The Clinical journal of pain
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Recent literature indicates a relationship between history of sexual abuse and subsequent psychological and social dysfunction. Less thoroughly examined are the possible abuse-related physical effects. This article examines the prevalence of sexual abuse among 135 chronic pain patients. ⋯ Twenty-eight percent reported child sexual abuse, with history of victimization more significant for women (39%) than men (7%). The abused and nonabused groups of women differed on such variables as marital status, occupation, history of rape and substance abuse, and age of hospitalization. The relationship between sexual abuse and chronic somatic reactions was discussed.
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This study examined the relationship of pain drawings to somatization in patients with sickle cell disease (SCD). Sixty-nine adult patients with SCD completed a pain drawing in which they shaded in areas of the body in which they experienced pain and also completed the symptom checklist (SCL) 90-R as an index of psychological distress. ⋯ The results suggest that health care professionals who treat SCD patients need to consider pain patterns. In individuals with pain patterns atypical for SCD, the psychological status of the patient may need to be evaluated to facilitate optimal pain management.
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Cerebral function was studied in a group of 34 cancer patients being treated with stable doses of 30-920 mg morphine/24 h using measurement of continuous reaction time. Sedation visual analog scale, pain visual analog scale and time from last medication were registered. ⋯ Small but statistically significant prolongations of continuous reaction time were seen in the opioid group. Analgesic dose and sedation visual analog scales were weakly positively correlated to continuous reaction time, but factors other than opioid treatment must influence cancer patients' performance of continuous reaction time.
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The surgical experience is often characterized by fear, stress, and pain. Whenever an individual has to confront a painful or stressful event such as surgery, the individual's opportunity to control some aspect of the situation may actually influence the degree of pain experienced. ⋯ Regression analyses controlling for age and type of opioid revealed that the psychological measures were important predictors of pain and PCA use. Patients with higher anxiety levels and less social support had higher postoperative pain and made more frequent PCA demands.
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Twenty consecutive, chronic low back pain patients admitted to our pain treatment unit completed the Attributional Style Questionnaire (an instrument that detects a cognitive style that is correlated with, and that predicts, depression) and the Beck Depression Inventory. An age, sex, and education-matched group of normal subjects, a group of patients with asymptomatic essential hypertension, and a group of patients with end-stage renal disease receiving dialysis treatment served as controls. The majority of the chronic-pain and renal-dialysis patients had elevated depression scores, whereas none of the normal subjects or hypertensive patients were outside the nondepressed range. ⋯ The results of this study suggest that individuals with a chronic medical condition, either symptomatic (chronic low back pain or renal disease) or asymptomatic (essential hypertension) in nature, develop an attributional style characteristic of depression. These data neither lend support nor refute the thesis that chronic pain syndromes are a variant of, or a masked, depression. Rather, this research implies that a more important question is what identifiable risk factors (for example, attributional style) predispose patients with chronic pain to develop a depressive illness.