Chronic pain syndromes and their relation to childhood abuse and stressful life events

Lampe, Astrid; Doering, Stephan; Rumpold, Gerhard; Sölder, E; Krismer, Martin; Kantner-Rumplmair, Wilhelm; Schubert, Christian; Söllner, Wolfgang

doi:10.1016/s0022-3999(02)00399-9

Cited by 187 publications

(127 citation statements)

References 28 publications

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“…Those with both disorders were more likely to report a history of physical/ sexual abuse, have a chronic medical condition, be older, have higher ratings of psychiatric distress and addiction severity, report more stressful life events, and have lower ratings of PA, social support, and confidence to cope with mental illness compared with persons with neither disorder. In prior studies, PTSD and chronic pain separately have shown associations with many of the factors found in the current study: physical/sexual abuse [26,41], chronic physical health problems [32,42], psychiatric or emotional distress [43][44], drug/alcohol use [45][46], ongoing stressful or traumatic life events [26,47], and lower social support [48][49]. In previous studies, chronic pain was associated with increased age [32] and lower PA [50]; therefore, that persons with both disorders in the current study demonstrated these characteristics is logical.…”

Section: Discussionmentioning

confidence: 62%

Prevalence and correlates of posttraumatic stress disorder and chronic severe pain in psychiatric outpatients

Villano¹,

Rosenblum²,

Magura³

et al. 2007

JRRD

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Abstract-This cross-sectional study reports the prevalence and correlates of posttraumatic stress disorder (PTSD) and chronic severe pain in psychiatric outpatients (n = 295), a sample that has not previously been examined for the co-occurrence of these two disorders. Nearly half the participants (46%) met the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition criteria for PTSD; 40% reported chronic severe pain; and 24% had both disorders. We compared four groups of subjects who had either both disorders, PTSD only, chronic severe pain only, or neither disorder for variables previously found to be associated with both disorders or either disorder alone (e.g., psychiatric distress, substance use, stressful life events, physical/sexual abuse). Multiple pairwise comparisons indicated that persons with both disorders were significantly different from persons with neither disorder for all dependent variables and that they had greater physical and psychosocial stressors. Persons with either PTSD or chronic severe pain alone were more likely to have a chronic medical condition, higher ratings of psychiatric distress, and more stressful life events than persons with neither disorder. Mental health treatment providers should be aware of the potential for the co-occurrence of PTSD and chronic severe pain and of the many related factors in psychiatric outpatients.

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Section: Discussionmentioning

confidence: 62%

Prevalence and correlates of posttraumatic stress disorder and chronic severe pain in psychiatric outpatients

Villano¹,

Rosenblum²,

Magura³

et al. 2007

JRRD

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“…From these, five studies [24][25][26][27][28] used an observational descriptive design and the remaining 13 8,20,21,[29][30][31][32][33][34][35][36][37][38] used a case-control design. Most of the studies were conducted in the United States (n = 6) and Brazil (n = 5).…”

Section: Resultsmentioning

confidence: 99%

Associations between chronic pelvic pain and psychiatric disorders and symptoms

Neto¹,

Crippa²,

Hallak³

et al. 2015

Arch. Clin. Psychiatry (São Saulo)

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Background: Chronic pelvic pain (CPP) is a complex condition wich is associated with emotional factors, specially depression and anxiety. Objectives: To make a systematic review to provide a detailed summary of relevant literature on the association between CPP and different psychiatric disorders/symptoms. Methods: A systematic review of articles in the international literature published between 2003 and 2014 was performed in the electronic databases PubMed, PsycINFO, LILACS, and SciELO using the terms (chronic pelvic pain) AND (psychiatry OR psychiatric OR depression OR anxiety OR posttraumatic stress OR somatoform). The searches returned a total of 529 matches that were filtered according to predefined inclusion and exclusion criteria. A total of 18 articles were selected. Results: The investigations focused mainly on the assessment of depression and anxiety disorders/symptoms, with rather high rates (17-38.6%). Depression and anxiety symptoms were more prevalent among women with CPP compared to healthy groups. Comparisons between groups with CPP and with specific pathologies that also have pain as a symptom showed that depression indicators are more frequent in CPP. Depressive symptoms tend to be more common in CPP and have no particular association with pain itself, the core feature of CPP. Discussion: Other aspects of CPP seem to play a specific role in this association. Anxiety and other psychiatric disorders require further investigation so that their impact on CPP can be better understood.

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“…[37][38][39][40][41][42] Although the cause of visceral hypersensitivity is unknown, clinical studies have shown that chronic stress worsens IBS symptomatology and ELS serves as a risk factor for IBS. [43][44][45][46] The sympatho-medullary and the HPA axes are activated by exposure to stress; the sympatho-medullary axis releases epinephrine from the adrenal medulla, to allow the organism to "fight" or "flee" from a threat, whilst activation of the HPA axis releases cortisol (or corticosterone [CORT] in rodents) from the adrenal cortex to mobilize reserves of glucose with the goal of replenishing the expended sympatho-medullary system. Activation of the HPA axis by stress releases CRH from the paraventricular nucleus of the hypothalamus into the hypophyseal portal circulation.…”

Section: Introductionmentioning

confidence: 99%

Mechanisms of Stress-induced Visceral Pain

Meerveld

Johnson

2018

J Neurogastroenterol Motil

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Evidence suggests that long-term stress facilitates visceral pain through sensitization of pain pathways and promotes chronic visceral pain disorders such as the irritable bowel syndrome (IBS). This review will describe the importance of stress in exacerbating IBS-induced abdominal pain. Additionally, we will briefly review our understanding of the activation of the hypothalamic-pituitary-adrenal axis by both chronic adult stress and following early life stress in the pathogenesis of IBS. The review will focus on the glucocorticoid receptor and corticotropin-releasing hormone-mediated mechanisms in the amygdala involved in stress-induced visceral hypersensitivity. One potential mechanism underlying persistent effects of stress on visceral sensitivity could be epigenetic modulation of gene expression. While there are relatively few studies examining epigenetically mediated mechanisms involved in stress-induced visceral nociception, alterations in DNA methylation and histone acetylation patterns within the brain, have been linked to alterations in nociceptive signaling via increased expression of pro-nociceptive neurotransmitters. This review will discuss the latest studies investigating the long-term effects of stress on visceral sensitivity. Additionally, we will critically review the importance of experimental models of adult stress and early life stress in enhancing our understanding of the basic molecular mechanisms of nociceptive processing. Taken together, the complex clinical phenotype makes recapitulating IBS in rodent models extremely challenging. However, an aim of this review will be to describe how the use of rodent models of adult stress, early life stress (ELS), and a dysregulated HPA axis has improved our understanding of stress in the pathophysiology of IBS. Pathophysiology of Irritable Bowel Syndrome: Activation of the Brain-Gut AxisEvidence from clinical and basic research points to dysregulation of the bidirectional communication between the brain-gut axis in IBS. 21 The brain-gut axis represents a dynamic interplay between central circuits and peripheral mechanisms. The messengers of this complex circuit include neural, endocrine, metabolic, and immune mediators that are activated by central factors such as stress (Fig. 1). Although IBS is not an inflammatory disorder, the immune system plays a role in the pathogenesis of IBS in at least a subset of patients and likely contributes to the etiology of IBS symptoms. 22,23 A subset of IBS patients display a low grade chronic inflammation, and there is also evidence that following an enteric infection and combined with stressful life events, there is an increased risk of developed post-infectious IBS. [24][25][26][27] Clearly, the immune system and inflammatory processes are modulated by the HPA and autonomic nervous systems. In support, IBS patients also show increased number and reactivity of mast cells. 28,29 Data from peripheral blood mononuclear cells, as well as in mucosal biopsies, from IBS patients show that cytokines levels including TNF-α...

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Chronic pain syndromes and their relation to childhood abuse and stressful life events

Cited by 187 publications

References 28 publications

Prevalence and correlates of posttraumatic stress disorder and chronic severe pain in psychiatric outpatients

Prevalence and correlates of posttraumatic stress disorder and chronic severe pain in psychiatric outpatients

Associations between chronic pelvic pain and psychiatric disorders and symptoms

Mechanisms of Stress-induced Visceral Pain

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