Pub Date : 2014-11-24DOI: 10.2174/1876386301407010041
Vassiliki Simoglou
Contemporary body practices providing an answer to the subjects' demand for assisted reproduction procedures, question the subjective experience of pain. The psychoanalytic approach of pain introduces the dimension of the unconscious in bodily experiences. Clinical field work and psychoanalytic psychotherapy with an infertile woman after failed egg-donation in vitro fertilization cycles, allows an understanding of psychic pain as analogous to somatic pain and considers the human body as a psychosomatic entity. In this case study, pain becomes a vector of subjectivation, allowing for the subject to negotiate acceptance of a gift impossible to receive.
{"title":"The Pain of Egg-Donation","authors":"Vassiliki Simoglou","doi":"10.2174/1876386301407010041","DOIUrl":"https://doi.org/10.2174/1876386301407010041","url":null,"abstract":"Contemporary body practices providing an answer to the subjects' demand for assisted reproduction procedures, question the subjective experience of pain. The psychoanalytic approach of pain introduces the dimension of the unconscious in bodily experiences. Clinical field work and psychoanalytic psychotherapy with an infertile woman after failed egg-donation in vitro fertilization cycles, allows an understanding of psychic pain as analogous to somatic pain and considers the human body as a psychosomatic entity. In this case study, pain becomes a vector of subjectivation, allowing for the subject to negotiate acceptance of a gift impossible to receive.","PeriodicalId":53614,"journal":{"name":"Open Pain Journal","volume":"7 1","pages":"41-45"},"PeriodicalIF":0.0,"publicationDate":"2014-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68125539","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: 10.2174/1876386301407010059
Aikaterini Malichin
The spectrum of depressing affective disorder countries a crowd of clinical types and cases and summarizes various symptoms, criteria and phenomena that are not explained in their quality and their causality and that potentially are symptomic events and sentimental situations that can oscillate from the neurosis up to the psychosis. It is estimated by epidemiologic researches that the 6% of roughly general population suffers from clinically diagnosed depression. The common point of subjects that suffer or have been diagnosed with depression is the pain of existence, as a complicated emotional, psychical and physical situation, and the inhibition that this involves. The psychoanalytical clinic is based in the decoding of this pain in the particular signifying chain of each subject separately, but also through the localization of mental structure that belongs to each subject. While the depression is not a structure but a hyper- structure, but neither a symptom, it is an affective painful situation which should be treated by the clinical process in its singularity. Thus, through a concise regard of pain in the depressing situations, the pain of existence in the post- modern melancholies, the moral pain of melancholy as psychotic structure, and the intense pain of loss and mourning, presenting three clinical ex- amples, the author concludes and emphasizes the clinical and ethical importance of elaboration of subjective causality of pain and inhibition.
{"title":"What Depression? Or The Elimination of the Subjective Causality of Pain?","authors":"Aikaterini Malichin","doi":"10.2174/1876386301407010059","DOIUrl":"https://doi.org/10.2174/1876386301407010059","url":null,"abstract":"The spectrum of depressing affective disorder countries a crowd of clinical types and cases and summarizes various symptoms, criteria and phenomena that are not explained in their quality and their causality and that potentially are symptomic events and sentimental situations that can oscillate from the neurosis up to the psychosis. It is estimated by epidemiologic researches that the 6% of roughly general population suffers from clinically diagnosed depression. The common point of subjects that suffer or have been diagnosed with depression is the pain of existence, as a complicated emotional, psychical and physical situation, and the inhibition that this involves. The psychoanalytical clinic is based in the decoding of this pain in the particular signifying chain of each subject separately, but also through the localization of mental structure that belongs to each subject. While the depression is not a structure but a hyper- structure, but neither a symptom, it is an affective painful situation which should be treated by the clinical process in its singularity. Thus, through a concise regard of pain in the depressing situations, the pain of existence in the post- modern melancholies, the moral pain of melancholy as psychotic structure, and the intense pain of loss and mourning, presenting three clinical ex- amples, the author concludes and emphasizes the clinical and ethical importance of elaboration of subjective causality of pain and inhibition.","PeriodicalId":53614,"journal":{"name":"Open Pain Journal","volume":"7 1","pages":"59-66"},"PeriodicalIF":0.0,"publicationDate":"2014-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68125661","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: 10.2174/1876386301407010067
D. Nikolopoulos, K. Chatira
The present study attempts to investigate the existence of psychic pain in young learners experiencing chronic school failure/learning disabilities. Using a projective technique, the participants were asked to express the thoughts, feel- ings, dreams and wishes of an 'imaginary' child of their own age. LD individuals: a mentioned terrifying nightmares, and b. did not 'admit' their LD, even though in subsequent questions the majority admitted a projection of their own thoughts and feelings onto the 'imaginary' child. A high proportion of 'average/good' academic performance individuals answered more positively. The response pattern of LD individuals in our projective task not only reveals the magnitude of the psy- chic pain experienced by LD individuals but also offers a unique depiction of the way in which each of these individuals experience the psychic pain. The feeling of 'helplessness' stemming from chronic LD, combined with other related nega- tive experiences during the sensitive years of personality development, add up to severe psychological pressure like that described in the psychological trauma literature.
{"title":"Psychic Pain in Chronic School Failure/Learning Disabilities: Evidence from a Projective Technique","authors":"D. Nikolopoulos, K. Chatira","doi":"10.2174/1876386301407010067","DOIUrl":"https://doi.org/10.2174/1876386301407010067","url":null,"abstract":"The present study attempts to investigate the existence of psychic pain in young learners experiencing chronic school failure/learning disabilities. Using a projective technique, the participants were asked to express the thoughts, feel- ings, dreams and wishes of an 'imaginary' child of their own age. LD individuals: a mentioned terrifying nightmares, and b. did not 'admit' their LD, even though in subsequent questions the majority admitted a projection of their own thoughts and feelings onto the 'imaginary' child. A high proportion of 'average/good' academic performance individuals answered more positively. The response pattern of LD individuals in our projective task not only reveals the magnitude of the psy- chic pain experienced by LD individuals but also offers a unique depiction of the way in which each of these individuals experience the psychic pain. The feeling of 'helplessness' stemming from chronic LD, combined with other related nega- tive experiences during the sensitive years of personality development, add up to severe psychological pressure like that described in the psychological trauma literature.","PeriodicalId":53614,"journal":{"name":"Open Pain Journal","volume":"7 1","pages":"67-76"},"PeriodicalIF":0.0,"publicationDate":"2014-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68125176","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: 10.2174/1876386301407010036
Yorgos Dimitriadis
In the present paper, we look into what is painful psychical analgesia in relation to what 19 th century clinicians have named "moral pain" in melancholia, and more particularly in the delusion of negation described by the French psy- chiatrist Jules Cotard in 1880, a form of delusion that can be seen mostly in cases of chronic anxious melancholia. This condition is characterized by a painful absence of emotions, which occurs when the subject, in the Lacanian sense of the word, ceases to be touched by the signifiers, and consequently ceases to exist as a subject. Hence, these patients often de- clare themselves to be already dead or incapable of dying. The psychoanalytical approach to this delusion allows an un- derstanding of the ''lack of lack'' concept, as these patients, having lost the lack, affirm that their body's orifices are clogged, that they have lost their mental vision, that they miss various visceral organs etc. The completeness of their body - the absence of orifices - can sometimes attain universal dimensions and these patients can thus identify themselves to the universe, which contains everything. The delusion of negation teaches us something important concerning the essence of desire, in relation to what has been named by Lacan area-between-two-deaths. This Lacanian concept refers essentially to the tragic hero, but also, more generally, to the lonely condition where anyone's desire should be able to exist beyond any narcissistic commitment, which means beyond the pleasure principle as well.
{"title":"The Painful Analgesia of Cotard’s Syndrome","authors":"Yorgos Dimitriadis","doi":"10.2174/1876386301407010036","DOIUrl":"https://doi.org/10.2174/1876386301407010036","url":null,"abstract":"In the present paper, we look into what is painful psychical analgesia in relation to what 19 th century clinicians have named \"moral pain\" in melancholia, and more particularly in the delusion of negation described by the French psy- chiatrist Jules Cotard in 1880, a form of delusion that can be seen mostly in cases of chronic anxious melancholia. This condition is characterized by a painful absence of emotions, which occurs when the subject, in the Lacanian sense of the word, ceases to be touched by the signifiers, and consequently ceases to exist as a subject. Hence, these patients often de- clare themselves to be already dead or incapable of dying. The psychoanalytical approach to this delusion allows an un- derstanding of the ''lack of lack'' concept, as these patients, having lost the lack, affirm that their body's orifices are clogged, that they have lost their mental vision, that they miss various visceral organs etc. The completeness of their body - the absence of orifices - can sometimes attain universal dimensions and these patients can thus identify themselves to the universe, which contains everything. The delusion of negation teaches us something important concerning the essence of desire, in relation to what has been named by Lacan area-between-two-deaths. This Lacanian concept refers essentially to the tragic hero, but also, more generally, to the lonely condition where anyone's desire should be able to exist beyond any narcissistic commitment, which means beyond the pleasure principle as well.","PeriodicalId":53614,"journal":{"name":"Open Pain Journal","volume":"7 1","pages":"36-40"},"PeriodicalIF":0.0,"publicationDate":"2014-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68125452","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 : 2014-11-14DOI: 10.2174/1876386301407010023
M. Boules, P. Fredrickson, E. Richelson
The analgesic efficacy of neurotensin agonists depends on their activation of two receptor subtypes, NTS1 and/or NTS2. In this study we determined the role of NTS2 in an animal model of persistent pain (intraplantar injection of formalin) with the use of the NTS2-selective analog, NT79 and NTS2-knockout mice (NTS2 -/- ). Wild type (WT) and NTS2 -/- mice were pretreated with NT79 and tested for formalin-induced lifting and biting. Additionally, the effect of repeated administration of NT79 and morphine alone and in combination was determined in WT mice. Intraplantar injection of formalin produced the typical biphasic nociceptive response of this persistent pain model. Formalin evoked lower pain intensity in NTS2 -/- mice as compared to that for WT mice. Pretreatment with NT79 attenuated formalin- induced nociception throughout phase II in the WT mice, and in early phase II in the NTS2 -/- mice. Lifting and biting responses were attenuated, indicating spinal and supra-spinal modulation of persistent nociception. More importantly, repeated injection of NT79 enhanced, while that of morphine reduced their antinociceptive effects, respectively. Subchronic co-administration of NT79 and morphine enhanced the analgesic effect over either drug alone. These data support the role of NTS2 in modulating formalin-induced pain. Additionally, these data provide a rationale for the potential therapeutic role of NTS2-selective analogs in chronic pain management alone or in combination with morphine and without the development of tolerance.
{"title":"An NTS2 Analog Enhances the Analgesic Effects of Morphine in an Animal Model of Persistent Pain and Does not Exhibit Tolerance","authors":"M. Boules, P. Fredrickson, E. Richelson","doi":"10.2174/1876386301407010023","DOIUrl":"https://doi.org/10.2174/1876386301407010023","url":null,"abstract":"The analgesic efficacy of neurotensin agonists depends on their activation of two receptor subtypes, NTS1 and/or NTS2. In this study we determined the role of NTS2 in an animal model of persistent pain (intraplantar injection of formalin) with the use of the NTS2-selective analog, NT79 and NTS2-knockout mice (NTS2 -/- ). Wild type (WT) and NTS2 -/- mice were pretreated with NT79 and tested for formalin-induced lifting and biting. Additionally, the effect of repeated administration of NT79 and morphine alone and in combination was determined in WT mice. Intraplantar injection of formalin produced the typical biphasic nociceptive response of this persistent pain model. Formalin evoked lower pain intensity in NTS2 -/- mice as compared to that for WT mice. Pretreatment with NT79 attenuated formalin- induced nociception throughout phase II in the WT mice, and in early phase II in the NTS2 -/- mice. Lifting and biting responses were attenuated, indicating spinal and supra-spinal modulation of persistent nociception. More importantly, repeated injection of NT79 enhanced, while that of morphine reduced their antinociceptive effects, respectively. Subchronic co-administration of NT79 and morphine enhanced the analgesic effect over either drug alone. These data support the role of NTS2 in modulating formalin-induced pain. Additionally, these data provide a rationale for the potential therapeutic role of NTS2-selective analogs in chronic pain management alone or in combination with morphine and without the development of tolerance.","PeriodicalId":53614,"journal":{"name":"Open Pain Journal","volume":"248 1","pages":"23-28"},"PeriodicalIF":0.0,"publicationDate":"2014-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68125371","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 : 2014-09-09DOI: 10.2174/1876386301407010009
R. Hauser, P. Blakemore, J. Wang, D. Steilen
Joint dysfunctions and associated musculoskeletal pain are among the most common medical complaints presented to clinicians. Ligaments are collagenous fibrous structures that are primarily responsible for maintaining smooth joint motion, restraining excessive joint displacement, and providing stability across the joint. Ligaments also act as sensory organs for the joints and have significant input to pain sensation. When ligaments are subjected to forces beyond their normal range of motion, injury and failure occur, resulting in joint laxity (looseness or instability), and subsequent disruptions in the balance between joint mobility and joint stability. These dysfunctions can result in joint pain and the development of osteoarthritis. Several strategies have been employed over the years in attempts to improve joint instability from ligament injury; however, some of the standard therapeutic approaches (drugs, corticosteroid injections, and surgery) employed to address these problems have not been very effective because they often do not address the underlying cause of the problems, and in fact can inhibit ligament healing and restoration. For these reasons, there is current and growing interest among patients and clinicians in prolotherapy, an alternative therapeutic modality that can reduce or eliminate pain by stimulating the natural regenerative processes in and around the joint to facilitate the restoration of degenerated ligaments and tendons to a healthy state, improving joint support, function and reducing pain. This review presents current evidence from clinical studies demonstrating that prolotherapy is a significant and effective alternative treatment modality for people with ligament-related injuries and resultant joint instability.
{"title":"Structural Basis of Joint Instability as Cause for Chronic Musculoskeletal Pain and Its Successful Treatment with Regenerative Injection Therapy (Prolotherapy)","authors":"R. Hauser, P. Blakemore, J. Wang, D. Steilen","doi":"10.2174/1876386301407010009","DOIUrl":"https://doi.org/10.2174/1876386301407010009","url":null,"abstract":"Joint dysfunctions and associated musculoskeletal pain are among the most common medical complaints presented to clinicians. Ligaments are collagenous fibrous structures that are primarily responsible for maintaining smooth joint motion, restraining excessive joint displacement, and providing stability across the joint. Ligaments also act as sensory organs for the joints and have significant input to pain sensation. When ligaments are subjected to forces beyond their normal range of motion, injury and failure occur, resulting in joint laxity (looseness or instability), and subsequent disruptions in the balance between joint mobility and joint stability. These dysfunctions can result in joint pain and the development of osteoarthritis. Several strategies have been employed over the years in attempts to improve joint instability from ligament injury; however, some of the standard therapeutic approaches (drugs, corticosteroid injections, and surgery) employed to address these problems have not been very effective because they often do not address the underlying cause of the problems, and in fact can inhibit ligament healing and restoration. For these reasons, there is current and growing interest among patients and clinicians in prolotherapy, an alternative therapeutic modality that can reduce or eliminate pain by stimulating the natural regenerative processes in and around the joint to facilitate the restoration of degenerated ligaments and tendons to a healthy state, improving joint support, function and reducing pain. This review presents current evidence from clinical studies demonstrating that prolotherapy is a significant and effective alternative treatment modality for people with ligament-related injuries and resultant joint instability.","PeriodicalId":53614,"journal":{"name":"Open Pain Journal","volume":"37 1","pages":"9-22"},"PeriodicalIF":0.0,"publicationDate":"2014-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68125146","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 : 2014-08-05DOI: 10.2174/1876386301407010001
H. Shimoyama, M. Tsuda, Takahiro Masuda, Ryohei Yoshinaga, Keiko Tsukamoto, H. Tozaki-Saitoh, Kazuhide Inoue
Neuropathic pain, a highly debilitating condition that commonly occurs after damage to the nervous system, is often resistant to commonly used analgesic agents such as non-steroidal anti-inflammatory drugs and even opioids. Several studies using rodent models reported that cannabinoid CB2 receptor (CB2R) agonists are effective for treating chronic pain. However, the analgesic mechanism of CB2R agonists in neuropathic pain states is not fully understood. In this study, we investigated the role of CB2Rs in the development and maintenance phases of neuropathic pain, and the mechanism of the CB2R-mediated analgesic effect on neuropathic pain. In a rat model of neuropathic pain, systemic administration of JWH133, a CB2R agonist, markedly improved tactile allodynia, and this effect was prevented by intrathecal pretreatment with AM630, a CB2R antagonist. The antiallodynic effect of intrathecally administered JWH133 was inhibited by intrathecal pretreatment with pertussis toxin or forskolin. In the spinal cord, CB2R expression was significantly increased on post-operative day 3, and persisted for 2 weeks. Furthermore, repeated intrathecal administration of JWH133 notably attenuated the development of tactile allodynia after peripheral nerve injury. In a culture of microglia activated by overexpressing interferon regulatory factor 8, a transcription factor crucial for neuropathic pain, JWH133 treatment suppressed the increased expression of interleukin-1� . Our findings suggest that activation of CB2Rs upregulated in the spinal cord after nerve injury alleviates existing tactile allodynia through the Gi/o- adenylate cyclase signaling pathway and suppresses the development of allodynia. This process may reduce the inflammatory response of microglia. Therefore, spinal CB2Rs may be a therapeutic target for the treatment of neuropathic
{"title":"Spinal cord is the primary site of action of the cannabinoid CB2 receptor agonist JWH133 that suppresses neuropathic pain: Possible involvement of microglia","authors":"H. Shimoyama, M. Tsuda, Takahiro Masuda, Ryohei Yoshinaga, Keiko Tsukamoto, H. Tozaki-Saitoh, Kazuhide Inoue","doi":"10.2174/1876386301407010001","DOIUrl":"https://doi.org/10.2174/1876386301407010001","url":null,"abstract":"Neuropathic pain, a highly debilitating condition that commonly occurs after damage to the nervous system, is often resistant to commonly used analgesic agents such as non-steroidal anti-inflammatory drugs and even opioids. Several studies using rodent models reported that cannabinoid CB2 receptor (CB2R) agonists are effective for treating chronic pain. However, the analgesic mechanism of CB2R agonists in neuropathic pain states is not fully understood. In this study, we investigated the role of CB2Rs in the development and maintenance phases of neuropathic pain, and the mechanism of the CB2R-mediated analgesic effect on neuropathic pain. In a rat model of neuropathic pain, systemic administration of JWH133, a CB2R agonist, markedly improved tactile allodynia, and this effect was prevented by intrathecal pretreatment with AM630, a CB2R antagonist. The antiallodynic effect of intrathecally administered JWH133 was inhibited by intrathecal pretreatment with pertussis toxin or forskolin. In the spinal cord, CB2R expression was significantly increased on post-operative day 3, and persisted for 2 weeks. Furthermore, repeated intrathecal administration of JWH133 notably attenuated the development of tactile allodynia after peripheral nerve injury. In a culture of microglia activated by overexpressing interferon regulatory factor 8, a transcription factor crucial for neuropathic pain, JWH133 treatment suppressed the increased expression of interleukin-1� . Our findings suggest that activation of CB2Rs upregulated in the spinal cord after nerve injury alleviates existing tactile allodynia through the Gi/o- adenylate cyclase signaling pathway and suppresses the development of allodynia. This process may reduce the inflammatory response of microglia. Therefore, spinal CB2Rs may be a therapeutic target for the treatment of neuropathic","PeriodicalId":53614,"journal":{"name":"Open Pain Journal","volume":"7 1","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2014-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68125639","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 : 2013-12-13DOI: 10.2174/1876386301306010208
A. Birtle, S. Davidson, G. Atkinson, C. V. Litsenburg
This article reports the outcomes of a sub-analysis of United Kingdom (UK) data collected during a non- interventional, cross-sectional study conducted in five European countries. The primary aim was to estimate the preva- lence of cancer-related neuropathic pain (CRNP) in an outpatient sample of adult cancer patients visiting oncology clinics in the UK for standard care. Secondary aims were to report the nature and characteristics of the cancer and the pain in the patients with CRNP. This sub-analysis also assessed the usefulness of the PainDETECT screening tool as an aid for phy- sicians in identifying the neuropathic component of cancer-related pain in daily practice. Based on physicians' clinical judgment before reviewing the scores on the PainDETECT tool, the estimated number of outpatients with cancer experi- encing chronic pain and considered to have CRNP was 104 of 195 patients (53.3%; 95% confidence interval (CI): 46.3%- 60.3%). After reviewing patients' scores on the tool, the estimate was 90 of 195 patients (46.2%; 95% CI: 39.2%-53.2%). Physicians changed from a positive (yes) to a negative (no) diagnosis of CRNP for 16 of 127 patients who had a low PainDETECT end score (<13; indicating that neuropathic pain was unlikely). Of the 11 physicians who completed the usefulness of PainDETECT survey, eight indicated that they would use the questionnaire in future for at least some of their patients, although they also indicated that in the majority of cases (63%), the PainDETECT tool did not help them evaluate whether a patient had CRNP. Because of missing data arising from missing or incomplete survey responses, however, these data should be interpreted with caution, and further studies are required to assess the usefulness of this tool.
{"title":"Screening for Cancer-Related Neuropathic Pain in the Oncology Outpatient Setting in the United Kingdom","authors":"A. Birtle, S. Davidson, G. Atkinson, C. V. Litsenburg","doi":"10.2174/1876386301306010208","DOIUrl":"https://doi.org/10.2174/1876386301306010208","url":null,"abstract":"This article reports the outcomes of a sub-analysis of United Kingdom (UK) data collected during a non- interventional, cross-sectional study conducted in five European countries. The primary aim was to estimate the preva- lence of cancer-related neuropathic pain (CRNP) in an outpatient sample of adult cancer patients visiting oncology clinics in the UK for standard care. Secondary aims were to report the nature and characteristics of the cancer and the pain in the patients with CRNP. This sub-analysis also assessed the usefulness of the PainDETECT screening tool as an aid for phy- sicians in identifying the neuropathic component of cancer-related pain in daily practice. Based on physicians' clinical judgment before reviewing the scores on the PainDETECT tool, the estimated number of outpatients with cancer experi- encing chronic pain and considered to have CRNP was 104 of 195 patients (53.3%; 95% confidence interval (CI): 46.3%- 60.3%). After reviewing patients' scores on the tool, the estimate was 90 of 195 patients (46.2%; 95% CI: 39.2%-53.2%). Physicians changed from a positive (yes) to a negative (no) diagnosis of CRNP for 16 of 127 patients who had a low PainDETECT end score (<13; indicating that neuropathic pain was unlikely). Of the 11 physicians who completed the usefulness of PainDETECT survey, eight indicated that they would use the questionnaire in future for at least some of their patients, although they also indicated that in the majority of cases (63%), the PainDETECT tool did not help them evaluate whether a patient had CRNP. Because of missing data arising from missing or incomplete survey responses, however, these data should be interpreted with caution, and further studies are required to assess the usefulness of this tool.","PeriodicalId":53614,"journal":{"name":"Open Pain Journal","volume":"6 1","pages":"208-216"},"PeriodicalIF":0.0,"publicationDate":"2013-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68125628","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 : 2013-11-29DOI: 10.2174/1876386301306010199
C. Garzón-Rodríguez, Luis Olay Gayoso, J. Sepúlveda, E. Martinez, I. Peláez, L. Merino, G. Atkinson, V. López-Gómez, M. P. Páramo, C. V. Litsenburg
Cancer patients with neuropathic pain have been shown to have higher levels of pain interference and impaired quality of life (QoL) compared with cancer patients without neuropathic pain. This article presents sub-analysis of data from a large non-interventional study conducted between 23 August 2010 and 22 July 2011 in Denmark, Germany, Greece, Spain and the UK. Descriptive data collected in 21 oncology or palliative care centers during patients' routine out-patient visits in Spain are reported here to further investigate the prevalence and nature of cancer-related neuropathic pain (CRNP). The prevalence of CRNP in 557 cancer patients with chronic pain in Spain was estimated at 30.9% (95% confidence interval (CI): 27.0-34.7) by physicians before considering scores on the PainDETECT questionnaire and 30.7% (95% CI: 26.9-34.5) after considering PainDETECT scores. Despite a similar overall number, there were shifts in the numbers of patients with or without a diagnosis of CRNP after physicians had had the opportunity to consider PainDETECT scores, particularly for patients who received an initial diagnosis of 'unknown'. In the opinion of the physicians, 92/171 (53.8%) of the CRNP population had mixed cancer-related pain with a neuropathic component, which can be difficult to identify and effectively manage. The self-reported responses to questions and scales in this Spanish sample indicated that many aspects of daily functioning were negatively impacted within the CRNP participants and that pain was not always controlled. These data highlight the need for national guidelines to identify and treat cancer-related pain with a neuropathic component.
{"title":"The Prevalence and Nature of Cancer-Related Neuropathic Pain in Out-Patient Services in Spain","authors":"C. Garzón-Rodríguez, Luis Olay Gayoso, J. Sepúlveda, E. Martinez, I. Peláez, L. Merino, G. Atkinson, V. López-Gómez, M. P. Páramo, C. V. Litsenburg","doi":"10.2174/1876386301306010199","DOIUrl":"https://doi.org/10.2174/1876386301306010199","url":null,"abstract":"Cancer patients with neuropathic pain have been shown to have higher levels of pain interference and impaired quality of life (QoL) compared with cancer patients without neuropathic pain. This article presents sub-analysis of data from a large non-interventional study conducted between 23 August 2010 and 22 July 2011 in Denmark, Germany, Greece, Spain and the UK. Descriptive data collected in 21 oncology or palliative care centers during patients' routine out-patient visits in Spain are reported here to further investigate the prevalence and nature of cancer-related neuropathic pain (CRNP). The prevalence of CRNP in 557 cancer patients with chronic pain in Spain was estimated at 30.9% (95% confidence interval (CI): 27.0-34.7) by physicians before considering scores on the PainDETECT questionnaire and 30.7% (95% CI: 26.9-34.5) after considering PainDETECT scores. Despite a similar overall number, there were shifts in the numbers of patients with or without a diagnosis of CRNP after physicians had had the opportunity to consider PainDETECT scores, particularly for patients who received an initial diagnosis of 'unknown'. In the opinion of the physicians, 92/171 (53.8%) of the CRNP population had mixed cancer-related pain with a neuropathic component, which can be difficult to identify and effectively manage. The self-reported responses to questions and scales in this Spanish sample indicated that many aspects of daily functioning were negatively impacted within the CRNP participants and that pain was not always controlled. These data highlight the need for national guidelines to identify and treat cancer-related pain with a neuropathic component.","PeriodicalId":53614,"journal":{"name":"Open Pain Journal","volume":"6 1","pages":"199-207"},"PeriodicalIF":0.0,"publicationDate":"2013-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68125617","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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