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261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Patients with undiagnosable low back pain have been observed to differ from patients with proven low back pain in their clinical description of pain and in their psychological status. More variable and diffuse pain qualities are emphasized in their clinical reports and more psychological disturbance characterizes them as a group, suggesting an association between pain expression and psychological disturbance. One hundred and two patients with low back pain were administered a standardized pain questionnaire to determine more systematically the association between pain expression and psychological disturbance in patients with and without demonstrable organic disease. Patients with psychological disturbance differed significantly from patients without psychological disturbance in the following ways. They used more words in their description of pain, distributed these words over more pain factors, and endorsed significantly more pain of the affective and skin pressure variety. The results underscore previous clinical impressions and suggest that patients without either organic or psychological findings may be cases of undiagnosed organic disease.
Pain 1979 Oct
PMID:Psychological disturbance and pain report differences in both organic and non-organic low back pain patients. 16 May 21

The experience of low-back pain and its psychosocial associates were directly compared among sufferers drawn from three populations, a blue-collar working group, a white-collar working group, and a patient group. Sufferers drawn from the patient population revealed the expected psychological disturbance. There was no evidence of such involvement for sufferers still at work. Disability resulting from low-back pain was positively linearly related to severity of pain for sufferers drawn from working groups, irrespective of psychological disturbance. For patients, on the other hand, the presence of psychological disturbance modified the relationship between severity and disability such that no simple linear relationship existed between the two variables. Work dissatisfaction was not found to be related to the presence of, and did not account for disability resulting from, low-back pain in working subjects.
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PMID:Role of psychosocial risk factors in work-related low-back pain. 148 62

Associations between the frequency of medical visits and psychological disturbance were explored using chronic low back pain patients from a back education class. Psychometric measures included the illness Behaviour Questionnaire (IBQ), somatic problems, and current mood. Males and females responded similarly on all psychological measures. Pain duration and IBQ disease affirmation significantly predicted visits to both general practitioners and specialists. Additional predictors for specialist visits included a self-rated pain/mood association, sex, age, and IBQ denial. Patients' expectations and attitudes about illness and treatment appeared most central to medical visits and several different forms of psychological disturbance accompanied increased visits.
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PMID:Medical visits and psychological disturbance in chronic low back pain. A study of a back education class. 183 10

A comparative evaluation of eight psychometric instruments was made in 274 patients who were currently suffering or previously had suffered from low-back pain. The specificity and sensitivity values for detection of psychological disturbance were calculated and optimum cutoff scores determined for each test. The influence of current pain, social group, compensation, migrant status, and unemployment on the accuracy of each test were evaluated. The Pain Drawing, the Inappropriate Symptoms, the Inappropriate Signs, and the Illness Behavior Questionnaire were found to be least discriminating. The Modified Somatic Perception Questionnaire, the Hospital Anxiety Scale, the Hospital Depression Scale, and the Zung Depression Scale were the most accurate and least affected by the factors examined. The combination of the Modified Somatic Perception Questionnaire and the Zung Depression Scale yielded specificities and sensitivities of 91% and 84% for men and 96% and 85% for women, respectively. This combination is recommended for the assessment of psychological disturbance in patients with low-back pain.
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PMID:Comparison of eight psychometric instruments in unselected patients with back pain. 183 63

Fibromyalgia syndrome (FS) is a chronic pain disorder characterized by diffuse musculoskeletal soreness, stiffness, non-restorative sleep and psychological disturbance. At present, much about the etiology, pathological mechanisms and course of FS are unknown. Indeed, standardized diagnostic criteria have only been recently agreed upon. The present paper is the first of a two-part series which reviews the extant empirical literature concerning FS, with a view to arriving at an integrated understanding of the syndrome. The present paper describes the clinical presentation of FS and historical conceptualizations of the disorder. Available research on pathophysiological mechanisms in FS is then presented. In this section we have included literature concerning histology of muscle, sleep architecture, neurotransmitter anomalies and neuropeptide involvement in FS symptomatology.
Pain 1991 Jun
PMID:Toward an integrated understanding of fibromyalgia syndrome. I. Medical and pathophysiological aspects. 178 8

The present paper is the second of a 2-part series in which extant empirical literature concerning fibromyalgia syndrome (FS) is reviewed in order to provide a preliminary approach to forming an integrated understanding of the syndrome. Research on psychological disturbance in FS is reviewed with particular emphasis on affective dysfunction among FS patients. The phenomenology of FS is then described. We attempt to suggest that FS represents a quantitatively and qualitatively experience distinct from similar chronic pain syndromes. Substantive findings in FS research are summarized in the final section and potential ways in which these findings might be integrated to provide a more cohesive model for future research are suggested.
Pain 1991 Jun
PMID:Toward an integrated understanding of fibromyalgia syndrome. II. Psychological and phenomenological aspects. 187 33

The subjective complaints of 41 chronic low back pain sufferers attending a chiropractic clinic were assessed twice prior to therapy with a widely used psychological self-report assessment tool, the Middlesex Hospital Questionnaire (MHQ) and a newly developed VAS Disability Scales Questionnaire (DISQ), both of which investigate various aspects of certain basic positions and activities. Reliability was generally acceptable with these two questionnaires. Subjects participating in the study were commonly found to score within the normal range on the MHQ, indicating that psychological disturbance was not a major feature of their presentation. However, mild mood disturbance was commonly reported, and a more sensitive tool may need to be developed for this type of mildly affected chronic low back pain sufferers. The DISQ generally indicated subjects were mildly to moderately affected by their low back trouble and that sitting and leisure activities were the most pain provoking. Recommendations for further development of the disability scale are made.
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PMID:Chiropractic chronic low back pain sufferers and self-report assessment methods. Part II. A reliability study of the Middlesex Hospital Questionnaire and the VAS Disability Scales Questionnaire. 252 47

The influence of compensation on recovery from low-back pain was assessed in a retrospective controlled cohort study. One hundred fifty compensable and 150 noncompensable back injury patients were invited for review between 1 and 5 years from presentation. A 91.3% follow-up was achieved, and there was no difference in the median age, follow-up, and initial injury score between the two groups. The incidence of reported pain, disability, psychological disturbance, unemployment, and length of time off work was greater in the compensation group (P less than 0.001). Settlement of the claim did not result in any reduction in morbidity, even up to 5 years later. These results demonstrate that the payment of compensation delays recovery from low-back injury.
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PMID:The effects of compensation on recovery from low-back injury. 252 24

The Minnesota Multiphasic Personality Inventory (MMPI) was analyzed in 30 patients with fibromyalgia and 30 patients with rheumatoid arthritis (RA). Eighteen statements on the hypochondriasis, depression and hysteria scales and 14 statements on the schizophrenia scale differentiated patients with fibromyalgia and RA. Patients with fibromyalgia had higher scores on 29 of the 32 statements. Patients with RA seemed appropriately concerned about health and the possibility of additional illness. By contrast, patients with fibromyalgia were more symptomatic and presented a more unusual and complex syndrome, raising the possibility of a somatoform disorder and also greater personal distress in these patients. On the basis of analyzing the scores of patients with RA, one can also conclude that physical illness alone is not sufficient to drive MMPI profiles into the abnormal range. Patients with fibromyalgia who have a similar degree of pain intensity compared with patients with RA (61.3 vs 60 on a scale of 100) have significantly more abnormal MMPI, and analysis of their MMPI suggest a more complex somatic syndrome and greater psychological disturbance.
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PMID:Is the MMPI invalid for assessing psychological disturbance in pain related organic conditions? 274 92

The literature on fibrositis (fibromyalgia), which originated in the early years of the last century in the UK and proliferated there in the first half of this century, has since diminished there in the last 30 years or so, but has increased in Canada and the US. Criteria suggested for diagnosis have created a syndrome with no diagnostic tests, serological or radiological signs, and no truly objective physical signs, but with predictable tender spots on pressure. The syndrome is largely, but not completely, confined to females, mostly of middle age; the symptoms include widespread aching of more than 3 months' duration, disturbed sleep, morning fatigue and stiffness, a failure to respond satisfactorily to any one form of therapy and a tendency to persist over long periods, but without permanent tissue changes. Features of psychological disturbance are present in many patients but not in all or even the majority. Definition of the condition as a disorder of pain modulation - a pain amplification syndrome - would seem to fit the facts best. Most would agree that an abnormal response to stress is an important factor in the appearance of the syndrome, as other stress related disorders, such as the irritable bowel syndrome and tension headaches, may coexist. Response to therapy, whether physical or pharmacological, is on the whole unsatisfactory. This type of patient has been well recognised in hospital clinic and general practice for many years.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Fibrositis (fibromyalgia). A common non-entity? 328 15


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