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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Imipramine binding to platelet membranes from depressed patients was analyzed. The patients were divided into two groups: one with depression alone, another with depression and psychogenic pain. The depressed patients with psychogenic pain had lower imipramine binding than the depressed patients without pain.
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PMID:Imipramine binding in depressed patients with psychogenic pain. 216 48

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

Recent studies indicate the relevance of psychological factors in the pathogenesis of primary fibromyalgia, although the results sometimes differ. Most of the studies investigated personality features and depression. Beyond these our study investigates defense mechanisms and illness behavior in primary fibromyalgia comparing them with those of psychogenic pain patients and with controls. All patients (fibromyalgia n = 47, psychogenic pain n = 63, controls n = 84) completed German adaptations of the Defense Mechanisms Inventory (DMI) and the Illness Behavior Questionnaire (IBQ) and the "Questionnaire of Psychosomatic Disease-Patterns" (FAPK). The two chronic pain groups show a high conformity: Reduced relation to reality, emotional vacancy in relationships, aggression restraint are the predominant personality features. Immature defense mechanisms and abnormal illness behavior are predominant. Somatic pain and its hypochondrical pursuit substitute the tackling of seemingly unsolvable life problems. Conclusions for the management of fibromyalgia patients are outlined.
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PMID:[Personality markers, defense behavior and illness concept in patients with primary fibromyalgia]. 273 55

This study compared the psychosocial hypotheses generated by 12 internists and 12 family physicians as they reviewed three patient presentations with diagnoses of congestive heart failure, common duct stone, and sick sinus syndrome. Family physicians, compared to internists, produced a significantly higher proportion of psychosocial hypotheses on two of the three cases. Diagnoses considered more frequently by family physicians included anxiety, anxiety-depression, psychogenic pain, alcoholism, and other alcohol-related diseases. These results are consistent with the findings of previous studies reporting that family physicians attend to psychosocial problems to a greater degree than do internists.
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PMID:Family physicians' and internists' consideration of psychosocial hypotheses during the diagnostic process. 274 26

High-affinity binding of 3H-imipramine was analyzed in platelet membranes from patients with chronic psychogenic pain. The patients who in addition to the pain also showed affective symptoms such as depression and anxiety had lower binding than the pain patients without these symptoms.
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PMID:Platelet 3H-imipramine binding in psychogenic pain patients. 285 99

In this study 35 consecutive patients diagnosed as having psychalgic depressive disorder (PDD) who lacked sadness but presented with chronic pain have been described. The patients were mainly female, middle-aged and from an urban background. Pain, usually at multiple sites, was reported to be severe by most patients. Predominant depressive symptoms were lack of interest in surroundings (97%), although this was not directly reported, early morning awakening (91%), loss of appetite (100%), and suicidal ideas (66%). None had marked sadness or weeping spells. Lack of reactivity of mood was present in only 2 cases. These psychalgic depression cases were compared with a group of 30 patients diagnosed as having psychogenic pain disorder. PDD cases were significantly more often female, married, less educated, and from an urban background. Pain was significantly more intense and at multiple sites, as compared with the psychogenic pain disorder cases. Clinical outcome was better for PDD cases.
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PMID:Psychalgic depressive disorder: a descriptive and comparative study. 292 87

The conversion 'V' is a familiar MMPI pattern which is traditionally used as a clinical marker of psychogenic pain. The 'V' form is assumed to arise because conversion suppresses depression thereby lowering scores on scale D, and exacerbates physical sensations thereby increasing scores on Hs and Hy. An inverse relationship between scales Hs and Hy, and D is therefore expected. These assumptions were tested in 102 patients with low back pain and organic findings, and 93 patients with non-organic findings. The pattern of correlation among the three scales did not distinguish organic patients from non-organic patients in which conversion is assumed to account for pain. Scale D was not inversely related to scales Hs and Hy in the non-organic group as expected from theory. The findings do not support the use of the conversion 'V' as a clinical marker.
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PMID:The value of the MMPI conversion 'V' in the assessment of psychogenic pain. 315 88

Exploration of the relative roles of family dynamics and release of constrained, negative emotion in changing pain and depressive symptoms. Eighteen patients presenting mild to moderate depression and diagnoses of psychogenic pain disorder were randomly assigned to 1 of 2 treatment groups. One group was designed to facilitate the release of constrained and overcontrolled negative affect while the other was designed to provide information about pain and depression. Findings suggest that initial incongruity between patient's and significant other's ratings of family relationships retard changes in pain status and depressive symptoms. No significant differences were noted between patients who were taught to express negative feelings and those who were taught simply to understand those feelings. Results are discussed in terms of theories about family dynamics in the initiation and maintenance of pain conditions and in terms of the role of constrained affect as a precursor to both psychogenic pain and depression.
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PMID:Family dynamics and emotional expression among patients with chronic pain and depression. 334 Apr 23

The assessment of patients with chronic pain is receiving increasing attention by psychiatrists. Recent publications have put forward the concept of the "pain-prone disorder" as a variant of depressive illness. This study describes a series of 50 consecutive patients with chronic pain in terms of the five axes of the DSM-III nosology. Diagnoses were made after a 90- to 120-minute psychiatric interview, and a check on diagnostic reliability was made on a small subsample. Psychological factors affecting physical condition were diagnosed in 34% and dysthymic disorder was diagnosed in 28%, while major depression, psychogenic pain disorder, somatization disorder, and anxiety disorders were each respectively diagnosed in 8%. Only 6% had no diagnosis on axis I and 4% had no diagnosis on axis III. Personality disorder was diagnosed in 40%, and traits of dependence, compulsiveness, and anxiety were common. Overall, the patients had experienced a high degree of psychosocial stress with fair to poor adaptive functioning. The notion of chronic pain as a variant of depressive disease is questioned on the basis of these findings. The author suggests that although pain-proneness is a useful psychodynamic concept, the case for its establishment as a new psychobiological disorder is not proven. Furthermore, the concepts of pain-proneness, depression, and psychogenic pain have become confused. The author argues that the current classification is adequate to deal with the varieties of depression associated with chronic pain and that psychogenic pain disorder should be remerged with conversion disorder for the sake of clarity.
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PMID:DSM-III diagnoses in chronic pain. Confusion or clarity? 370 17

Patients with chronic, unexplained physical complaints are evaluated diagnostically in two steps in primary care: (1) brief consideration of three specific, but rare, disorders (somatic delusion, conversion, and malingering); and (2) extensive consideration of the remaining three common but overlapping disorders (somatization disorder, hypochondriasis, and psychogenic pain). Because of frequent confusion in differentiating among the common somatizing disorders and because the treatment is similar for all, the family physician can be content with the general designation of "common somatization syndrome" when unable to distinguish among them. This diagnosis can be easily established by a good history and physical examination. Psychiatric referral is required for the rare somatizing disorders. The primary physician can manage the majority of the common somatizing patients by observing the following principles: develop a good physician-patient relationship, apply techniques of behavior modification, engage the patient at the somatic level but extend it to include associated life stresses, strategically use symptomatic measures, treat depression with full doses of antidepressants, and accept the importance of ongoing contact with the patient irrespective of symptoms. When these therapeutic principles are employed, decreased morbidity, medical utilization, and cost can be expected to follow.
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PMID:A clinical approach to the somatizing patient. 390 Feb 69


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