The Clinical journal of pain
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Information-processing biases such as attentional, interpretation, and memory biases are supposed to play a role in the exacerbation and maintenance of chronic pain. Current research in the area of cognitive biases shows that all these biases seem to have an influence on attention to, interpretation of, and recall of pain and can lead to maladaptive strategies and the exacerbation of pain. ⋯ Current research supports the importance of individual diagnosis of chronic pain patients and their response patterns of pain, psychological processing, and information processing. This leads to the conclusion that depressed pain patients need other clinical interventions when compared with depressed patients without pain. Previous research showed that a combination of a cognitive-behavioral therapy with mindfulness meditation seems to be a promising approach.
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Whiplash Patients' Responses on the Impact of Events Scale-R - Congruent With Pain or PTSD Symptoms?
Posttraumatic stress disorder (PTSD) symptoms are common among people with whiplash following a motor vehicle crash. The Impact of Events Scale-Revised (IES-R) screens for PTSD symptoms with psychologist referral recommended for above-threshold scores. Recent data indicate that PTSD symptoms post-whiplash may relate more to pain and disability than the crash itself. This study explored the interpretation of IES-R items by people with whiplash to establish whether responses relate to the crash or to whiplash pain and disability. ⋯ Incongruent responses on nonspecific PTSD items may inadvertently inflate levels of PTSD symptoms measured with the IES-R for some whiplash patients, raising implications for the assessment and treatment of the psychological sequelae of whiplash.
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The main objectives of this study were to retrospectively characterize the rate of referrals to an outpatient chronic pain clinic among adolescents with chronic pain, and to identify factors associated with referral. ⋯ Referrals to our chronic pain clinic were more likely for adolescents with generalized chronic pain, regional pain syndromes, and patients with mental health comorbidities. Recent hospitalization or surgery, but not recent emergency department visits, were associated with pain clinic referral. The multivariable analysis did not find disparities in referral by race or socioeconomic status.
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Numerous psychological factors have been found to be associated with acute and chronic pain following breast cancer surgery. However, individual studies tend to be limited to a small number of predictors and many fail to employ prospective designs. This study aimed to identify a broader range of psychological predictors of acute and chronic pain following breast cancer surgery through a systematic review of relevant prospective studies. ⋯ This review has identified a range of psychological predictors of acute and chronic pain following breast cancer surgery; however, the evidence was conflicting and limited. Future studies should demonstrate adequate power and take account of known confounders.
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Randomized Controlled Trial
Analgesic Potentials of Preoperative Oral Pregabalin, Intravenous Magnesium Sulfate, and their Combination in Acute Postthoracotomy Pain.
The objective of this study was to investigate the effects of the preoperative combination of oral Pregabalin and intravenous (IV) magnesium sulfate as analgesic adjuvants in postthoracotomy pain. ⋯ The combined preoperative single dose of pregabalin and magnesium sulfate is an effective method for attenuating postoperative pain and total morphine consumption in patients undergoing thoracotomy.