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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The pain adaptation rates of high- and low-emotional deficit schizophrenics were compared. Electrical stimulation pain thresholds were calculated and retaken at four intervals after administration of shocks in a learning task. Low scorers on the General Sensation-Seeking and Thrill/Adventure Seeking scales showed significantly less pain adaptation than did their high sensation-seeking counterparts. No differences in level of adaptation appeared between high and low scorers on the Anhedonia scale or three other sensation-seeking scales. The results suggested that the neurotic emotional deficit defined by the sensation-seeking scales may be mediated by inadequate adaptation to painful stimuli.
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PMID:Pain adaptation and emotional deficit. 87 May 43

In this paper, we have described a type of resistance that has attracted increasing psychoanalytic attention in recent years. Patients exposed to intense negativity during early life may develop an addiction to negative experience as adolescents and adults, and this may constitute a central organizing feature of their personality. In almost all patients, however, some moments of negativity may be observed. We have traced the developmental origins of an attachment to negativity, drawing especially on psychoanalytic investigations of preoedipal pathology. Manifestations and derivatives of early negativity include anhedonia, attachment to physical pain, fear of success, masochism, deprivation of self and others, and negative voyeurism. In discussing the dynamic functions of negativity, we place particular emphasis on two motives: the patient's desires for revenge against early objects that have been a source of deprivation and frustration; and the defensive function of negativity in helping to express as well as ward off dangerous wishes to merge with the object. Deviant forms of autoerotism are likely to be used by these patients to deal with the reactivation of early experiences of neglect and rejection. When negativity is used as a defense or method of relating to others it can lead to a severe disruption of the psychotherapeutic relationship. We have reviewed suggestions for the management of extreme negativity in treatment. Resolution of the therapist's countertransference reactions, especially induced feelings of frustration, rage, and helplessness, is crucial. Emphasis also has been placed on the patient's desires for revenge against self and object, and the manner in which these may be understood and eventually resolved. Only when patient and therapist begin to investigate the adaptive functions of extreme negativity can this pathological symptom be resolved and the patient's awareness of self and sense of autonomy be enhanced.
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PMID:The addiction to negativity. 176 49

In this paper, I have presented the assumption that some symptom pictures such as attachment to pain, the masochistic character, the negative therapeutic reaction, a basic depressive response, and anhedonia are rooted in a prevalence of organismic distress during the symbiotic phase. Neuroscientists taught us that early experiences are associated with the neuronal structuring of the developing brain, which then affects concurrent or subsequent reactions. In particular I followed Ginsburg's (1982) assumption of a neuronally, genetically given aggressive drive potential which influences and is influenced by early experiences, and which can interact with other gene potentials. In some patients aggressive drive components contributed to a less than harmonious basic core associated with failure of the early infant/mother interaction. Unpleasure prevailed during the symbiotic phase; aggressive energies predominated and enmeshed with the neuronal encoding, the early structuralization in both the neurophysiological and psychological meaning. Thus, the structuring of the function of internalization and the emerging self-object experience were disturbed from early on. This then continued to foster a proclivity for unstable (fusion and) diminished neutralization tendencies. As biological discharge phenomena evolve into vague psychological awareness, such an infant does not attain a sense of well-being, but rather attains a sense of "not-well-being" (Joffe and Sandler, 1965) which remains continuous or can be triggered--kindled--by any reactivating constellation, and the object is experienced as a source of unpleasure. This is in line with Mahler's bad mother and bad self-introjects. Primary narcissism has not evolved well or, said differently, is invested more with aggressive than with libidinal cathexis and is in an unfortunate association or balance with primary masochism. Aggressive drive components subsequently color fantasies, readiness for and severity of conflicts. The aggressivization of self-feelings and of the function of internalization with its influence on--and exacerbation of--the rapprochement crisis is traced into later symptomatology. The basic pathology as described in this paper then compounds the oedipally derived problems.
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PMID:Thoughts about early pathology. 402 27

The study purpose was to assess the value of laparoscopy in a small community hospital (Northeastern Ohio General Hospital) with 1 operator utilizing the procedure and to examine its complications, failures, and problems. 518 laparoscopies were performed over the August 1972 to November 1975 period. 93% of the procedures (484 patients) were for interval sterilization. 4% (18 patients) were for diagnostic purposes, and 3% (16 patients) were for infertility. The surgical technique utilized throughout most of the study was a single puncture method using the Jacobs-Palmer operating laparoscope. Study results are derived from analysis of 3 different factors. The 1st part of the study was carried out to collect the data on the population in general, and this was acquired from a review of the hospital charts. The 2nd segment was the 3 week and 6 week office follow-up reviews of the patients and their problems. The 3rd part was the longterm follow-up in which patients returned for routine gynecologic care. There were 5 failures of the procedure in this study, or 10/1000. There have been no cases of delayed postoperative bleeding. All bleeding that was identified was seen at the time of the surgery and managed at that point. There were no deaths in this series. The following side effects were found in longterm follow-up. This consisted of 376 patients. 3% (15 patients) had delayed menses after the surgery, which appeared to be associated with longterm use of oral contraceptives, 6% (30 patients) had amenorrhea for more than 75 days postoperatively. 22 patients (5.5%) had hypomenorrhea within the 1st 2 years postoperatively. 5% (25 patients) had a discharge from catgut suture while less than 1% had an umbilical difficulty or discharge from the Dexon suture. 18 patients (3.6%) of the population had postoperative dysuria within the 1st month. Delayed pain, dysmenorrhea, or dysparenuia within the 1st 2 years was detected in 2.5% (12) of the total population but could not be totally explained on a physiologic or anatomic basis. 7 patients (1.2%) had sexual anhedonia. There were 3 hysterectomies carried out subsequent to laparoscopic sterilization. The report of the Complications Committee of the American Association of Gynecologic Laparoscopists is reviewed. In this series the major difficulties or complications encountered in laparoscopy have not been observed. This is due in part to the training of the individual operator but also to a team effort at this hospital.
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PMID:Laparoscopy: a retrospective study with two or more years follow-up of patients in a small community hospital. 621 Jun 47

Levels of depression, anhedonia, and illness behavior, as well as clinical and demographic variables, were measured in two groups of patients with chronic pain, one with facial, the other with back pain. For the total sample, significant correlations (p less than 0.01) were found between illness behavior and pain estimate (r = 0.30), anhedonia and depression (r = 0.33), and pain estimate and pain duration (r = 0.31). Facial pain patients showed illness behavior most strongly related to estimate of pain severity (r = 0.62); back pain patients showed illness behavior significantly related to depression (r = 0.59). Results also show that the physical site of pain relates to illness behavior but not mood of chronic pain patients.
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PMID:Illness behavior, depression and anhedonia in myofascial face and back pain patients. 622 Apr 21

The scarce or absent analgesic effect exhibited by morphine on pain from migraine attack and the poor inhibition of the spasmogenic effect of 5-HT (tested on the hand dorsal vein, computerized venotest) suggest the hypothesis of an opioid receptor deficiency in headache sufferers. Since endogenous opioids control the nociception, the sense of well being, and the vegetative balance, an opioid receptoral hypofunction could be the background of the headache and central panalgia, where the trinity pain, anhedonia, and dysautonomia are the characteristic features.
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PMID:Opioid receptor impairment--underlying mechanism in "pain diseases"? 628 33

Beta-endorphin (RIA method, previous chromatographic extraction) was evaluated in plasma of migraine sufferers in free periods and during attacks. Decreased levels of the endogenous opioid peptide were found in plasma sampled during the attacks but not in free periods. Even chronic headache sufferers exhibited significantly lowered levels of beta-endorphin, when compared with control subjects with a negative personal and family history of head pains. The mechanism of the hypoendorphinaemia is unknown: lowered levels of the neuropeptide, which controls nociception, vegetative functions and hedonia, could be important in a syndrome such as migraine, characterized by pain, dysautonomia and anhedonia. The impairment of monoaminergic synapses ("empty neuron" condition) constantly present in sufferers from serious headaches, could be due to the fact that opioid neuropeptides, because of a receptoral or metabolic impairment, poorly modulate the respective monoaminergic neurons, resulting in imbalance of synaptic neurotransmission.
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PMID:Intermittent hypoendorphinaemia in migraine attack. 629 72

Depression, anhedonia, state anxiety (A-state), trait anxiety (A-trait), and self-reported pain estimate were measured in almost 500 facial pain patients. These patients were divided into 3 diagnostic categories: myofacial pain dysfunction syndrome (MPD) [18], arthritis of the temporomandibular joints (TMJ arthritis), and trigeminal neuralgia. Three control groups were measured for comparison. They consisted of an normal, or non-patient group, a group of arthritis patients, and a group of movement disorder patients attending a neurology clinic. Among the facial pain patients and the normal controls few differences were found with regard to anhedonia and depression, The arthritis and neurology patients produced significantly higher depression and anhedonia scores than did several of the facial pain groups. Pain estimate ranged from 0 for control, to a mean of 67.6 +/- 31.3 for the trigeminal neuralgia patients with the MPD (means = 56.2 +/- 32.5) and the TMJ arthritis patients (means = 46.7 +/- 30.8) somewhat lower. Clinical variables such as duration of pain, help seeking behavior and total number of symptoms were correlated with depression but not with anhedonia scores, It is hypothesized that anhedonia is a measure separate from depression and may be more closely linked to suffering behavior that to pain behavior. Psychological variables did not discriminate among facial pain patients and in particular did not distinguish between so-called functional and organic illness.
Pain 1981 Aug
PMID:Depression, anhedonia and anxiety in temporomandibular joint and other facial pain syndromes. 730 2

This prospective cohort study was designed to test whether a distinct fatigue syndrome existed after the onset of glandular fever. Two hundred and fifty primary care patients, with either glandular fever or an ordinary upper respiratory tract infection (URTI) were interviewed three times in the 6 months after the clinical onset of their infection. At each interview a standardized psychiatric interview was given and physical symptoms were assessed. There were 108 subjects with and Epstein-Barr virus (EBV) infection; 83 subjects had glandular fever not caused by EBV and 54 subjects had an ordinary URTI. Five subjects were excluded because they had no evidence of an infection. Principal components analyses of symptoms supported the existence of a fatigue syndrome, particularly in the two glandular fever groups. The addition of symptoms not elicited by the standard interviews gave the full syndrome. This included physical and mental fatigue, excessive sleep, psychomotor retardation, poor concentration, anhedonia, irritability, social withdrawal, emotional lability, and transient sore throat and neck gland swelling with pain. A fatigue syndrome probably exists after glandular fever.
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PMID:The existence of a fatigue syndrome after glandular fever. 858 9

The authors interviewed a consecutive series of medical inpatients (N = 241) using the Schedule for Affective Disorders and Schizophrenia to determine which depressive symptoms are associated with in-hospital mortality. Fifteen depressive symptoms, pain, and physical discomfort were assessed along with medical comorbidity. Twenty patients died in-hospital (8.3%). Logistic regression showed that anhedonia, hopelessness, worthlessness, indecisiveness, and insomnia predicted in-hospital death after adjusting for physical comorbidity and age. Clinicians should be aware that these depressive symptoms may predict mortality in medical inpatients. Future studies should address which treatment modalities lead to better outcomes.
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PMID:Association between depressive symptoms and mortality in medical inpatients. 1101 29


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