The Clinical journal of pain
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Randomized Controlled Trial Comparative Study
The Subjective Psychoactive Effects of Oral Dronabinol Studied in a Randomized, Controlled Crossover Clinical Trial For Pain.
The oral cannabinoid dronabinol has similar psychoactive effects to smoking marijuana.
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The aim of this study was to (1) test the concurrent validity of brief screening questions for 5 psychosocial constructs (anxiety, depression, social isolation, catastrophization, and fear of movement) and (2) translate into Danish and validate those screening questions. ⋯ The concurrent validity of these screening questions was comparable to, or better than, alternate questions previously reported, and stable across age, sex, pain intensity, pain duration, and counties. On the basis of the observed likelihood ratios, all of the screening questions provided moderate or strong evidence to rule in or out an extreme score on each psychosocial construct. Given the ease of administration of these brief screening questions, their prognostic and treatment implications should be investigated.
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Cultural differences in pain perception exist. Although chronic whiplash-associated disorder (WAD) is well investigated in western countries, little is known about its presentation in Singapore. We studied the neck motion and pain sensitivity in people with chronic WAD in Singapore. ⋯ These findings of sensory hypersensitivity and decreased neck motion in Singaporeans with chronic WAD are consistent with physical impairments reported in western populations.
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Multicenter Study
The Canadian STOP-PAIN Project: The Burden of Chronic Pain-Does Sex Really Matter?
The Canadian STOP-PAIN Project assessed the human and economic burden of chronic pain (CP) in individuals on waitlists of Canadian multidisciplinary pain treatment facilities. This article focuses on sex differences. Objectives were to (1) determine the pain characteristics and related biopsychosocial factors that best differentiated women and men with CP; and (2) examine whether public and private costs associated with CP differed according to sex. ⋯ This study suggests that women and men who are referred to multidisciplinary pain treatment facilities do not differ significantly in terms of their pain-related experience. However, the aspects that differ may warrant further clinical attention when assessing and managing pain.
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Systematic reviews have consistently shown that multidisciplinary interventions are more effective than waitlist and other unimodal active treatments for a range of chronic pain conditions. However, these group-based statistics fail to inform us whether these programs result in clinically meaningful improvement at the individual level. The current study examines group changes and individual responsiveness to a CBT-informed multidisciplinary chronic pain management program. ⋯ The results of our study are consistent with previous research, and highlight the potential for multidisciplinary programs to improve the well-being of individuals with chronic pain. Clinically important change analyses underscore the variability that exists in chronic pain patients and allows for a more fine grained evaluation of individual responsiveness to treatment. Considering the strengths and limitations of each methodological approach for assessing clinically important change, guidelines are offered for future research and program development.