently treatable, unlike other disorders in the roster of psychiatric diseases. Catatonia is not a form of “schizophrenia,” and, although it may “piggyback” on other diseases, it is also a disease in its own right. Today, catatonia is often not recognized; clinicians and the public are more familiar with the term as a subtype of “schizophrenia.” Failure to diagnose it is very common. This introduction documents the earliest descriptions of the disorder and its treatment and gives a brief history of the acceptance of the term “catatonia” by the psychiatric discipline. The authors emphasize the importance of recognizing the symptoms of catatonia and appreciating how straightforward its treatment is. Proper recognition is important because catatonia may be life-threatening, so diagnosing and treating it properly are matters of importance.

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