The Journal of nervous and mental disease
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J. Nerv. Ment. Dis. · Aug 2015
Chronic Low Back Pain: Perception and Coping With Pain in the Presence of Psychiatric Comorbidity.
This retrospective study investigated the influence of psychiatric comorbidity on pain perception and coping with pain in tertiary pain clinic patients, 427 treated for chronic low back pain (CLBP) and 629 for other forms of chronic pain (CG). No differences in psychosomatic dimensions were found between the two groups, but Italian Pain Questionnaire dimensions and intensity scores (t = 7.35; p < 0.0001) were higher in CLBP than in CG subjects. ⋯ The Multidimensional Pain Inventory showed a close association between CLBP and both agoraphobia (χ2 = 3.74; p < 0.05) and dysfunctional coping style (χ2 = 8.25; p < 0.01), which increased disability. Both agoraphobia and lifetime depression were associated with an overall increase in dimensions and pain intensity in CLBP, but not in CG.
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Despite growing empirical evidence, the distinction between normal and pathological grief remains controversial. Few studies have investigated public attitudes towards distinguishing normal from pathological grief. An international sample of 348 participants from a wide range of cultures was asked if certain expressions of grief could be considered a mental disorder and to explain their answer. ⋯ The presence of pervasive distress, of harm to self and/or others, functional impairment, and persistent grief were described as the circumstances under which grief can be a mental disorder. Reasons grief is not a mental disorder were that it is normal, temporary, in response to an event, and that efforts to include it in diagnostic manuals will lead to medicalization and stigma. The investigation of public norms informs the inclusion of pathological grief in diagnostic nosology.