The Clinical journal of pain
-
Cognitive theories of appraisal argue for the importance of beliefs as determinants of adjustment to stress. The current investigation sought to examine the relation between beliefs about chronic pain and adjustment in a group of chronic pain patients. Patients' belief in themselves as disabled was found to be inversely related to activity level for patients reporting low and medium levels of pain severity. ⋯ Finally, an expressed belief in the appropriateness of solicitous responses from family members was negatively related to psychological functioning for patients reporting relatively low levels of pain. Although these findings support the broad-based hypothesis that the illness-relevant beliefs of chronic pain patients are associated with their multidimensional pain adjustment, they emphasize the importance of beliefs concerning whether or not one is disabled by pain. The findings also highlight the fact that the belief/functioning relation is not always direct and can be moderated by perceived pain severity.
-
Currently, no literature is available regarding the clinical efficacy and treatment outcome of psychological interventions for chronic pain among spinal cord injured (SCI) persons. The present article provides a framework for cognitive-behavioral interventions used with other pain populations and suggested application for the SCI population with chronic pain. ⋯ SCI rehabilitation has traditionally relied upon self-management strategies, as have recent psychological treatment approaches for chronic pain. In addition, recommendations for treatment outcome research are provided with the emphasis on using existing standardized assessment and measurement protocols.
-
The problem of severe chronic pain following spinal cord injury (SCI) has been well delineated for many years. However, progress has been slow in determining which treatment procedures work for which type of SCI pain in a particular individual at a particular time. ⋯ Design limitations of many existing studies that can be remedied in future investigations are reviewed. Finally, discussion of two conceptual models of SCI pain is presented and an argument raised for the utility of both.
-
Randomized Controlled Trial Clinical Trial
Plasma beta-endorphin is not affected by treatment with imipramine or paroxetine in patients with diabetic neuropathy symptoms.
To determine the possible role of endogenous opioid peptides in the action of imipramine and paroxetine in painful diabetic neuropathy, beta-endorphin concentrations in plasma were measured in 20 patients during a double-blind, placebo-controlled randomized three-way crossover trial. Despite a significant reduction in neuropathy symptoms during both imipramine and paroxetine treatment, the beta-endorphin level was unaltered throughout the study. The plasma concentration of beta-endorphin was not related to plasma drug concentrations. Thus, this study does not provide evidence of a role of endogenous opioid peptides in the mechanism of action of imipramine and paroxetine in painful diabetic neuropathy.
-
It is claimed that a significant percentage of chronic pain patients suffer from drug/alcohol abuse/dependency/addiction. To address this question, 24 articles alluding to chronic pain patient drug/alcohol dependence/addiction were reviewed according to the following criteria: method for drug misuse diagnosis, which drug misuse diagnosis used (abuse, dependence, or addiction), and percentage of patients within each diagnostic category of drug misuse. ⋯ It is concluded that these diagnoses occur in a significant percentage of chronic pain patients. However, there is little evidence in these studies that addictive behaviors are common within the chronic pain population.