Der Schmerz
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The aim of this study was to investigate how sex differences affect psychological measures and coping with pain of patients with fibromyalgia. Gender differences in pain coping strategies would require different gender-specific interventions. ⋯ No gender differences were found in pain measures. Differences were found regarding psychological measures and coping strategies. Women showed more psychological strains and used more adaptive coping strategies on the scales "cognitive restructuring", "perceived self-competence", "mental diversion" and "counterbalancing activities" than men. This implies that women need more treatment for psychological aspects and men need assistance in pain management.
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The efficacy of opioids has been proved and several guidelines and expert panel-based recommendations regarding the use of opioids in different pain syndromes are available. Nevertheless, undertreatment of pain with strong opioids was reported in previous studies. It was shown that physicians' lack of knowledge, their concerns and misconceptions about the opioid use and the controlled substances regulations that govern the prescriptions of opioids occasionally contribute to insufficient pain treatment. This study was designed to evaluate German physicians' knowledge and their concerns about the use of opioids. ⋯ It is necessary to improve the medical students' education and the physicians' postgraduate training regarding principles of pain management such as the WHO guidelines for the treatment of cancer pain. A better knowledge of important pharmacological aspects of opioids should help to reduce physicians' concerns about the use of strong opioids. Nevertheless, improvement of physicians' skills in pain therapy is only one aim in a multidisciplinary concept in order to improve patients' pain therapy.
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The purpose is to clarify if comorbidity of depression reduces health-related quality of life (SF-36) in patients with chronic low back pain (CR) and if those comorbid patients (CR+DE) benefit from multimodal pain treatment. Two groups (CR and CR+DE) each with 29 patients are compared over 6 months on study days 0, 21 (inpatient) and 180 (outpatient). ⋯ The comorbid group is more severely affected by their illness, but improves very constantly. The outpatient improvement suggests a good long-term prognosis.
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Functional neuroimaging methods such as positron emission tomography (PET) or functional magnetic resonance imaging (fMRI) provide fascinating insights into the cerebral processing of pain. Neuroimaging studies have shown that no clearly defined "pain centre" exists. ⋯ Sophisticated study designs nowadays permit the characterisation of different components of pain processing. In this review, we summarise neuroimaging studies, which contributed to the characterisation of these different aspects of cerebral pain processing, such as somatosensory (discrimination of different stimulus modalities, noxious vs non-noxious, summation), emotional, cognitive (attention, anticipation, distraction), vegetative (homeostasis) and motor aspects.