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

The DSM-III multiaxial classification was used to evaluate the one-year clinical activity of a psychiatry and medical psychology department in a general hospital. Compared to the general population, the patients (n = 1,071) corresponded to a sample of professionally active subjects in which top and middle executives as well as students were over=represented. Fifty-one per cent of the patients suffered from anxiety or affective disorders, while 9 per cent presented somatoform disorders. Histrionic and dependent personalities were more frequent in women. Thirty six per cent of the subjects had a concurrent physical illness. Psychosocial stress and altered adaptation were higher in unemployed people and in patients with physical illness. Specific diagnostic and socioprofessional patterns corresponded to the various types of mental care: psychoanalytically oriented psychotherapy, behaviour therapy, psychopharmacological treatments, consultation-liaison, pain consultation.
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PMID:[Evaluation using DSM-III of the clinical activity of a psychiatry department at a general hospital]. 297 44

DSM, an agent which occludes arterial blood flow temporarily, was experimentally proved to enhance the uptake of co-administered anti-cancer drugs in the target organ and, conversely, to reduce the systemic side effects. Intra-arterial chemotherapy combined with MMC and DSM was performed on eight cases of unresectable metastatic liver carcinoma. The primary site of all these cases (7 gastric, 1 rectal) was resected. A catheter was inserted into the proper hepatic artery via the gastroduodenal artery, and the other end was connected to an implantable drug delivery system which was placed at the abdominal wall. DSM (180 to 900 mg) mixed with MMC (4 to 20 mg) was injected through the system every one, two or three weeks. The response rate in evaluable 7 cases was 57% (4 partial response, 1 minor response, 2 no change) and prognoses in the frequently treated group (7 times or more) were better than in the group with less frequent treatment (3 times or less). Pain (25.0%), nausea and vomiting (20.6%), and high fever (11.8%) were side effects, but they could be treated by medication. Our results suggest that intra-arterial chemotherapy combined with MMC and DSM is one of the effective treatments for unresectable metastatic liver carcinoma.
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PMID:[Intra-arterial chemotherapy combined with mitomycin C and degradable starch microspheres in unresectable metastatic liver carcinoma]. 313 81

The relationship between chronic pain and depression has become enmeshed in the literature. In an attempt to unravel the relationship between chronic pain and depression, the authors studied a uniform group of 80 chronic back pain patients with and without depression using the dexamethasone suppression test (DST). The DST examines the hypothalamic response to an exogenously administered steroid (dexamethasone) challenge. In normal subjects and patients without major depression, the dexamethasone suppresses the release of cortisol from the adrenal glands. In 40% of patients with major depression, there is an early escape of cortisol from dexamethasone suppression. We found that 40% of patients with a DSM-III major depression (dysphoric mood, appetite and sleep changes, loss of energy and interest, decreased concentration, suicidal ideation, and feelings of self-reproach) were non-suppressors and none of the patients without major depression showed this abnormality. These findings suggest that the concept of chronic pain as a variant of depression might be an oversimplification.
Pain 1985 Jan
PMID:The dexamethasone suppression test as a biologic marker of depression in chronic pain. 315 90

A sample of 41 women suffering from psychogenic pain according to DSM-III diagnostic criteria were psychometrically studied, in order to ascertain if they showed specific psychological traits or mechanisms. Type A behavior, extraversion, neuroticism, psychoticism and dissimulation and hostility-aggressivity traits were the psychological variables studied both in the pain sample and in a matched control group. Psychogenic pain patients were significantly more neurotic and suspicious and less physically aggressive than healthy subjects and also scored significantly higher in dissimulation, which suggests a tendency to use defense mechanisms of denial.
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PMID:Psychogenic pain and psychological variables: a psychometric study. 324 27

Two patients with a chronic residual schizophrenic disorder, according to DSM-III-R, showed a marked resistance to intensive light, manifested through a lack of intolerance and pain when looking at the Sun directly. Light suppresses melatonin secretion in humans, and the melatonin rhythm reflects the subject's light/darkness exposition. A photomaniac character of such a behavior (or phenomena that could favor it) recalls its opposite--the photophobic behavior as described in some cases of depression, and could cause a different profile of exposition to the light. Knowing about such phenomena--such though they lack every explanation for the time being--could be useful--from a methodology point of view, as well as heuristically valuable--during the study of photosensitive neuroendocrine processes in patients who evidence such phenomena.
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PMID:[Photomaniac behavior and schizophrenia]. 325 29

Alexithymic characteristics were examined in a sample of 30 patients fulfilling the DSM-III criteria for psychogenic pain disorder using an interviewer-rated scale (Beth Israel Hospital Psychosomatic Questionnaire), a self-rated scale (Toronto Alexithymia Scale) and a projective technique (Thematic Apperception Test). The findings were compared with a control group of healthy subjects matched on sociodemographic variables. Pain patients were found to be more alexithymic in contrast to the control group as evidenced by the interviewer-rated and self-rated scales. The correlations among the three measures were in the expected direction.
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PMID:Controlled study of alexithymic characteristics in patients with psychogenic pain disorder. 343 40

It has been suggested that "fibrositis" or rheumatic pain modulation disorder (RPMD) is a variant of depressive illness. Both disorders are associated with abnormalities in sleep physiology. Since the clinical features of RPMD do not meet all the criteria for a major depressive disorder, the symptoms and sleep physiology in subjects with dysthmic disorder (DSM III criteria) (N = 6), and RMPD (N = 6) were compared, in order to determine the similarity between the two groups. The sleep physiology in dysthymic disorder was first examined over three consecutive nights since a systematic evaluation of the sleep physiology in this group of disorders has not yet been reported. All dysthymic patients showed episodic bursts of high-amplitude (75-150 microvolts) theta (3-5 Hz) bursts in stage 2 sleep, and REM onset latency was abbreviated only on night 2. The theta bursts have not been previously reported, and may be an early marker of disorganization of non-REM sleep in the dysthymic subjects. The comparison of the two groups revealed that RPMD subjects reported more pre- and post-sleep pain (p less than 0.01), lighter sleep (p less than 0.01), and more physical ailments during sleep (p less than 0.01), and had more alpha (7-11.5 Hz) in non-REM sleep (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Dysthymic disorder and rheumatic pain modulation disorder (fibrositis syndrome): a comparison of symptoms and sleep physiology. 346 26

The concept of psychogenic pain is discussed and reviewed from multiple theoretical perspectives. The validity of psychogenic pain disorder as a clinical diagnosis is also examined, as are regional pain syndromes such as psychogenic abdominal, facial, pelvic, chest, and headache pain. The term "psychogenic pain" is considered to have limited clinical or diagnostic usefulness and the preferred term "idiopathic pain syndrome" used in DSM-III-R is advocated.
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PMID:Psychogenic/idiopathic pain syndromes. 355 78

A comparison between 102 depressed and 101 non-depressed pain patients, identified with the use of DSM-III criteria, showed that depressed patients were more often elderly and employed as compared to non-depressed patients who were significantly more often found to be younger (P less than 0.001) and were students (P less than 0.02). No other demographic differences were observed. Family psychiatric morbidity as well as family history of depressive spectrum disorders were noted in both the groups, without much difference. The relevance of classifying pain patients on the basis of their predominant psychopathology is discussed.
Pain 1987 Jun
PMID:Depressed and non-depressed chronic pain patients. 361 70

The assessment of patients with chronic pain is receiving increasing attention by psychiatrists. Recent publications have put forward the concept of the "pain-prone disorder" as a variant of depressive illness. This study describes a series of 50 consecutive patients with chronic pain in terms of the five axes of the DSM-III nosology. Diagnoses were made after a 90- to 120-minute psychiatric interview, and a check on diagnostic reliability was made on a small subsample. Psychological factors affecting physical condition were diagnosed in 34% and dysthymic disorder was diagnosed in 28%, while major depression, psychogenic pain disorder, somatization disorder, and anxiety disorders were each respectively diagnosed in 8%. Only 6% had no diagnosis on axis I and 4% had no diagnosis on axis III. Personality disorder was diagnosed in 40%, and traits of dependence, compulsiveness, and anxiety were common. Overall, the patients had experienced a high degree of psychosocial stress with fair to poor adaptive functioning. The notion of chronic pain as a variant of depressive disease is questioned on the basis of these findings. The author suggests that although pain-proneness is a useful psychodynamic concept, the case for its establishment as a new psychobiological disorder is not proven. Furthermore, the concepts of pain-proneness, depression, and psychogenic pain have become confused. The author argues that the current classification is adequate to deal with the varieties of depression associated with chronic pain and that psychogenic pain disorder should be remerged with conversion disorder for the sake of clarity.
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PMID:DSM-III diagnoses in chronic pain. Confusion or clarity? 370 17


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