Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts: Gene/Protein Disease Symptom Drug Enzyme Compound   Target Concepts: Gene/Protein Disease Symptom Drug Enzyme Compound

---

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

Persistent pain is often accompanied by functional disability. This study investigated the effect of pain extent and the involvement of specific pain sites on pain-related disability, as determined by the Pain Disability Index (PDI). Complete data were available from 278 persistent facial pain (PFP) patients. Patients were divided into one of two groups based on drawings of their pain distribution. When the patient's pain drawing was limited to the region supplied by the trigeminal nerves (Nn. V(1) V(2), and/or V(3)), with or without the inclusion of any combination of the cervical dermatomes C2, C3 and C4, the patient was assigned to the local/regional pain group. If the pain extended beyond this area, the patient was allocated to the group exhibiting widespread pain. In addition to the PDI, patients filled out the Beck Depression Inventory (BDI) and the State-Trait Anxiety Inventory (STAI). The local/regional pain group had significantly lower scores on the PDI, the BDI and STAI state than cases with widespread pain. Patients with widespread pain who indicated pain locations in any one or more of the extremities plus the lower back scored significantly higher on the PDI and the BDI than patients with no such combined involvement. Multiple regression analysis revealed that depressive preoccupation, pain extent and pain intensity were significant predictors of pain-related disability, whereas the STAI was not. If controlled for pain extent and pain intensity, the presence of high as opposed to low depressive scores added almost 11 points to the PDI score. These results showed that pain distribution, pain intensity and depressive mood are significant predictors of pain-related disability.
...
PMID:Greater disability with increased pain involvement, pain intensity and depressive preoccupation. 1510 92

Evaluation of the prevalence and characteristics of tinnitus in a Brazilian series of sleep bruxism patients. In this descriptive study, 100 patients (80 women and 20 men) were selected through the self-report of grinding teeth during sleep, confirmed by room mate or family member. They were evaluated according to a systematized approach: a questionnaire for orofacial pain and the Portuguese version of the Research Diagnostic Criteria for Temporomandibular Disorders. The patients were divided into two groups: group A, 54 patients with complaint of tinnitus and group B, 46 patients without tinnitus complaint. The mean age was 37.85 (13-66 years) and 34.02 years (20-59 years), respectively, for groups A and B (P = 0.1164). There was statistically significant difference between the two groups, with higher prevalence for the group A, in relation to: presence of chronic facial pain (P = 0.0007); number of areas painful to palpation in the masticatory and cervical muscles (P = 0.0032); myofascial pain in the masticatory muscles (P = 0.0003); absence of teeth without prosthetic replacement (P = 0.0145) and indices of depression (P = 0.0234). Structural alterations of the TMJ, like disc displacement and vertical dimension loss did not differ for the two groups. Tinnitus frequency was higher in patients with sleep bruxism and chronic facial pain. Myofascial pain, number of areas painful to palpation in the masticatory and cervical muscles, higher levels of depression and tooth absence without prosthetic replacement were more frequent in the group with tinnitus.
...
PMID:Clinical evaluation of tinnitus in patients with sleep bruxism: prevalence and characteristics. 1620 44

In 14 patients with unilateral persistent idiopathic facial pain (PIFP), classified according to the criteria of the International Headache Society, and 16 age-matched control subjects sensory functions were examined on the face by quantitative sensory testing (QST). Additionally, the somatotopy of the primary somatosensory cortex (SI) to tactile input from the pain area was evaluated by means of magnetoencephalography. Previously reported abnormalities in PIFP as a dishabituation of the R2 component of the blink reflex and psychiatric disturbances were co-evaluated. Psychiatric evaluation included a Structured Clinical Interview for axis-I DSM IV disorders (SCID-I) and employment of the SCL-90-R and a depression scale (ADS). Thresholds to touch, pin prick, warm, cold, heat and pressure pain as well as the pain ratings to single and repetitive (perceptual wind up) painful pin prick stimuli did not indicate a significant sensory deficit or hyperactivity in the pain area when compared with the asymptomatic side nor when compared with the values of healthy control subjects. QST results were not significantly altered in patients (n=4) that showed an abnormal dishabituation of the R2 component of the blink reflex. The interhemispheric difference in distance between the cortical representation of the lip and the index finger did not differ between patients and control subjects. Psychiatric evaluation did not disclose significant abnormalities at a group level. It is concluded that PIFP is maintained by mechanisms which do not involve somatosensory processing of stimuli from the pain area.
...
PMID:Persistent idiopathic facial pain exists independent of somatosensory input from the painful region: findings from quantitative sensory functions and somatotopy of the primary somatosensory cortex. 1620 26

Temporomandibular disorder (TMD) pain, abdominal pain, migraine and tension-type headache are more prevalent in women than in men. This study assessed the relationship of back pain, headache, abdominal pain, TMD pain, and the presence of multiple pain conditions to gender and pubertal development in a cross-sectional, population-based survey of adolescents. We also examined the association between pubertal development and depressive and somatic symptoms, factors often associated with pain in adults. We hypothesized that prevalence of all pain conditions, as well as rates of other symptoms, would increase as puberty progresses in females, but not males. Subjects (3,101 boys and girls, 11-17 years old, selected from an HMO population) reported on the presence of each pain condition in the prior 3 months and completed scales assessing pubertal development, and depressive and somatic symptoms. Data were analyzed using descriptive statistics and multivariate logistic regression. Prevalence rates were weighted for factors affecting response. Prevalence of back pain, headache and TMD pain increased significantly (odds ratios, OR=1.4-2.0, P<0.001) and stomach pain increased marginally with increasing pubertal development in girls. Rates of somatization, depression and probability of experiencing multiple pains also increased with pubertal development in girls (P<0.0001). For boys, prevalence of back (OR=1.9, P<0.0001) and facial pain (OR=1.5, P<0.01) increased, stomach pain decreased somewhat and headache prevalence was virtually unchanged with increasing maturity. For both sexes, pubertal development was a better predictor of pain than was age. Thus it appears that pain, other somatic symptoms and depression increase systematically with pubertal development in girls.
...
PMID:Relationship of pain and symptoms to pubertal development in adolescents. 1621 87

Somatic symptoms are common in primary care and clinicians often prescribe antidepressants as adjunctive therapy. There are many possible reasons why this may work, including treating comorbid depression or anxiety, inhibition of ascending pain pathways, inhibition of prefrontal cortical areas that are responsible for "attention" to noxious stimuli, and the direct effects of the medications on the syndrome. There are good theoretical reasons why antidepressants with balanced norepinephrine and serotonin effects may be more effective than those that act predominantly on one pathway, though head-to-head comparisons are lacking. For the 11 painful syndromes review in this article, cognitive-behavioral therapy is most consistently demonstrated to be effective, with various antidepressants having more or less randomized controlled data supporting or refuting effectiveness. This article reviews the randomized controlled trial data for the use of antidepressant and cognitive-behavior therapy for 11 somatic syndromes: irritable bowel syndrome, chronic back pain, headache, fibromyalgia, chronic fatigue syndrome, tinnitus, menopausal symptoms, chronic facial pain, noncardiac chest pain, interstitial cystitis, and chronic pelvic pain. For some syndromes, the data for or against treatment effectiveness is relatively robust, for many, however, the data, one way or the other is scanty.
...
PMID:Antidepressants and cognitive-behavioral therapy for symptom syndromes. 1657 78

Temporomandibular disorders (TMD) comprise the most common cause of chronic facial pain conditions, and they are often associated with somatic and psychological complaints including fatigue, sleep disturbances, anxiety, and depression. For many health professionals, the subjectivity of pain experience is frequently neglected even when the clinic does not find any plausible biologic explanation for the pain. This strictly biomedical vision of pain cannot be justified scientifically. The purpose of this study is to demonstrate, by original articles from the literature and recent studies conducted in our own laboratory, the biological processes by which psychological stress can be translated into the sensation of pain and contribute to the development of TMD. The role of the hypothalamic-pituitary-adrenal axis, the serotoninergic and opioid systems in the pathogenesis of facial pain is exposed, including possible future therapeutic approaches. It is hoped that knowledge from apparently disparate fields of dentistry, integrated into a multidisciplinary clinical approach to TMD, will improve diagnosis and treatment for this condition through a clinical practice supported by scientific knowledge.
...
PMID:How may stressful experiences contribute to the development of temporomandibular disorders? 1692 58

Amitriptyline is a tricyclic antidepressant that is historically indicated and used to manage depression. More recently, due to clinical evidence demonstrating efficacy, it is often prescribed in the management of painful neuropathic disorders (PNDs). However, the amitriptyline label contains numerous preclusions (contraindications, warnings/precautions, drug interactions). Our objective was to measure the frequency of amitriptyline prescriptions in PND patients using the U.K. General Practice Research Database and assess whether any prescriptions were given to patients with preclusions listed in the product label. We identified a total of 13,546 patients (mean age 59 +/- 16.2 years; 66.7% female) who had a diagnosis of a PND and received > or =1 prescription for amitriptyline between July 1998 and June 2001. Nearly half (46.7%) of PND patients prescribed amitriptyline had > or =1 preclusion for its use; 3.5% had > or =1 contraindication; 22% had > or =1 warning/precaution; and 33% received > or =1 medication with a potential for drug interactions with amitriptyline. Preclusions were more likely in women than in men (48.3% vs. 43.4%, P < 0.0001); their incidence increased with age (42.8%, 50.4%, 55.1%, and 52.3% among those ages <65, 65-74, 75-84, and 85+ years, P < 0.0001), and the number of patients with preclusions was the highest in the phantom limb pain group (67.4%) and lowest in the atypical facial pain group (42.9%), P < 0.001. The average daily amitriptyline doses (starting: 33.6 +/- 32.4 mg; maintenance: 42.1 +/- 39.9 mg) were low compared to those used for the treatment of depression. Results indicate that, in a significant number of cases, the existence of preclusions did not prevent the prescribing of amitriptyline. Our findings raise a potential concern about the way this medication is being used. However, the clinical significance of these data is, as yet, unclear. Although, in theory, adverse outcomes may have been associated with this practice, we could not confirm this with this database analysis.
...
PMID:Prevalence of contraindicated medical conditions and use of precluded medications in patients with painful neuropathic disorders prescribed amitriptyline. 1712 7

Trigeminal neuralgia (TN) is an uncommon neuropathic condition associated with excruciating facial pain. It is important to determine the effect of TN pain on patient functioning and to characterize relevant pharmacologic treatment patterns and health resource utilization in general practice. Eighty-two patients with TN were identified in a general practice setting during an observational survey of broad neuropathic pain syndromes in six European countries. Patients answered a questionnaire that included pain severity and interference items from the modified Short Form Brief Pain Inventory (mBPI-SF), the EuroQol Survey of functioning and well-being (EQ-5D), and questions related to current treatment, health status, and resource utilization. Physicians provided information on medications prescribed for TN pain and pain-related comorbidities (anxiety, depression, and sleep disturbance). The mean patient age was 62.7 +/- 15.8 years, 46% were > or =65 years, and 66% of patients had TN >1 year of duration. The mean Pain Severity Index was 4.2 (range 0-10), reflecting moderate pain despite 94% of patients taking prescription medications for their TN pain. Prescription medications included carbamazepine (mean daily dose 534.1 +/- 269.8 mg), the recommended first-line pharmacologic therapy for TN. Pain severity was significantly associated with reduced EQ-5D health state valuation (P < 0.001) and greater pain interference (mBPI-SF) (P < 0.001). These findings demonstrate that TN pain presents a substantial patient burden expressed as interference with daily functioning and reduced health status associated with pain severity. This burden may result from both suboptimal management strategies and the frequent resistance of this neuropathic condition to treatment, and suggests a need for more effective pain management strategies.
...
PMID:Patient burden of trigeminal neuralgia: results from a cross-sectional survey of health state impairment and treatment patterns in six European countries. 1714 91

To evaluate in patients with different types of facial pain the association between muscle tenderness and a set of characteristics, 649 consecutive outpatients with facial myogenous pain (MP), TMJ disorder, neuropathic pain (NP) and facial pain disorder (FPD) (DSM-IV) were enrolled. For each patient a psychological assessment on the Axis 1 of the DSM-IV and standardized palpation of pericranial and cervical muscles were carried out. A pericranial muscle tenderness score (PTS), a cervical muscle tenderness score (CTS) and a cumulative tenderness score (CUM, range 0-6) were calculated. Univariate analyses (one-way analysis of variance or chi(2) test) indicated that both age- and sex-distribution, tenderness scores and prevalence of psychiatric disorders markedly differed between groups. The prevalence of depression was highest in FPD patients (44.9%). Both muscle tenderness scores (either PTS or CTS) and prevalence of anxiety were higher in patients with MP than in those with TMJ or NP. To assess associations between CUM score and patients' demographic and clinical characteristics an ordered logit model was fit and interactions between psychiatric disorders and diagnostic groups were tested. The analysis showed that, regardless of the diagnostic group, anxiety and depression independently increase the likelihood of having one point higher muscle tenderness score (OR=1.55, 95% CI: 1.13-2.12 and OR=1.56, 95% CI: 1.10-2.21, respectively). A careful screening for the presence of an underlying psychiatric disorder, either anxiety or depression, should be part of the clinical evaluation in patients suffering from facial pain.
...
PMID:Muscle tenderness in different types of facial pain and its relation to anxiety and depression: A cross-sectional study on 649 patients. 1725 97

Chronic pain is common in the elderly, but it is often under-estimated and under-treated. The aim of this study was to evaluate the prevalence and characteristics of chronic pain in nursing home residents and to analyze its influence on patient's QoL and functional status. We studied 105 patients (mean age 82.2+/-9 years), living in two nursing homes in Torino, Italy. The McGill Pain Questionnaire (MGPQ), the Visual Analogical Scale (VAS) and the Face Pain Scale (FPS) were used to test pain. Depression, functional and cognitive status were also evaluated by using specific instruments, such as the Geriatric Depression Scale (GDS), Instrumental Activities of Daily Living (IADL), Activities of Daily Living (ADL) and the Mini-Mental State Examination (MMSE). Pharmacological and non-pharmacological treatments were documented. It was found that chronic pain was present in 82.9% of the sample; it lasted over 24 months and it was persistent in half of them (49.4%). We observed that chronic pain in the elderly has a strong affective component and its intensity influences older patients' mood, nutrition, sleep and QoL. Our study showed that chronic pain was under-treated. We conclude that chronic pain in institutionalized elderly is common and worsens patients' QoL. It is important to assess and manage pain as a relevant problem in particular for the population at increased risk for under-recognition and under-treatment.
...
PMID:Chronic pain in a sample of nursing home residents: prevalence, characteristics, influence on quality of life (QoL). 1800 88


<< Previous 1 2 3 4 5 6 7 8 9 Next >>

---