scholarly journals Torture survivors’ symptom load compared to chronic pain and psychiatric in-patients

2018 ◽  
Vol 26 (2) ◽  
pp. 11
Author(s):  
Uwe Harlacher ◽  
Linda Nordin ◽  
Peter Barth Polatin
Keyword(s):  
Chronic Pain ◽  
Rating Scales ◽  
Functional Disability ◽  
Depression Scale ◽  
Rehabilitation Program ◽  
Research Centre ◽  
Anxiety And Depression ◽  
Psychotic Symptoms ◽  
Pronounced Difference ◽  
Mixed Pain

Before their entry into the rehabilitation program at the Rehabilitation and Research Centre for Torture Victims (‘RCT’) in Copenhagen, the degree of symptoms of a group of resettled traumatized refugees was assessed by means of two rating scales: the Disability Rating Index (DRI) (n=197), measuring pain-related functional disability, and the Hospital Anxiety and Depression Scale (HADS) (n=147). The results obtained were compared with other patient populations, which included (1) a large Swedish mixed pain group and (2) various groups of pain patients previously investigated in the validation study of the DRI scale. The DRI scores of the refugee group were comparable to, or higher than, those of the pain groups, except for patients suffering from multiple sclerosis. The degree of anxiety and depression was found to be considerably greater in the refugee group than in the pain groups. Another recently published Danish study comparing traumatized refugees with psychiatric in-patients in terms of Health of Nation Outcome Scores (HoNOS) documented a higher degree of psychiatric disability for refugees. Based on the hypothesis that the observed differences in this study were underestimated due to the exclusion of refugees with psychotic symptoms and substance abuse, a partial re-analysis of the data was carried out by calculating effect sizes with and without the items measuring these symptoms. Controlling for the exclusion of the critical items resulted in a more pronounced difference between the refugees and psychiatric inpatients. Based on the data compared in this study, traumatized refugees are shown to suffer from multiple problems, including chronic pain, at a high symptom-level. This challenges prior clinical assumptions that single factors like PTSD can explain all symptoms.

scholarly journals Sleep patterns and symptoms of anxiety and depression in patients with chronic pain

2009 ◽  
Vol 67 (1) ◽  
pp. 25-28 ◽  
Author(s):  
Martha M.C. Castro ◽  
Carla Daltro
Keyword(s):  
Chronic Pain ◽  
Sleep Disturbances ◽  
Myofascial Pain ◽  
Depression Scale ◽  
Anxiety And Depression ◽  
Depression And Anxiety ◽  
Sleep Patterns ◽  
Symptoms Of Depression ◽  
High Prevalence ◽  
The Mean

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.

scholarly journals Adolescents with chronic pain and associated functional disability

2014 ◽  
Vol 19 (4) ◽  
pp. 478-484 ◽  
Author(s):  
Andrea A Wojtowicz ◽  
Gerard A Banez
Keyword(s):  
Chronic Pain ◽  
Functional Disability ◽  
Sleep Problems ◽  
Medical Condition ◽  
Rehabilitation Program ◽  
Medical Procedure ◽  
Contributing Factors ◽  
Physical Trauma ◽  
Pain Experiences ◽  
Parent Personality

The purpose of this research was to describe the biopsychosocial characteristics of adolescents with chronic pain and functional disability. Data were obtained from a registry of 100 adolescents (mean age = 15.84, SD = 2.72; 21 males) admitted to an interdisciplinary pain rehabilitation program. Clinician ratings were used to categorize coping and personality styles. The most common chief complaint at admission was limb pain ( n = 44), followed by headache ( n = 21) and abdominal pain ( n = 17). Eighteen patients presented with other types of pain. The most frequent triggers to pain were physical trauma, medical condition or disability, and surgery or another medical procedure. Sleep problems, mental health difficulties, and high academic performance were common. Seven previously identified pain-associated disability factors, including passive or dependent coping style, chronic illness in a parent, personality consistent with alexithymia, unresolved family problems, early pain experiences, learning/developmental difficulties, and perfectionistic personality, were common. Ninety-eight adolescents presented with two or more of these contributing factors. Fifty-six adolescents had four or more of the factors. Adolescents with chronic pain and associated disability presented with numerous biopsychosocial factors that relate to their impairment. The understanding and attention to these factors will be important for successful rehabilitation.

scholarly journals Caregiver–Child Discrepancies in Reports of Child Emotional Symptoms in Pediatric Chronic Pain

2019 ◽  
Vol 45 (4) ◽  
pp. 359-369
Author(s):  
Sarah R Martin ◽  
Lonnie K Zeltzer ◽  
Laura C Seidman ◽  
Katherine E Allyn ◽  
Laura A Payne
Keyword(s):  
Chronic Pain ◽  
Depressive Symptoms ◽  
Functional Impairment ◽  
Internalizing Symptoms ◽  
Functional Disability ◽  
Child Anxiety ◽  
Depression Scale ◽  
Proxy Report ◽  
Proxy Reports ◽  
Pediatric Chronic Pain

Abstract Objective Pediatric chronic pain evaluation includes self-reports and/or caregiver proxy-reports across biopsychosocial domains. Limited data exist on the effects of caregiver–child discrepancies in pediatric pain assessment. In children with chronic pain, we examined associations among discrepancies in caregiver–child reports of child anxiety and depressive symptoms and child functional impairment. Methods Participants were 202 children (Mage=14.49 ± 2.38 years; 68.8% female) with chronic pain and their caregivers (95.5% female). Children and caregivers completed the Revised Child Anxiety and Depression Scale (RCADS) and RCADS-Parent, respectively. Children also completed the Functional Disability Inventory. Mean difference tests examined caregiver–child discrepancies. Moderation analyses examined whether associations between child self-reported anxiety and depressive symptoms and functional impairment varied as a function of caregiver proxy-report. Results Children reported more anxiety and depressive symptoms compared with their caregivers’ proxy-reports (Z = −4.83, p < .001). Both informants’ reports of child anxiety and depressive symptoms were associated with child functional impairment (rs = .44, rs = .30, p < .001). Caregiver proxy-report moderated associations between child-reported anxiety and depressive symptoms and functional impairment (B = −0.007, p = .003). When caregiver proxy-report was low, child self-reported anxiety and depressive symptoms were positively related to functional impairment (B = 0.28, SE = 0.07, 95% CI [0.15, 0.41], p < .001). Conclusions Discrepant caregiver–child perceptions of child anxiety and depressive symptoms may be associated with functioning in children with chronic pain, especially when caregivers report less child internalizing symptoms. These findings highlight the need for further examination of the effects of caregiver–child discrepancies on pediatric chronic pain outcomes and may indicate targets for intervention.

Recognizing the Psychiatric Burden of Anxiety and Depression in Children With Headache, Chest Pain, and Abdominal Pain

2020 ◽  
pp. 160-175
Author(s):  
Susan T. Tran ◽  
Ana B. Goya Arce ◽  
Anjana Jagpal
Keyword(s):  
Chronic Pain ◽  
Functional Disability ◽  
Anxiety And Depression ◽  
Depression And Anxiety ◽  
Pediatric Pain ◽  
Treatment Of Depression ◽  
Pediatric Chest ◽  
Psychiatric Conditions ◽  
Headache Pain

Anxiety and depression are particularly common in pediatric chest, abdominal, and headache pain. Shared genetic factors, biological processes, and neurochemical mechanisms may underlie these comorbidities. Chronic pain in children and adolescents is associated with substantial functional disability, and impairments are especially notable when youths have comorbid anxiety or depression. Thus, early detection and treatment of comorbid psychiatric conditions in youths with chronic pain is imperative. Screening for anxiety and depression in pediatric pain is made difficult by the number of overlapping symptoms between pain and psychiatric conditions. Research on the treatment of chronic pain and comorbid depression or anxiety has advanced, but larger trials with follow-up data are needed to improve confidence in effectiveness. Implications for considering developmental and familial factors in the screening and treatment of depression and anxiety in youths with chronic pain are discussed.

A Comparative Trial of Depot Pipothiazine

1986 ◽  
Vol 14 (2) ◽  
pp. 72-77 ◽  
Author(s):  
J Steinert ◽  
A Neder ◽  
E Erba ◽  
C R Pugh ◽  
C Robinson ◽  
...  
Keyword(s):  
Side Effects ◽  
Rating Scales ◽  
Rating Scale ◽  
Statistical Significance ◽  
Depression Scale ◽  
Psychotic Symptoms ◽  
Biochemical Tests ◽  
Psychiatric Rating ◽  
Psychiatric Rating Scale ◽  
Flupenthixol Decanoate

Thirty-nine chronic schizophrenic patients were selected for a 12-month double-blind evaluation of the effectiveness of pipothiazine palmitate (PPT) and flupenthixol decanoate (FPX) in the maintenance management of their illness. Allocation was at random and, in order to allow constant injection intervals, the patients typically received every 2 weeks either 40 mg of flupenthixol decanoate or alternating injections of 100 mg of pipothiazine palmitate and placebo. At monthly intervals the patients were assessed using both a battery of rating scales (which included the Brief Psychiatric Rating Scale (BPRS), the Extrapyramidal Symptoms Rating Scale (EPS)) and a general side-effects evaluation. At 3-monthly intervals they were also rated on the Comprehensive Psychiatric Rating Scale (CPRS) and the Zung Depression Scale. Haematological and biochemical tests were performed every 3 months. Both drugs provided good control of psychotic symptoms and side-effects were not troublesome. No substantial difference was detected on the CPRS and the Zung scales. There was a trend in favour of PPT on the BPRS survey, detectable at 6 months and reaching statistical significance by 12 months. We conclude that the PPT regime is at least as effective as the FPX treatment and probably more so. It is possible that even longer periods of control could be obtained with PPT.

Sensitivity and specificity of the Geriatric Anxiety Inventory and the Hospital Anxiety and Depression Scale in the detection of anxiety disorders in older people with chronic obstructive pulmonary disease

2011 ◽  
Vol 24 (1) ◽  
pp. 128-136 ◽  
Author(s):  
Gary Cheung ◽  
Colin Patrick ◽  
Glenda Sullivan ◽  
Manisha Cooray ◽  
Catherina L. Chang
Keyword(s):  
Anxiety Disorders ◽  
Older People ◽  
Rating Scales ◽  
Depression Scale ◽  
Anxiety And Depression ◽  
Chronic Obstructive ◽  
Hospital Anxiety ◽  
Obstructive Pulmonary Disease ◽  
Cut Points ◽  
Anxiety Subscale

ABSTRACTBackground: Anxiety and depression are prevalent in patients with chronic obstructive pulmonary disease (COPD). This study evaluates the sensitivity and specificity of two self-administered anxiety rating scales in older people with COPD. The Geriatric Anxiety Inventory (GAI) and the Hospital Anxiety and Depression Scale (HADS) are established useful screening tools but they have not been previously validated in this population.Methods: Older people with COPD completed the GAI and the HADS along with a structured diagnostic psychiatric interview, the Mini International Neuropsychiatric Interview (MINI). The outcomes of both rating scales were compared against the diagnosis of anxiety disorders based on the MINI. Receiver operating characteristic (ROC) curves were used to identify the optimal diagnostic cut points for each scale.Results: Fourteen (25.5%) of the 55 participants, were diagnosed with an anxiety disorder. Mean GAI and HADS-anxiety subscale scores were significantly higher in subjects with an anxiety disorder than those without the diagnosis (p = 0.002 and 0.005 respectively). Both scales demonstrated moderate diagnostic value (area under the ROC curve was 0.83 for GAI and 0.79 for HADS). Optimal cut points were ≥3 (GAI) and ≥4 (HADS-anxiety subscale). At these cut-points, the GAI had a sensitivity of 85.7%, specificity of 78.0% and the HADS had a sensitivity of 78.6%, specificity 70.7%.Conclusion: Our results support the use of the GAI and HADS as screening instruments for anxiety disorders in older people with COPD. The optimal cut points in this population were lower than previously recommended for both rating scales. The results of this study should be replicated before these cut points can be recommended for general use in older people with COPD.

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