Pub Date : 2017-01-01Epub Date: 2017-09-15DOI: 10.2174/1876386301710010081
T Clinkinbeard, R H Kline, L P Zhang, S L McIlwrath, J F Watkins, K N Westlund
Background/aims: Study of acute pancreatitis in chemically-induced rodent models has provided useful data; models of alcoholic chronic pancreatitis have not been available in mice. The aim of the present study was to characterize a mouse model of chronic pancreatitis induced solely with an alcohol and high fat (AHF) diet.
Methods: Mice were fed a liquid high fat diet containing 6% alcohol as well as a high fat supplement (57% total dietary fat) over a period of five months or as control, normal chow ad libitum. Pain related measures utilized as an index of pain included mechanical sensitivity of the hind paws determined using von Frey filaments and a smooth/rough textured plate. A modified hotplate test contributed information about higher order behavioral responses to visceral hypersensitivity. Mice underwent mechanical and thermal testing both with and without pharmacological treatment with a peripherally restricted μ-opioid receptor agonist, loperamide.
Results: Mice on the AHF diet exhibited mechanical and heat hypersensitivity as well as fibrotic histology indicative of chronic pancreatitis. Low dose, peripherally restricted opiate loperamide attenuated both mechanical and heat hypersensitivity.
Conclusion: Mice fed an alcohol and high fat diet develop histology consistent with chronic pancreatitis as well as opioid sensitive mechanical and heat hypersensitivity.
背景/目的：在化学诱导的啮齿类动物模型中对急性胰腺炎的研究已经提供了有用的数据，但酒精性慢性胰腺炎的小鼠模型尚未出现。本研究的目的是描述仅用酒精和高脂肪（AHF）饮食诱导的慢性胰腺炎小鼠模型的特征：方法：给小鼠喂食含 6% 酒精和高脂肪补充剂（膳食脂肪总量的 57%）的液态高脂肪膳食，为期五个月，或作为对照组喂食普通饲料。作为疼痛指数的疼痛相关测量包括使用 von Frey 纤维和光滑/粗糙纹理板测定后爪的机械敏感性。改良的热板试验有助于了解内脏超敏反应的高阶行为反应。在使用或不使用外周限制性μ-阿片受体激动剂洛哌丁胺进行药物治疗的情况下，小鼠均接受了机械和热测试：结果：以 AHF 为食的小鼠表现出机械和热过敏性以及表明慢性胰腺炎的纤维化组织学。低剂量、外周限制性阿片类药物洛哌丁胺减轻了机械和热超敏反应：结论：以酒精和高脂肪饮食喂养的小鼠会出现与慢性胰腺炎一致的组织学表现，以及对阿片类药物敏感的机械和热超敏反应。
{"title":"A Mouse Model of Chronic Pancreatitis Induced by an Alcohol and High Fat Diet.","authors":"T Clinkinbeard, R H Kline, L P Zhang, S L McIlwrath, J F Watkins, K N Westlund","doi":"10.2174/1876386301710010081","DOIUrl":"10.2174/1876386301710010081","url":null,"abstract":"<p><strong>Background/aims: </strong>Study of acute pancreatitis in chemically-induced rodent models has provided useful data; models of alcoholic chronic pancreatitis have not been available in mice. The aim of the present study was to characterize a mouse model of chronic pancreatitis induced solely with an alcohol and high fat (AHF) diet.</p><p><strong>Methods: </strong>Mice were fed a liquid high fat diet containing 6% alcohol as well as a high fat supplement (57% total dietary fat) over a period of five months or as control, normal chow <i>ad libitum</i>. Pain related measures utilized as an index of pain included mechanical sensitivity of the hind paws determined using von Frey filaments and a smooth/rough textured plate. A modified hotplate test contributed information about higher order behavioral responses to visceral hypersensitivity. Mice underwent mechanical and thermal testing both with and without pharmacological treatment with a peripherally restricted μ-opioid receptor agonist, loperamide.</p><p><strong>Results: </strong>Mice on the AHF diet exhibited mechanical and heat hypersensitivity as well as fibrotic histology indicative of chronic pancreatitis. Low dose, peripherally restricted opiate loperamide attenuated both mechanical and heat hypersensitivity.</p><p><strong>Conclusion: </strong>Mice fed an alcohol and high fat diet develop histology consistent with chronic pancreatitis as well as opioid sensitive mechanical and heat hypersensitivity.</p>","PeriodicalId":53614,"journal":{"name":"Open Pain Journal","volume":"10 1","pages":"81-89"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8317824/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39258381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-12-30DOI: 10.2174/1876386301609010038
Serge Marchand
The primary reason for patients to visit hospital is pain. They don't necessarily know the reason of the pain however, they can precisely describe when the pain started, it’s evolution, location and intensity. The motivation to be free of this painful condition is clear. In fact, it is generally the importance of the painful condition that will alert the patient that there is a need to consult. In most cases, the doctor will find the health problem responsible for this painful condition, and with the adequate treatment, the pain will gradually disappear in parallel with the healing process. Pain is therefore actually a blessing in several conditions. Without this signal, health problems that can be cured if diagnosed rapidly enough can become a serious threat without adequate treatment. Pain is also an important tool for clinicians, giving important information on the clinical condition, the evolution and the effect of treatment. Clinicians in a hospital environment are prepared to intervene on acute pain conditions; they have the necessary skills and equipment to deal with them.
{"title":"Chronic Pain Management for the Hospitalized Patient","authors":"Serge Marchand","doi":"10.2174/1876386301609010038","DOIUrl":"https://doi.org/10.2174/1876386301609010038","url":null,"abstract":"The primary reason for patients to visit hospital is pain. They don't necessarily know the reason of the pain however, they can precisely describe when the pain started, it’s evolution, location and intensity. The motivation to be free of this painful condition is clear. In fact, it is generally the importance of the painful condition that will alert the patient that there is a need to consult. In most cases, the doctor will find the health problem responsible for this painful condition, and with the adequate treatment, the pain will gradually disappear in parallel with the healing process. Pain is therefore actually a blessing in several conditions. Without this signal, health problems that can be cured if diagnosed rapidly enough can become a serious threat without adequate treatment. Pain is also an important tool for clinicians, giving important information on the clinical condition, the evolution and the effect of treatment. Clinicians in a hospital environment are prepared to intervene on acute pain conditions; they have the necessary skills and equipment to deal with them.","PeriodicalId":53614,"journal":{"name":"Open Pain Journal","volume":"9 1","pages":"38-38"},"PeriodicalIF":0.0,"publicationDate":"2016-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68125277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-09-30DOI: 10.2174/1876386301609010026
D. Fritzinger, D. E. Benjamin
Certain types of pain are major unmet medical needs that affect more than 8 percent of the population. Neuropathic pain can be caused by many pathogenic processes including injury, autoimmune disease, neurological disease, endocrine dysfunction, infection, toxin exposure, and substance abuse and is frequently resistant to available pain therapies. The same can be said of postsurgical pain, which can arise from uncontrolled inflammation around the wound site. The complement system is part of the innate immune system and can both initiate and sustain acute and chronic inflammatory pain. Here we review the complement system and original investigations that identify potential drug targets within this system. Drugs that act to inhibit the complement system could fill major gaps in our current standard of care for neuropathic pain states.
{"title":"The Complement System in Neuropathic and Postoperative Pain","authors":"D. Fritzinger, D. E. Benjamin","doi":"10.2174/1876386301609010026","DOIUrl":"https://doi.org/10.2174/1876386301609010026","url":null,"abstract":"Certain types of pain are major unmet medical needs that affect more than 8 percent of the population. Neuropathic pain can be caused by many pathogenic processes including injury, autoimmune disease, neurological disease, endocrine dysfunction, infection, toxin exposure, and substance abuse and is frequently resistant to available pain therapies. The same can be said of postsurgical pain, which can arise from uncontrolled inflammation around the wound site. The complement system is part of the innate immune system and can both initiate and sustain acute and chronic inflammatory pain. Here we review the complement system and original investigations that identify potential drug targets within this system. Drugs that act to inhibit the complement system could fill major gaps in our current standard of care for neuropathic pain states.","PeriodicalId":53614,"journal":{"name":"Open Pain Journal","volume":"9 1","pages":"26 - 37"},"PeriodicalIF":0.0,"publicationDate":"2016-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68125239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-09-26DOI: 10.2174/1876386301609010015
H. Comberg, S. Schach
{"title":"Hyperuricemia is Associated with Musculo-skeletal Pain - Results from a Cross-sectional Study","authors":"H. Comberg, S. Schach","doi":"10.2174/1876386301609010015","DOIUrl":"https://doi.org/10.2174/1876386301609010015","url":null,"abstract":"","PeriodicalId":53614,"journal":{"name":"Open Pain Journal","volume":"9 1","pages":"15-25"},"PeriodicalIF":0.0,"publicationDate":"2016-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68125226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-03-14DOI: 10.2174/1876386301609010001
Mruvil Abooj, M. Bishnoi, Christine A. Bosgraaf, L. Premkumar
Peripheral inflammation or nerve injury results in changes in the spinal cord, initiating a process of central sensitization. Although nociceptive Transient Receptor Potential (TRP) channels have been studied extensively, the role of these channels expressed at the central terminals in the spinal cord is not fully understood. Here, we studied the expression and function of TRPV1 channels at the spinal cord following induction of inflammatory pain by Complete Freund's Adjuvant (CFA) and neuropathic pain by Chronic Constriction Injury (CCI). Rats treated with CFA or subjected to CCI developed long-term thermal and mechanical hypersensitivity. Peripheral inflammation or injury induced an inflammatory response at the levels of spinal cord, which included activation of glia and increased levels of proinflammatory mediators. As a result, expression of TRPV1 was significantly increased and the associated function of TRPV1-mediated CGRP release was also significantly increased. Single intrathecal administration of resiniferatoxin (RTX), an ultrapotent TRPV1 agonist, selectively reversed inflammatory thermal hypersensitivity and the associated changes in TRPV1 expression and function without affecting mechanical hypersensitivity. In summary, peripheral nerve activity triggers an inflammatory response at the spinal dorsal horn, which results in enhanced expression and function of TRPV1 channels. Targeting TRPV1 expressed in the central terminals is a viable strategy to alleviate certain modalities of pain.
{"title":"Changes in Spinal Cord Following Inflammatory and Neuropathic Pain and the Effectiveness of Resiniferatoxin","authors":"Mruvil Abooj, M. Bishnoi, Christine A. Bosgraaf, L. Premkumar","doi":"10.2174/1876386301609010001","DOIUrl":"https://doi.org/10.2174/1876386301609010001","url":null,"abstract":"Peripheral inflammation or nerve injury results in changes in the spinal cord, initiating a process of central sensitization. Although nociceptive Transient Receptor Potential (TRP) channels have been studied extensively, the role of these channels expressed at the central terminals in the spinal cord is not fully understood. Here, we studied the expression and function of TRPV1 channels at the spinal cord following induction of inflammatory pain by Complete Freund's Adjuvant (CFA) and neuropathic pain by Chronic Constriction Injury (CCI). Rats treated with CFA or subjected to CCI developed long-term thermal and mechanical hypersensitivity. Peripheral inflammation or injury induced an inflammatory response at the levels of spinal cord, which included activation of glia and increased levels of proinflammatory mediators. As a result, expression of TRPV1 was significantly increased and the associated function of TRPV1-mediated CGRP release was also significantly increased. Single intrathecal administration of resiniferatoxin (RTX), an ultrapotent TRPV1 agonist, selectively reversed inflammatory thermal hypersensitivity and the associated changes in TRPV1 expression and function without affecting mechanical hypersensitivity. In summary, peripheral nerve activity triggers an inflammatory response at the spinal dorsal horn, which results in enhanced expression and function of TRPV1 channels. Targeting TRPV1 expressed in the central terminals is a viable strategy to alleviate certain modalities of pain.","PeriodicalId":53614,"journal":{"name":"Open Pain Journal","volume":"9 1","pages":"1-14"},"PeriodicalIF":0.0,"publicationDate":"2016-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68125560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-03-31DOI: 10.2174/1876386301508010001
Shuang-quan Yu, L. Premkumar
Transient Receptor Potential Vanilloid 1 (TRPV1) expressed in peripheral terminals is responsible for transducing thermal and chemical nociception. Role of TRPV1 expressed in the central terminals is not clear, however, its activation modulates synaptic transmission and contributes to central sensitization. In this study, we have determined the role of TRPV1 expressed in the peripheral and central terminals using resiniferatoxin (RTX), a potent TRPV1 agonist. A single intraplantar injection of RTX, within two days induced loss of capsaicin-induced nocifensive behavior and enhanced response latency to hot plate, which recovered over a period of two months. RTX treatment resulted in the ablation of peripheral TRPV1 expressing fibers in paw skin, which regenerated over the same time period. On the other hand, a single dose of intrathecal administration of RTX, within two days caused thermal hypoalgesia. RTX treatment ablated TRPV1 expressing central sensory nerve terminals. Intriguingly, in contrast to peripheral nerve terminal regeneration that occurred within two months, the central TRPV1 expressing nerve terminals did not regenerate even after five months. The present study demonstrates that TRPV1 in the peripheral and central terminals play a role in nociception and the peripheral terminals have the ability to regenerate, whereas the central terminals do not regenerate even after five months.
{"title":"Ablation and Regeneration of Peripheral and Central TRPV1 Expressing Nerve Terminals and the Consequence of Nociception","authors":"Shuang-quan Yu, L. Premkumar","doi":"10.2174/1876386301508010001","DOIUrl":"https://doi.org/10.2174/1876386301508010001","url":null,"abstract":"Transient Receptor Potential Vanilloid 1 (TRPV1) expressed in peripheral terminals is responsible for transducing thermal and chemical nociception. Role of TRPV1 expressed in the central terminals is not clear, however, its activation modulates synaptic transmission and contributes to central sensitization. In this study, we have determined the role of TRPV1 expressed in the peripheral and central terminals using resiniferatoxin (RTX), a potent TRPV1 agonist. A single intraplantar injection of RTX, within two days induced loss of capsaicin-induced nocifensive behavior and enhanced response latency to hot plate, which recovered over a period of two months. RTX treatment resulted in the ablation of peripheral TRPV1 expressing fibers in paw skin, which regenerated over the same time period. On the other hand, a single dose of intrathecal administration of RTX, within two days caused thermal hypoalgesia. RTX treatment ablated TRPV1 expressing central sensory nerve terminals. Intriguingly, in contrast to peripheral nerve terminal regeneration that occurred within two months, the central TRPV1 expressing nerve terminals did not regenerate even after five months. The present study demonstrates that TRPV1 in the peripheral and central terminals play a role in nociception and the peripheral terminals have the ability to regenerate, whereas the central terminals do not regenerate even after five months.","PeriodicalId":53614,"journal":{"name":"Open Pain Journal","volume":"8 1","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2015-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68125188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-11-24DOI: 10.2174/1876386301407010046
L. Canellopoulos
In anorexia which classically shows the difficulty in adolescence to link bodily transformations and sexuality, psychic suffering is undeniable and is embodied in the body while taking into account contemporary social data. Building on some elements of the psychoanalysis of a young anorexic girl, the article attempts to break through the wall of pain and get to perceive that in an order that is no longer governed by the paternal instance, which allows the representation, the subject can no longer support a phallusized image and the body is reduced to its reality. This results in a particularly painful female transmission in the clinic of anorexia, in which the contemporary world is not innocent. Pain is not the goal for the anorexic; it shows a willingness to feel the existence of the body. She seeks this nothing through which she attempts to capture the rift in the Other. But to achieve this nothing she must feel the pain of its absence. Pain is thus a claimed effect. The article ends with a reflection on the therapeutic work with the anorexic subject, which would be to allow the dis-completeness of the discourse concerning it, to reintroduce a relationship to its own image marked with a lack and offer the conditions of its own enunciation.
{"title":"The Unbearable Heaviness of Being: Pain and Suffering in Anorexia","authors":"L. Canellopoulos","doi":"10.2174/1876386301407010046","DOIUrl":"https://doi.org/10.2174/1876386301407010046","url":null,"abstract":"In anorexia which classically shows the difficulty in adolescence to link bodily transformations and sexuality, psychic suffering is undeniable and is embodied in the body while taking into account contemporary social data. Building on some elements of the psychoanalysis of a young anorexic girl, the article attempts to break through the wall of pain and get to perceive that in an order that is no longer governed by the paternal instance, which allows the representation, the subject can no longer support a phallusized image and the body is reduced to its reality. This results in a particularly painful female transmission in the clinic of anorexia, in which the contemporary world is not innocent. Pain is not the goal for the anorexic; it shows a willingness to feel the existence of the body. She seeks this nothing through which she attempts to capture the rift in the Other. But to achieve this nothing she must feel the pain of its absence. Pain is thus a claimed effect. The article ends with a reflection on the therapeutic work with the anorexic subject, which would be to allow the dis-completeness of the discourse concerning it, to reintroduce a relationship to its own image marked with a lack and offer the conditions of its own enunciation.","PeriodicalId":53614,"journal":{"name":"Open Pain Journal","volume":"7 1","pages":"46-55"},"PeriodicalIF":0.0,"publicationDate":"2014-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68125602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-11-24DOI: 10.2174/1876386301407010031
L. Croix
Based on a research and clinical work conducted in a pain treatment centre in France, the author shows that the conceptual dichotomies of psyche-soma that dominate the current discussion of the phenomenon of pain cannot ultimately account for its clinical realities. Although pain manifests in the body, it cannot be reduced to organic causes. The psycho- analytic approach to the body on the other hand allows us to make sense of the reality of pain, of the objectivity and cer- tainty that mark its experience for the suffering subject and, in parallel, of the cases where no organic substrate has been identified. The body is not only organic. It is then up to the clinician, whether a physicalist or a psychoanalyst, to know how to work with this sign - one that does not call for interpretation -- regardless of its presumed aetiology.
{"title":"The Subjective Aspects of Pain and its Objectivity in Research","authors":"L. Croix","doi":"10.2174/1876386301407010031","DOIUrl":"https://doi.org/10.2174/1876386301407010031","url":null,"abstract":"Based on a research and clinical work conducted in a pain treatment centre in France, the author shows that the conceptual dichotomies of psyche-soma that dominate the current discussion of the phenomenon of pain cannot ultimately account for its clinical realities. Although pain manifests in the body, it cannot be reduced to organic causes. The psycho- analytic approach to the body on the other hand allows us to make sense of the reality of pain, of the objectivity and cer- tainty that mark its experience for the suffering subject and, in parallel, of the cases where no organic substrate has been identified. The body is not only organic. It is then up to the clinician, whether a physicalist or a psychoanalyst, to know how to work with this sign - one that does not call for interpretation -- regardless of its presumed aetiology.","PeriodicalId":53614,"journal":{"name":"Open Pain Journal","volume":"7 1","pages":"31-35"},"PeriodicalIF":0.0,"publicationDate":"2014-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68125437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-11-24DOI: 10.2174/1876386301407010056
K. Chatira
According to the psychoanalytical Freudian approach, the pain in a conversion symptom (hysterical pain), whether defined or indefinable, corresponds to a displacement of the intrapsychic conflict to the subject's physical body. The libidinal energy attached to the repressed representation is transformed into neurotic energy in organs or parts of the body so as to dramatically represent the desirable as well as the prohibitive. The body lends itself as a 'location' to the conversion disorder in order for the anguish of the intrapsychic conflict to be expressed in openly manipulative terms. Does this hysterical pain designate both the pleasure of the performance and the discontent of the psychological anguish? On the contrary, the psychosomatic pain manifests itself in the actual physical body of the organism and not in the illusory body of the hysteric. It is possible for the (psycho)somatic disorder to be expressed through the pain symptom upon an ex- isting, objective condition diagnosed in an organ or body part. But is it not the very nature of the psychosomatic disorder a unique differentiation criterion between the two types of the disorder? The rationale, the type of the psychological defense mechanisms and the nature of the impulsive dynamics which subdue each of those two types of painful symptoms consti- tute criteria of other differentiators within the psychopathological and psychoanalytic approach.
{"title":"Pain as a Conversion Symptom or a Psychosomatic Phenomenon: Fake or Real?","authors":"K. Chatira","doi":"10.2174/1876386301407010056","DOIUrl":"https://doi.org/10.2174/1876386301407010056","url":null,"abstract":"According to the psychoanalytical Freudian approach, the pain in a conversion symptom (hysterical pain), whether defined or indefinable, corresponds to a displacement of the intrapsychic conflict to the subject's physical body. The libidinal energy attached to the repressed representation is transformed into neurotic energy in organs or parts of the body so as to dramatically represent the desirable as well as the prohibitive. The body lends itself as a 'location' to the conversion disorder in order for the anguish of the intrapsychic conflict to be expressed in openly manipulative terms. Does this hysterical pain designate both the pleasure of the performance and the discontent of the psychological anguish? On the contrary, the psychosomatic pain manifests itself in the actual physical body of the organism and not in the illusory body of the hysteric. It is possible for the (psycho)somatic disorder to be expressed through the pain symptom upon an ex- isting, objective condition diagnosed in an organ or body part. But is it not the very nature of the psychosomatic disorder a unique differentiation criterion between the two types of the disorder? The rationale, the type of the psychological defense mechanisms and the nature of the impulsive dynamics which subdue each of those two types of painful symptoms consti- tute criteria of other differentiators within the psychopathological and psychoanalytic approach.","PeriodicalId":53614,"journal":{"name":"Open Pain Journal","volume":"48 1","pages":"56-58"},"PeriodicalIF":0.0,"publicationDate":"2014-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68125652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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