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Chronic Pain Disorder


Presentation

  • Therefore, no data about further BV therapy can be presented. Discussion In this case report, we presented the case of a middle-aged woman suffering from chronic headache and with a history of mental disorders who ‘treated’ herself with bee stings.[cureus.com]
  • In the present choice viewing paradigm, we presented picture pairs for 3 s each, consisting of an emotional picture paired with a neutral picture.[frontiersin.org]
  • The present study had some limitations which should to be considered when interpreting the results.[scielo.br]
  • An interdisciplinary approach combining (1) rehabilitation; (2) integrative medicine/active mind-body techniques; (3) psychology; and (4) normalizing daily school attendance, sports, social life and sleep will be presented.[mdpi.com]
  • In the present study, the aim was to analyse the association of chronic pain and depression.[journals.plos.org]
Hypersomnia
  • […] worthlessness or guilt and depressed mood or loss of interest and pleasure (or anhedonia) Changes in behavior, such as significant distress or impairment in social, occupational, or other area of functioning Changes in physical well-being, such as insomnia or hypersomnia[practicalpainmanagement.com]
  • The other criteria are (3) significant weight loss or gain, (4) insomnia or hypersomnia, (5) psychomotor agitation or retardation, (6) fatigue or loss of energy nearly every day, (7) feelings of worthlessness or excessive or inappropriate guilt, (8) diminished[journals.plos.org]
Asymptomatic
  • Although this does often cause severe pain, it doesn’t always: this study reports that 17% of 29 patients were asymptomatic, even with substantial joint degradation revealed by MRI, CT, or X-ray.[painscience.com]
Unable to Stand
  • As I recently learned, I have metabolic issues with most drugs, so trying all of the new meds I was being prescribed by these doctors constantly made me break out in then-unexplainable rashes, vomit, and I'd get dizzy to the point of being unable to stand[huffpost.com]
Lactose Intolerance
  • For the neuropathic pain, pregabalin, due to severe lactose intolerance as a solution, was titrated up to a dose of 60 mg twice daily and was tolerated.[cureus.com]
Indecisiveness
  • […] loss or gain, (4) insomnia or hypersomnia, (5) psychomotor agitation or retardation, (6) fatigue or loss of energy nearly every day, (7) feelings of worthlessness or excessive or inappropriate guilt, (8) diminished ability to think or concentrate, or indecisiveness[journals.plos.org]
Psychiatric Symptoms
  • While much of the research into psychiatric symptoms and chronic clinical conditions is centered on depression, with apparently significant associations between these conditions being identified, there is growing evidence that anxiety also coexists with[scielo.br]
Psychomotor Retardation
  • Some of the symptoms of depression and pain also overlap, such as difficulty sleeping, poor concentration, low energy, psychomotor retardation, and decreased interest.[practicalpainmanagement.com]

Workup

  • Imaging studies, including with radiography, magnetic resonance imaging (MRI), and computed tomography (CT) scanning, are important tools in the workup of patients with CPS.[emedicine.medscape.com]
  • Clinical Testing and Workup Magnetic resonance imaging (MRI) is the technique of choice to visualize tumors, infarcts, cerebral hemorrhage, demyelinating plaques and other causal lesions.[rarediseases.org]

Treatment

  • . 23,24 Thus, a pain treatment model that incorporates the assessment and treatment of depression seems necessary for optimal outcomes.[practicalpainmanagement.com]
  • Psychologic and behavioral treatments are usually helpful.[merckmanuals.com]
  • Median time from injury to treatment was 720 days. At 3 months post-treatment, 136 (14%) of the participants were working.[academic.oup.com]
  • The average duration of inpatient treatment was approximately 1 to 5 weeks.[mdedge.com]
  • However, these treatment options are much used for fibromyalgia in Norway. No studies are so far available on myofascial pain treatment in fibromyalgia ( 18 ).[tidsskriftet.no]

Prognosis

  • […] of comorbid depression and pain is poor compared with the prognosis for individuals with depression without pain. 18 In fact, a recent population-based study found that persons with concomitant depression and pain initiated more visits to medical providers[practicalpainmanagement.com]
  • Prognosis The prognosis for chronic pain syndromes is extremely variable. Treatment Treatment for chronic pain syndrome can involve several different approaches. It is not always possible to get rid of chronic pain completely.[healthengine.com.au]
  • That is, pain is no longer indicative of another prognosis — it is the prognosis, and a disabling one at that. Specifically, under the strain of prolonged pain, nerves not only become super-sensitized to pain signals, but begin amplifying them.[health.harvard.edu]
  • Managing medical comorbidities in patients with depression to improve prognosis. J Clin Psychiatry, 77 (2016), pp. 22-27 [9] J.D. Coplan, C.J. Aaronson, V. Panthangi, Y. Kim.[elsevier.es]
  • Treatment [ edit ] The prognosis is worse when there are more areas of pain reported. [8] Treatment may include psychotherapy (with cognitive-behavioral therapy or operant conditioning ), medication (often with antidepressants but also with pain medications[en.wikipedia.org]

Etiology

  • Determining the etiology of a specific symptom is difficult or impossible [ 5 – 9 ].[journals.plos.org]
  • What differs among them is their duration, timing, or presumed etiology. 1 The primary difference between the DSM-5 and prior iterations is the abolishment of a bereavement exclusion applied to depressive symptoms lasting less than 2 months following[practicalpainmanagement.com]
  • […] carry any necessary implication regarding the individual’s degree of control over the behaviors that may be associated with the disorder.” [9] It is also noted that inclusion of a disorder in the manual does not require that there be knowledge about its etiology[bcmj.org]
  • Individuals with sensory or limiting cognitive deficits, debilitating or potentially serious or fatal clinical illnesses, a history of hospitalization in the last three months, or pain with a neoplastic etiology were excluded.[scielo.br]
  • Published: 13 March 2013 BMC Psychiatry volume 13, Article number: 84 ( 2013 ) Download Citation Article metrics 5261 Accesses 47 Citations 5 Altmetric Metrics details Abstract Background Recent functional imaging studies on chronic pain of various organic etiologies[bmcpsychiatry.biomedcentral.com]

Epidemiology

  • Chronic pain epidemiology and its clinical relevance. Br J Anaesth. 2013 ;111(1): 13 – 18. Google Scholar Crossref Medline ISI 19.[journals.sagepub.com]
  • […] of Chronic Pain" – Chapter 5, Epidemiology of Pain (1999) Fact Sheets[iasp-pain.org]
  • A variety of instruments have been used to screen/assess for depression, 7 including the Beck Depression Inventory, the Center for Epidemiological Studies-Depression Scale, the Geriatric Depression Scale, and the Patient Health Questionnaire (PHQ-9).[practicalpainmanagement.com]
  • Assessing depression among persons with chronic pain using the Center for Epidemiological Studies-Depression Scale and the Beck Depression Inventory: a comparative analysis. Clin J Pain 1997 ; 13 : 163 – 170. 16..[academic.oup.com]
  • As noted, several steps would be involved: The first step is to identify and consolidate existing quality data that provide reliable insight into FM epidemiology and to determine where epidemiologic gaps currently exist.[ncbi.nlm.nih.gov]
Sex distribution
Age distribution

Pathophysiology

  • Methods Narrative review of the pathophysiological and clinical aspects of depression and chronic pain comorbidity.[elsevier.es]
  • Free Reviews of Educational Material May 2010 Functional Pain Syndromes: Presentation and Pathophysiology. Author Notes The University of Michigan Health Systems, Ann Arbor, Michigan.[anesthesiology.pubs.asahq.org]
  • Pathophysiology – Understanding Why People Get CAPS To understand the basis for chronic abdominal pain syndrome it is helpful to understand how the body experiences pain.[iffgd.org]
  • Pains described as central pain in such conditions as Parkinson’s disease are not truly central pain and have a different pathophysiology and treatment: these are termed central-pain allied conditions.[rarediseases.org]
  • There has been a surge of interest in using brain neuroimaging to study pain in a more quantitative, objective manner and to better understand the potential pathophysiology of FM.[ncbi.nlm.nih.gov]

Prevention

  • This could lead to early avoidance of the negative long-term consequences of mental disorders and the prevention of chronic pain. Story Source: Materials provided by Universität Basel. Note: Content may be edited for style and length.[sciencedaily.com]
  • Early, aggressive treatment of acute pain is always preferable and may limit or prevent sensitization and remodeling and hence prevent progression to chronic pain. Drugs or physical methods may be used.[merckmanuals.com]
  • In the United States, approximately 29% of patients prescribed an opioid misuse it, and approximately 80% of heroin users started with prescription opioids. 1,2 The NIH and HHS have outlined 5 priorities to help resolve this crisis: Improve access to prevention[mdedge.com]
  • Evidence-based Chronic Pain Overviews Prevention Preventing chronic pain may be possible – depending on its cause. Many people are surprised to learn that, not all, but many cases of chronic pain can in fact be prevented.[wwdpi.org]
  • Some possible strategies to manage acute pain and prevent development of chronic post-ICU pain may include protocolized acute pain management, opioid-sparing adjunct analgesics, prevention of post-ICU depression and PTSD, and early mobilization.[uspharmacist.com]

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