Der Schmerz
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Migraine is a syndrome and not a nosological entity. It is therefore relatively improbable that a uniform etiology can be defined, and it must be assumed that there are different multifactorial etiological conditions for each individual. It is probable that a therapy concept that is equally valid and promising for all patients can therefore never be developed. ⋯ The intrinsic action of a therapy method should be compared to the placebo effect on a randomized doubleblind basis. If this preconditions is fulfilled, appraisals of the real chances of success in the practice can be made more accurately on the basis of large-scale open studies comprising a representative cross-section of migraine patients. Further topics for therapy studies should include the analysis of responders and nonresponders and the development of differential indications for certain methods of therapy.
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Acute postoperative pain has an important psychological component. This psychological element could be registered by observing or measuring interindividual differences in pain experience, expressions of pain, and pain-coping behavior. Emotions such as anxiety, anger, and helplessness accompany postoperative pain, and postoperative pain can also be elicited by very intense preoperative anxiety. ⋯ Psychological factors also influence pain reduction. Postoperative aggression and its underlying metabolism facilitates recovery if the physicians or nurses can cope with the anger of the patient. Providing sensory descriptions of the pain during the preoperative visit and careful attention to both the pain-experiencing and the pain-free patient help to reduce pain or prevent its escalation.