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

Adolescents can be expected to inflict some pain on their environment periodically, and complete conformity of an adolescent is not necessarily a sign of mental health. With the exception of some particular behaviors such as a suicide attempt, auditory hallucinations, or a school phobia, one cannot make a prediction about the existence of, or seriousness of, a psychological problem of an adolescent based solely on the occurrence of any one particular antisocial act. Such typical adolescent problems such as stealing, truancy, sexual involvements, and drug use can be either a normal part of adolescent growth, the manifestation of a situational stress reaction, or the indication of a serious personality disturbance or identity crisis. Only by putting this behavior into the framework of an adolescent's age, social situation, general stress factors and developmental history can one attempt to reach a true evaluation of the seriousness of his behavior. To put it simply, one must try to understand the individual, rather than judging the behavior itself. The type of evaluation outlined here is often difficult and time consuming, but in terms of the long range help that it can be both to the teenager who is using his behavior as a means of asking for help and for the normal teenager who just needs to be told that he is not carzy, this is time and effort well spent.
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PMID:Evaluating the seriousness of adolescent adjustment reactions. 104 50

Although there is increasing awareness of the short-term psychological and social adaptations to childhood sexual abuse, little is known about the long-term effects of such abuse, particularly its effect on subsequent medical utilization and the experience and reporting of physical symptoms. We re-analyzed data from a previous study of 100 women scheduled for diagnostic laparoscopy (50 for chronic pain, 50 for tubal ligation or infertility evaluation) who received structured, physician-administered psychiatric and sexual abuse interviews. Women were regrouped by severity of childhood sexual abuse, and we compared the groups with respect to lifetime psychiatric diagnoses and medically unexplained symptom patterns. Unadjusted odds ratios showed that risk for lifetime diagnoses of major depression, panic disorder, phobia, somatization disorder and drug abuse, and current diagnoses of major depression and somatoform pain disorder were significantly higher in the severely abused group compared with women with no abuse or less severe abuse. Logistic regression analysis demonstrated that number of somatization symptoms, lifetime panic disorder and drug dependence were predictive of a prior history of severe childhood sexual abuse. Psychiatric disorders and medical symptoms, particularly chronic pelvic pain, are common in women with histories of severe childhood sexual abuse. Clinicians should inquire about childhood sexual and physical abuse experiences in patients with multiple medical and psychiatric symptoms, particularly patients with chronic pelvic pain.
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PMID:Medical and psychiatric symptoms in women with childhood sexual abuse. 145 59

The present investigation examined whether pain sensitivity is associated with dental avoidance. Whereas the aim of the first study was to determine whether pain sensitivity can be distinguished from dental fears and health concerns, the aim of the second study was to examine the structure of cognitive aspects of pain sensitivity, and the aim of the third study was to examine the relationships of pain sensitivity to anxiety sensitivity, fear, pain, and avoidance. In the first study (n = 222), a factor analysis performed with items from the Dental Phobia and Pain Sensitivity Inventory distinguished a pain sensitivity factor from factors relating to dental phobia and health concerns. The factor structure of the Pain Sensitivity Index was examined in the second study (n = 181), and similarly, a pain sensitivity factor was interpreted in the data. The third study (n = 65) found that although pain sensitivity correlated significantly with anxiety sensitivity, these constructs are not identical to each other. For instance, pain sensitivity but not anxiety sensitivity correlated significantly with blood-injury phobia. Pain sensitivity should be taken into account in future studies of dental phobia as pain sensitivity was found to be predictive of pain intensity, and pain intensity was found to be predictive of dental avoidance.
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PMID:Is pain sensitivity associated with dental avoidance? 154 Jan 16

Out of a sample of 2,000 patients, one group was identified whose fear of dental care presented all the characteristics of phobia. This phobia seems to be linked to the pain of previous dental care. Following our hypothesis, it would not be a pathological state, but rather a particular example of genetically programmed learning.
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PMID:[Dental care phobia: example of genetically-programmed learning?]. 175 97

Benzodiazepines have so many uses in cancer patients that the physician may target more than one advantage as he considers choice of drug and dose. Nausea, pain, and anxiety may be treated simultaneously. Since these patients are often taking a number of medications, the simplest regimen has the most benefit. These drugs treat reactive anxiety, insomnia, claustrophobia, and panic disorder. As they treat anticipatory anxiety and phobia, they mitigate anticipatory nausea and a component of post-treatment nausea. With chemotherapy itself, they cause sedation, suppress recall of treatment, limit vomiting, and are seen as desirable by patients. They suppress the restlessness associated with metoclopramide and other dopamine-antagonist antiemetics. The analgesic effects are best seen in conditions of high anxiety, muscle spasm, and deafferentation syndromes. The advantages of sedative and antipsychotic effects may be exploited to suppress the psychiatric complications of high-dose corticosteroids.
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PMID:Strategic use of benzodiazepines in cancer patients. 183 Oct 42

Any undue concern with bodily function is often labeled as hypochondriacal. Kellner's Illness Attitude Scales, self-rating instruments, distinguish between generic worry about illness, concern about pain, health habits, hypochondriacal beliefs, thanatophobia, disease phobia, and bodily preoccupations. The Illness Attitude Scales have been used in a number of studies concerned with patients suffering from DSM-III-R hypochondriasis, panic disorder, melancholia, in the medically ill, in pregnant women, during medical procedures such as mammography, and in experiments in therapeutics, such as drug trials. The results of these studies and of clinical investigations suggest that the differential diagnosis between hypochondriacal beliefs (characterized by resistance to reassurance), disease phobia, thanatophobia, and the other less specific illness attitudes, is worthy of clinical attention and may entail prognostic and therapeutic implications. Pilowsky's concept of abnormal illness behavior, unlike the DSM-III-R, provides a framework for such differentiation.
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PMID:Differential diagnosis of hypochondriacal fears and beliefs. 189 57

Hypnosis has been used as a therapeutic tool for centuries, but only in the past 50 years have the clinical applications been delineated. As evident in the medical literature, the use of hypnosis by the medical community has increased, partly as a result of a growing awareness of hypnotherapy as an available treatment modality, and also as a result of major improvements in research methodology through strict standardization. Hypnotherapy, once considered to be limited to entertainment, has now proven useful in the treatment of a wide variety of medical illness. Two cases of the use of hypnosis are presented. In the first case, hypnosis is used to alleviate pain in a gravid patient in sickle cell crisis. In the second case, hypnosis is used for desensitization of dental phobia in a 27-year-old women. The historical, theoretical, and clinical applications of hypnosis are reviewed.
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PMID:Clinical applications of hypnotherapy. 198 28

Dental anxiety and phobia afflict millions of people. Dental patients who are anxious anticipate pain and feel vulnerable and out of control. Hypnotherapy to alleviate dental anxiety and phobias has received clinical and empirical support. Our purpose in this paper is to provide a body of objective data from American Society of Clinical Hypnosis members regarding incidence rates and the relative importance of various etiological and conceptual issues in the development and maintenance of dental anxiety and treatment interventions. From these data, we constructed a model of etiology, maintenance, and treatment of dental anxiety.
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PMID:Etiology and treatment of dental anxiety and phobia. 222 Jun 53

Between 5 and 10% of patients attempting a magnetic resonance imaging (MRI) scan become claustrophobic during the procedure. There has been a paucity of reported research in this area. This study was designed to investigate MRI-related phobia and identify risk factors for claustrophobia development. There were 108 subjects who had never had a scan, 57 males and 51 females, ranging in age from 19 to 72 years (mean age of 43 years). Subjects were evaluated before and after the scan and contacted for 1-month follow-up. Major findings included the following: (1) prescan report of pain was significantly correlated with stopping the scan, (2) prescan Fear Survey Schedule scores correlated significantly with reported claustrophic feelings after the scan, and (3) stopping the scan correlated significantly with follow-up report of an increase in claustrophobic feelings. Conclusions were that prescan pain and fear assessment may help predict, and allow intervention in, phobic response during and after the MRI scan. Implications for referring physicians and MRI technicians are discussed.
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PMID:Magnetic resonance imaging scanning procedures: development of phobic response during scan and at one-month follow-up. 224 85

For 2 months we observed side-effects and indwelling times when using a subcutaneous catheter (Insuflon, Viggo AB, Sweden) for insulin injections. This method is used by approximately 600 children and adolescents with IDDM in Sweden today. 22 children and adolescents aged 4-19 years with a diabetes duration of 4.0 +/- 3.0 (mean +/- SD) years participated. Their HbA1c was 5.8 +/- 1.0%. All used 4-6 dosages of insulin per day. The catheter was placed subcutaneously in the abdominal wall, and replaced by parents when home tests showed increased blood or urine glucose, when the child experienced pain or when skin changes were observed. The 22 patients used 239 catheters with a mean time between changing catheters of 4.8 +/- 2.2 (range 0.5-17) days (= 1147 catheter days). Noted side effects were (% of catheter days): fixation problems, 5.6%; minor infection/irritation (= redness greater than 1 mm), 5.6%; pain, 2.8%; sore skin from plastic wings, 2.4%; itching/dry skin, 2.0%; eczema from band-aid, 1.7%; blocked catheter/injection needle, 1.6%; leakage of insulin, 1.3%, transient lipohypertrophies, 1.1%; hematoma/blood in catheter, 0.8%, and moist skin, 0.3%. No major infections requiring surgical or antibiotic treatment occurred. In conclusion, the use of indwelling insulin catheters seems to be a safe method to lessen the pain of insulin injections with a low frequency of side effects. The long-term metabolic control was not altered in this group of well-controlled children. We therefore find that we can recommend the use of indwelling catheters to children and adolescents who have difficulties with injections because of needle phobia or pain, particularly when using MIT.
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PMID:Side effects and indwelling times of subcutaneous catheters for insulin injections: a new device for injecting insulin with a minimum of pain in the treatment of insulin-dependent diabetes mellitus. 224 6


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