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

A pain may seem to resist all kinds of therapy without necessarily being absolutely refractory to treatment. The factors are discussed which may contribute to the "refractoriness" of a pain to therapy in the area of pain due to carcinoma, i.e. lack of understanding of modern pain concepts, inability to diagnose pain as due to conversion, failure to recognize the influence of the affects anxiety, hopelessness etc. on pain intensity, administration of analgesics in situations where another form of therapy would be indicated, e.g. plexus blockade, and insufficient knowledge of the effects, side effects, dosage and timing of the administration of mild analgesics, neuroleptics, antidepressives and narcotics.
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PMID:[Therapy resisting pains. Drug therapy of cancer pain]. 7 38

Of 6 outpatients with chronic pain, 5 completed therapy based on a 3-part treatment package designed to provide symptom control, stimulus control and social system modification. Each of the components of the treatment package resulted in therapeutic change. A mean of 35.8 weekly hour long therapy sessions resulted in statistically significant decreases in pain, hopelessness, depression and analgesic medication intake. Generally, these improvements were maintained at 6 months and 1 year follow-up. This study is consistent with the notion that chronic pain is maintained by a combination of inter- and intrapersonal factors. A controlled comparison of this treatment program with other treatments for chronic pain is indicated.
Pain 1978 Aug
PMID:A pilot study of the treatment of outpatients with chronic pain: symptom control, stimulus control and social system intervention. 35 68

Much has been written about social worker/general-practitioner collaboration, particularly about conflict of roles, differing functions, avenues of accountability, and problems of distributing scarce resources.We suggest that if the two professions are to work more comfortably together, then it is imperative that both also share the despair, hopelessness, anxiety, and anger that are the occupational hazards of each. We suggest ways in which doctors and social workers can look at the pain their patients are suffering to the benefit of the patient and their own working relationship.
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PMID:Social work and general practice. A report of a three-year attachment. 125 54

Patients (200) with chronic intractable pain were evaluated to identify various psychiatric symptoms. Identifiable psychiatric illness, commonest being neurotic depression and anxiety states, was found in 72 per cent patients. The common symptoms reported on the present state examination (PSE) were worrying (77%), depression (40%), loss of interest (31.5%), hopelessness (16.5%), loss of weight (18%), and suicidal ideas (8%) and irritability (41.5%). Two thirds of patients had both anxiety and depression.
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PMID:Psychiatric symptoms in patients with non-organic chronic intractable pain. 207 Nov 86

The relevant literature on the relationship between physical illness and suicide is briefly reviewed. Some important studies on the relationship between pain from physical illnesses like duodenal ulcer, uterine diseases (dysmenorrhea, dysfunctional uterine bleeding) and suicide are referred to. The Madurai studies reveal that high scores on hopelessness and suicide intent in patients with pain from duodenal ulcer, dysmenorrhea, and other uterine problems are associated with suicidal behavior. The need for assessing the suicide risk in such patients under the care of nonpsychiatric medical personnel is discussed. A simple, easy-to-administer questionnaire is presented.
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PMID:Physical illness, pain, and suicidal behavior. 207 17

Chronic facial pain syndromes are associated with high levels of distress and depression. Immune system measures were investigated in otherwise healthy patients suffering from chronic temporomandibular pain and dysfunction syndrome (TMPDS) and in matched controls. No mean differences were found between TMPDS patients and the controls on any of the immune measures; however, both ConA and PWM responses in TMPDS patients were decreased in relation to the level of demoralization (P less than 0.05). Cognitive symptoms such as low self-esteem and perceptions of helplessness/hopelessness were implicated in these effects. In addition, among patients pain severity was independently associated with decreased ConA response (P less than 0.05). The data suggest possible correlates of stress-induced changes in the immune system.
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PMID:Facial pain, distress, and immune function. 208 80

Following a brief presentation of the clinical picture of major depression, attention is directed to different forms of missed diagnosis. The clinical picture of major depression is characterized by marked uniformity and includes 2 highly typical disturbances: pronounced diurnal fluctuations and early or very early awakening. Other central features include a feeling of hopelessness, the disappearance of all prospects for the future, and feelings of guilt sometimes assuming absurd proportions. In addition, there are many other accompanying manifestations. Yet, despite this, it is not easy to recognize depression, particularly since the patient's gloomy and dejected mood often occupies the background of the picture. Cross-cultural psychiatric studies reveal that in non-Western cultures expression often mainfests itself in the form of a wide variety of somatic complaints, including pain. The term "masked depression" has come into common use to describe what are cases where, in the presence of predominantly physical signs and symptoms, an underlying depressive state goes unrecognized. This applies particularly to syndromes of which headache and pains in the chest, abdomen, and limbs are prominent features. It is unclear as to what extent somatic manifestations of depression are on the increase in the Western world. Yet, clearly, many patients deny that they suffer from depression and cling firmly to their physical complaints. Although depression may lurk behind a series of poorly defined physical complaints, essential characteristics of genuine depression emerge upon further diagnostic exploration. Secondary accompaiments to depression include periodic abuse of alcohol or medicines and disturbances affecting sexual behavior. In the elderly, the differential diagnosis of dementia and depression may give rise to confusion. Anxiety emerges as a frequent accompanying manifestation in depressive patients, yet all anxious patients do not suffer with depression. Additionally, many manifestations of anxiety and depression closely resemble one another, adding to the confusion. There is limited awareness of phobic and compulsive phenomena as manifestations of depression. These phenomena may disappear in response to treatment for the depression and are by no means always related to a premorbid compulsive personality structure. The issue of the application of the term "depression" to conditions that most likely are not depressive are considered from the standpoints of endocrinopathy and of pharmacology. The problem posed by depressive syndromes occurring in oral contraceptive (OC) users is more complex. When the progesterone content is high in relation to the estrogen component, the patient may sometimes suffer from loss of libido and loss of pleasure in sex or life in general. These changes respond favorably to a change in the type of OC.
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PMID:Depression--a diagnosis sometimes missed and sometimes mistaken. 357 25

This paper describes and discusses some late effects of massive traumatization on two women survivors of the Holocaust. Both had appeared to recover from their affective experience of psychic death and hopelessness in Auschwitz and to have moved towards a resumption of further stages of the life cycle. The normal transitional crises of adolescence, when children emotionally separate from their parents, led to severe breakdown in both these patients. Analysis showed that denial, repression and splitting had enabled them to distance themselves from the overwhelming horror of their past, but it had also led to concrete thinking as opposed to metaphorical, and to non-differentiation of psychic and somatic pain. Their inability to dream and the absence of fantasy life in the material could neither facilitate the analytic task of working through these patients' unbearable experience, nor enable them at first to face and recover unbearable affects during the course of the analysis. Hence the analyst's acceptance of an unbearable countertransference and careful monitoring of the affects evoked proved to be an invaluable tool.
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PMID:Working with women survivors of the Holocaust: affective experiences in transference and countertransference. 374 88

This paper will discuss some of the effects that psychological factors have on chest pain during and following myocardial infarction: 1. Psychological factors and the development of a myocardial infarction; a) the relationships of personality and other high risk factors, b) the onset situation of hopelessness and helplessness, c) immediate psychological precipitants (fact and fantasy), d)denial and delay. 2. Psychological factors during recovery; a)problems associated with the Type A personality, b) critical periods, c)absence of angina and denial, d) the effect of post M.I. angina, e) co-existence of angina and psychogenic pain. 3. How reaction of the marital partner can affect the patient and his experience of pain. 4. Factors which tend to minimize psychogenic invalidism.
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PMID:The influence of psychological factors on chest pain associated with myocardial infarction. 694 43

This article reports the results of a survey of 204 persons with chronic nonmalignant pain who were members of a national self-help organization. The survey evaluated the organization, explored the perceived effect of pain on quality of life, and assessed experiences with and perceptions of health-care providers. Response rate was 40%. Of survey respondents, 50% reported inadequate pain relief. Respondents identified depression as one of the worst problems caused by their chronic pain: 50% reported that they had considered suicide due to feelings of hopelessness associated with their pain, 51% reported taking only as much medication as prescribed, and 44% reported taking less medication than prescribed. Further investigation is needed to describe the personal impact of chronic nonmalignant pain.
J Pain Symptom Manage 1994 Jul
PMID:The experience of chronic nonmalignant pain. 796 83


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