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

Hypnosis can be a useful adjunct to other treatment modalities. For example, hypnosis may induce a level of relaxation that allows patients to cooperate more easily with conventional treatment. The often dramatic historical background of hypnosis has led to misconceptions about hypnotic technique and its clinical applications in modern medicine. Hypnosis is useful in the treatment of acute and chronic pain, somatoform and habit disorders, anxiety and depression. Persons who are attempting to stop smoking, patients with bulimia and those with psychogenic impotence may respond to hypnosis.
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PMID:Hypnosis in family medicine. 223 52

A three-process model of chronic pain comprising tissue damage, anxiety, and depression is hypothesized. Within this model, the effectiveness of flurbiprofen (for analgesia) plus either alprazolam (for anxiety and depression) or placebo was evaluated in a randomized, double-blind trial with a single crossover. Flurbiprofen was found to have a significant analgesic effect but this was not enhanced by combining it with alprazolam.
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PMID:Comparison of flurbiprofen and alprazolam in the management of chronic pain syndrome. 224 77

The present study examined the relationship between psychological factors and pain in order to assess the contribution of emotional disturbance to the perpetuation of pain. A group of 163 chronic pain suffers in multiple settings was compared with 81 control subjects on measures of personal history antecedent to pain onset, as well as on measures of current emotional disturbance. In addition, these psychological variables were examined for their associations with subjectively rated pain intensity. Overall, pain was found to be related to more current depression and less current life satisfaction, but was not associated with most of the personal history variables examined. These results suggests that emotional disturbance in pain patients is more likely to be a consequence than a cause of chronic pain. The dangers of routinely ascribing intractable pain to psychological causation are discussed in the light of these findings.
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PMID:Is emotional disturbance a precipitator or a consequence of chronic pain? 224 16

Psychiatric disorder is reported to occur in a large proportion of patients with irritable bowel syndrome (IBS) and psychological treatment methods have been advocated for this patient group. In a sample of 25 out-patients with intractable IBS, only four patients with psychiatric disorder were identified. The majority did not have elevated levels of anxiety or depression nor was there evidence of significant abnormal illness behaviour. Electrodermal activity did not show the extremes of responding and habituation associated with anxiety, depression or chronic pain. It is suggested that, when accurate diagnostic criteria are employed, a specific relationship between IBS and psychopathology is no longer evident.
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PMID:Psychological and psychophysiological characteristics in irritable bowel syndrome. 225 52

Two groups of patients with psychogenic pain syndromes were compared: in one group, pain was the sole major clinical complaint; in the other symptoms of depression also presented in addition to the pain. In both groups, the patient considers himself to be physically ill, despite the absence of organic findings. On the basis of the clinical examples, the psychodynamics of chronic pain is discussed with respect to primary and secondary epinosic gain, conscious and unconscious processes involving personal loss, proffered offences, desires and affects. In the absence of depressive symptoms, the psychological organization of pain can be understood as a substitution. Such a situation leads to a "stabilization" of the symptom and more prolonged chronicity than when depression presents at the same time, since in these patients, referral for psychotherapy is delayed.
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PMID:[Depressive symptoms in psychosomatic pain syndromes]. 226 92

Chronic pain and depression frequently occur together. A selection bias afflicts all hospital clinic and family practice populations in which this relationship has been examined. We report here some of the results from civilian populations outside institutions, examined in the United States in national surveys. The findings are based upon the recollection of individuals with respect to the period of 12 months prior to interview and upon the occurrence of depression in the previous week as indicated by the answers to the Depression Scale of the Centre for Epidemiologic Studies (CES-D). They indicate that 14.4% of the United States population between the ages of 25-74 suffer from definite chronic pain related to the joints and musculoskeletal system. Another 7.4% have some pain of uncertain duration. Eighty-three percent of the definite pain group received treatment. Chronic pain subjects scored significantly higher than normals on the CES-D (10.68 +/- S.E.M. 0.76 vs. 8.05 +/- 0.23, P less than 0.01) with subjects with pain of uncertain duration scoring similar to the definite chronic pain population (11.13 +/- 0.76). Using a high cut-off score for depression. 18% of the population with chronic pain were found to have depression. This is in contrast to 8% of the population who did not have chronic pain.
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PMID:Chronic musculoskeletal pain and depressive symptoms in the general population. An analysis of the 1st National Health and Nutrition Examination Survey data. 229 41

This article describes the development of the Checklist for Interpersonal Pain Behavior (CHIP), an observation scale which assesses overt pain behavior. The study is an extension of an earlier study in which the dimensions and components of observed chronic pain behavior were examined. A broad definition of pain behavior is chosen (interpersonal pain behavior), namely the interaction between the pain patient and his/her direct environment. The list of pain behaviors, taken from the earlier study, has been transformed into a 78-item global rating scale to be used by nurses to quantify observed pain behavior in a clinical setting. Six studies examine the factor structure and the psychometric properties of this behavioral observation method. In the first study, 6 internally reliable factors are derived using factor analytic techniques from a sample of 152 chronic pain patients. They are labeled as: 'distorted mobility,' 'verbal complaints,' 'non-verbal complaints,' 'nervousness,' 'depression' and 'day sleeping.' Internal consistency of all factors, except 'day sleeping' was excellent. The following studies show that the CHIP is sufficiently reliable and valid. After a discussion on the advantages of this observation scale, the conclusion seems justified that the CHIP is a useful tool in pain assessment that can easily be used by nurses.
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PMID:Assessment of the components of observed chronic pain behavior: the Checklist for Interpersonal Pain Behavior (CHIP). 229 44

There is a long standing position that pain, and especially chronic pain, may arise from psychological mechanisms of defence. We have compared a group of chronic pain patients with a sample of psychiatric patients attending for reasons other than pain. The pain group had less evidence of poor care in childhood (measured by the Parental Bonding Instrument) and tended to use more mature psychological defence mechanisms (assessed with the Defense Mechanisms Inventory), compared with the other group. The pain group also had fewer current psychiatric diagnoses but more evidence of anxiety and depression on the Hospital Anxiety and Depression Scale. We conclude that in general the patients with chronic pain had more normal childhoods and more mature defences than the psychiatric control group. They showed an increase in the diagnosis of depression, attributable to reactive factors. In the sample of patients with pain the majority of the psychological change cannot be attributed to the operation of primitive psychological defences.
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PMID:Psychological defence mechanisms in patients with pain. 230 62

To explore Ward and colleagues' 1982 hypothesis of a biochemical link between depression and pain mediated by the paleospinothalamic tract (PSTT), the author retrospectively examined a series of questionnaires completed by 113 chronic pain patients. The measures included the Beck Depression Inventory, the Minnesota Multiphasic Personality Inventory, the Millon Behavioral Health Inventory, and a background questionnaire assessing demographic and pain variables that included portions of the McGill Pain Questionnaire (MPQ). Adjectives on the sensory scale of the MPQ were divided into two groups: those descriptive of pain mediated by the PSTT and those descriptive of pain mediated by the neospinothalamic tract (NSTT). To facilitate analysis of the data, two median splits were performed on the basis of PSTT and NSTT adjective scores to create four groups. Group differences were then examined by way of multivariate analysis of variance and chi-square. As hypothesized, psychologic distress was found to be related to the use of PSTT sensory adjectives but not to the use of NSTT sensory adjectives. The findings may be supportive of Ward et al.
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PMID:Depression and the mediation of chronic pain. 234 62

There is considerable controversy in the literature regarding the extent to which chronic pain and depression are associated and the possible causal relationship of such an association. The present study examines these issues with a sample of 243 patients diagnosed with rheumatoid arthritis (RA) who were mailed questionnaires for six waves of data collection. The results indicated that RA patients experience higher levels of depressive symptomatology than community samples. Using a two-latent-variable, cross-lagged design, covariance structural modeling was conducted on self-report measures of pain and depression over 6-month intervals. Results most strongly supported a causal model in which pain predicts depression during the last 12 months of the study.
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PMID:A causal analysis of chronic pain and depression. 234 6


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