The Clinical journal of pain
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It has been proposed that serotonin dysfunctions underlie the pathophysiology of various mood disorders (including major depressive disorder, MDD) and chronic pain conditions characterized by deficient pain inhibition, such as fibromyalgia (FM). There is reliable data showing that serotonin disturbances are involved in the pathophysiology of MDD. However, in the case of FM, results published so far are less consistent. Therefore, the current cross-sectional study sought to measure plasma serotonin levels in FM patients, MDD patients, and healthy controls (HC). ⋯ Our results further confirm that MDD is associated with decreased serotonin levels, but that serotonin levels are not altered in FM per se, and suggest that 5-Hydroxytryptamine is related to mood symptoms in these patient groups. Our results also suggest that the taking of antidepressant is a major confound to consider when studying serotonin functioning in FM. The long-term use of antidepressants in FM may lead to serotonin depletion. Conversely, serotonin depletion may be before the taking of antidepressants in FM.
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Randomized Controlled Trial Multicenter Study
Patient characteristics and variation in treatment outcomes: which patients benefit most from acupuncture for chronic pain?
The aim of this study was to identify patients' characteristics that increase or decrease their benefit from acupuncture treatment of chronic pain. ⋯ Future research to clarify the modifying effects with special focus on patients' expectations and other psychological variables is needed.
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General practitioners (GPs) manage the majority of patients with chronic low back pain (LBP) in the Republic of Ireland's health system; however, little is known about their attitudes and beliefs, and how these influence their practice behavior. This study aimed to determine the attitudes and beliefs of GPs regarding chronic LBP, the factors that influence these, and their impact on the management of patients with chronic LBP. ⋯ The current results show partial adherence to current LBP guidelines: GPs manage patients within a biomedical framework, and postgraduate education is not significantly impacting on chronic LBP management. GPs' beliefs do not correlate with their management, which only reflects partial adherence to LBP guideline recommendations. Further research is needed to explore the role of patient factors in the consultation outcomes.