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172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Fifty-nine chronic pain patients satisfying one of four previously identified pain group classifications were evaluated using the NEO Personality Inventory (NEO-PI), a standardized measure of normal adult personality structure. Minnesota Multiphasic Personality Inventory (MMPI) pain subgroups differed with respect to level of NEO-PI Neuroticism. In particular, emotionally overwhelmed pain patients as defined by multiple MMPI scale elevations had higher NEO-PI Neuroticism scores. Post hoc analyses revealed higher levels of depression, anxiety, vulnerability, and hostility in emotionally overwhelmed subjects. None of the remaining groups differed from each other on NEO-PI Neuroticism. Additionally, none of the other NEO-PI domains discriminated pain subgroups. NEO-PI profiles for pain patients (except for Neuroticism in emotionally overwhelmed patients) yielded t scores in the average range, suggesting that chronic pain patients present with a relatively normal underlying personality structure.
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PMID:Patterns of normal personality structure among chronic pain patients. 173 73

The present study examined the relationship between depression and a constellation of pain-related variables that describe the experience of chronic pain patients. Thirty-seven depressed and 32 non-depressed heterogeneous chronic pain patients were identified through structured interviews, use of standardized criteria and scores on the Beck Depression Inventory (BDI). The 2 groups were compared on demographic variables and scores on the Marlowe-Crowne Social Desirability scale (MC), as well as measures of disability and medication use, pain severity, interference due to pain and reported pain behaviors. The depressed group was found to be younger and to score lower on the MC than the non-depressed group. Multivariate analyses of covariance (MANCOVA), using age and MC as covariates, revealed that depressed chronic pain patients, relative to their non-depressed counterparts, reported greater pain intensity, greater interference due to pain and more pain behaviors. There were no group differences on the measures of disability and use of medications. The results provide further support for the importance of incorporating depression into clinical and theoretical formulations of chronic pain. Future use of structured interviews and standardized criteria for diagnosing depression may clarify some of the inconsistencies found in the literature.
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PMID:Depression and the chronic pain experience. 174 40

A differentiation between the normal sensation of tiredness and the symptom "fatigue" is often difficult. Both are influenced by cultural, social, psychological and biological factors, which can lead--interactively--to symptom formation. Psychiatric disorders frequently associated with fatigue are all forms of depression, somatization and anxiety disorders, chronic pain states and drug abuse among many others. In at least 2/3 of patients with the fashionable chronic fatigue syndrome--formerly called neurasthenia--a psychiatric diagnosis can be made, most of them also suffer from many symptoms attributes to the autonomous nervous system. The clinical approach should be cautious avoiding diagnostic and therapeutic overaction and therapy should emerge from a diagnosis properly assessed.
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PMID:[Intense fatigue in humans. Psychosocial and cultural aspects]. 175 73

Chronic pain is a problem among patients with spinal cord injuries, but the psychosocial factors associated with spinal cord injury (SCI) pain are not well understood. To understand SCI pain further, 54 patients (19 with quadriplegia and 35 with paraplegia) completed the Beck Depression Inventory, State-Trait Anxiety Inventory, Profile of Mood States, Acceptance of Disability Scale and SCI Interference Scale. Forty-two patients stated they had SCI pain and completed the Multidimensional Pain Inventory and the Pain Experience Scale. Results revealed that anger and negative cognitions were associated with greater pain severity. Patients who reported pain in response to a general prompt experienced more severe pain than patients who reported pain only when directly questioned about the presence of pain, but these different reporting groups did not differ on emotional variables. Those who were less accepting of their disability reported greater pain severity. Additionally, patients who perceived a significant other expressing punishing responses (e.g., expressing anger at the patients or ignoring the patients) to their pain behaviors reported more severe pain. Level of lesion, completeness of injury, surgical fusion and/or instrumentation and veteran status were not associated with pain severity. Finally, pain was associated with emotional distress over and above the distress associated with the SCI itself. Overall, psychosocial factors, not physiological factors, were most closely associated with the experience of pain. Multidimensional aspects of pain are used to explain these findings and suggest that treatment should be directed at the emotional and cognitive sequelae of chronic SCI pain.
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PMID:Psychosocial factors in chronic spinal cord injury pain. 781

The German version of the Beck Depression Inventory (BDI) was administered to 477 depressed in- and out-patients, 180 patients with chronic pain and 86 matched healthy control subjects. Earlier studies have applied the German BDI successfully, but only on students and other non-clinical samples. The clinical use of the BDI was found to have good internal consistency and validity. Cronbach's alpha reached 0.88, the average item-total correlation was 0.47. With one exception (weight loss), all items showed significant item-total correlation with the overall severity of depression. Correlations with other self-rating scales were 0.72 and 0.74 and with the Hamilton rating scale 0.34 and 0.37. A factor analysis showed a general factor as the most appropriate solution. Age, sex, and diagnostic subgroups (e.g. endogenous depression) had no significant influence on these results. A score of 18 and higher indicates depressive symptoms severe enough to require further clinical consideration. The BDI is also sensitive to changes in symptomatology over one week or one month, and can be used for pre-post comparisons in psychological and/or pharmacological interventions. Altogether, the German BDI proved to be a useful psychometric instrument for measuring the intensity of depressive symptoms in clinical samples.
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PMID:[The Beck Depression Inventory in clinical practice]. 177 Sep 69

It has been widely recognized that an appreciable proportion of chronic pain patients have depressive disorders. Although numerous studies and several literature reviews have examined the relationship between chronic pain and depression, disorders of mood come in many forms, and little attention has been paid to the different types of depressive disorders found among patients with chronic pain. In this article, the different ways in which a chronic pain patient may manifest depression are discussed. Diagnostic criteria for major depression, dysthymia, and atypical depression are described, and the relevance of these disorders and of masked depression to chronic pain is discussed. The medical illnesses and medications that can cause symptoms of depressive disorders are also briefly described. Depressive disorders and their concomitants are an integral part of the experience of chronic pain and are important in developing an optimal treatment plan. For these reasons, they should be carefully evaluated in all patients with chronic pain.
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PMID:Clinical aspects of depression in chronic pain patients. 180 23

There is a lack of information about the precise strength of the relationship between chronic pain and depression. In a prior study, women with temporomandibular pain and dysfunction syndrome (TMPDS) had much higher scores than did controls on a measure of nonspecific psychological distress. The question arose as to whether rates of clinical depression are also unusually high in TMPDS patients. Their former treating clinician rates cases for likely lifetime presence or absence of depression. A subset of those rated as likely depressed then had their diagnoses verified independently through a structured clinical interview by a psychiatrist and clinical psychologist. Results revealed a minimum lifetime prevalence rate for major depression of 41%. A rate of this magnitude in TMPDS cases is clearly much higher than would be found for women of similar background in the general population.
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PMID:Is major depression comorbid with temporomandibular pain and dysfunction syndrome? A pilot study. 180 30

This study examined the extent to which being involved in civil and industrial litigation predicted outcome in an population of chronic pain patients. Data were collected in a structured telephone interview for a litigant group of 80 patients and a nonlitigant group of 47 patients. There were no significant differences in the amount of medication used, the number of hours spent resting per day, or the number of individuals who were able to return to work. Litigants showed significantly higher levels of depression. Multiple regression analyses indicated that litigation was not the primary predictor of downtime or medication use. Litigation was found to be the primary predictor of Zung depression scores. Discriminant function analyses indicated that litigation was not the most important variable in distinguishing between those working and not working. Results lend support to previous studies that suggest that the suspicion and disbelief with which litigating patients are often treated is unfounded.
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PMID:The role of litigation in predicting disability outcomes in chronic pain patients. 180 43

In this study the effects of psychosocial factors on chronic pain recall were investigated. 61 female back pain patients first rated their pain intensity on visual analogue scales during a baseline period. At follow-up 18 mo. later the participants were asked to recall their pain. In addition, they completed a battery of questionnaires including such factors as current depression, pain, helplessness, activities of daily living, and psychosocial work environment, to assess whether these factors affect memory. The results indicated that about 70% of the participants "overestimated" their remembered pain. No significant relationships between recall accuracy and current depression, pain, activities of daily living, or sleep quality were found. However, moderate and significant correlations were found for helplessness and four psychosocial work environment items. These results replicate other reports showing poor memory for intensity of pain and underscore the possible importance of psychosocial work environment factors in memory for intensity of chronic pain.
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PMID:Memory for chronic pain intensity: correlates of accuracy. 183 85

A cross-sectional evaluation of 117 people who sustained acute back injuries was undertaken within 15 days of the first report of the pain. The subjects showed no discal or neural signs and had not experienced previous episodes of back or neck pain. All subjects were given a structured interview and filled in a series of psychological evaluation instruments. Results show acute pain reactions to be comparable to those seen in chronic pain groups. The predominant emotion is one of frustration rather than anxiety or depression and considerable behavioural disruption is evident from this early point. The extent to which these data undermine the model of gradual evolution of chronic back pain problems is discussed.
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PMID:Acute back pain: a psychological analysis. 183 35


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