Der Schmerz
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Review Comparative Study
[Gender differences in acute and chronic pain conditions : Implications for diagnosis and therapy.]
Gender differences can influence incidence and outcome of acute and chronic pain conditions. The reasons are to be found in genetic factors, hormonal effects and differences in anatomy and physiology. Furthermore differences relating to psychiatric comorbidities (i.e. depression) and psychosocial factors (roles, coping strategies) have been demonstrated. ⋯ There is a gender bias in diagnosis and therapy. There is a need to study the influence of gender, age and race in order to optimize treatment towards a more individualized therapy. This article highlights already identified differences.
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Burnout is not a medical diagnosis but a developmental aberration which is associated with the risk of subsequent mental and somatic diseases. It can be summarized under a fatigue process with stress symptoms, societal-linked stressors and a driving force stress intensifier. In the mental stress circle, burnout presents as an accelerated vicious spiral driven by high demands. ⋯ Burnout is also a meaning of life crisis, triggered by the narrowing of performance and success. The anthropological therapeutic approach targets an enhancement of self-conception and lifestyle. Other available therapy approaches for burnout include pharmacotherapy, coaching, management consulting and inpatient treatment.
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Case Reports
[Patient careers in the orthopedic pain treatment : Sociological studies on pain behavior.]
Based on case histories the following study raises the question why some pain patients remain permanently on the path of specialist pain treatment after initial treatment whereas other patients with similar pain reports do not. ⋯ Conceptions of pain and pain behavior are formed in the course of patient careers while this is not necessarily a conscious or reflected process. As an unintended consequence it evolves into pain acting within the patient that integrates patients into distinct care milieus and holds them tight in the respective pain care. In these cases pain patients and their doctors fall so to say into a pain trap.