Der Schmerz
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The evaluation of patients' satisfaction and outcome after surgery is of increasing importance. An optimized postoperative pain management may contribute substantially to this important goal. ⋯ Evaluation of patients' satisfaction with postoperative epidural pain therapy resulted in a high degree of satisfaction without correlation between patients' satisfaction and recalled maximum pain levels. These results, including side effects and special problems during pain therapy, provide motivation to further improve postoperative pain management.
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Currently it is unclear whether functional somatic syndromes can be explained by one common underlying functional syndrome. In any case it does not seem justified to view functional somatic syndromes as purely psychological disorders (somatized anxiety or depression). Psychiatric comorbidity and life time stress including traumatisations are mainly, but not exclusively responsible for triggering health care utilisation. ⋯ The predominance of female patients can be due to gender specific illness behaviour as well as to estrogen-induced changes in pain sensitivity. In sum, functional somatic syndromes currently are best explained by a biopsychosocial model of predisposing, triggering and maintaining factors. More research is needed particularly to clarify the role of genetic and of cultural factors.
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The symptom complex called prostatitis represents a multifactorial problem of unclear etiology. Standardized diagnostic and therapeutic approaches do not exist. Controlled studies which fulfil evidence-based medical criteria are missing. A review of the currently available literature leads to the conclusion that a multimodal therapy concept should be developed and examined.
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Within clinical practice fibromyalgia is diagnosed according to the classification criteria of the American College of Rheumatology. The examination of the tender points is still to be standardized. By using additional diagnostic criteria fibromyalgia changes into a polysymptomatic syndrom with multiple functional and psychic symptoms. ⋯ Patient education, medical training therapy, physical therapy (heat or cold) and relaxation therapy are recommended. There is a moderate evidence for the effectiveness of tricyclic antidepressants and aerobic training. The effectiveness of multicomponent therapy in fibromyalgia is still to be demonstrated.
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Multicenter Study
[Relationship of depression and anxiety with social desirability in chronic pain patients].
This study examines the extent of self-reported pain and psychological distress in chronic pain patients and the influence of social desirability on the data collected. ⋯ Both psychological distress and social desirability are common in chronic pain patients. Patients with high scores for social desirability reveal less depression and anxiety. The psychological distress caused by pain seems to be expressed by somatic complaints and therapy seeking. Since pain research is strongly dependent on the patient's self-report, social desirability should be considered as a factor which may impact measurements and decisions.