Pain Sensitivity and Psychiatric Comorbidities in Chronic Pancreatitis Patients With and Without Pain: Past Experience Matters

Phillips, Anna E.; Bick, Benjamin L.; Faghih, Mahya; Yadav, Dhiraj; Drewes, Asbjørn Mohr; Singh, Vikesh K.; Olesen, Søren Schou

doi:10.1016/j.gastha.2022.04.013

Cited by 7 publications

(5 citation statements)

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“…Based on this result, we can infer that relieving pain could change physiological responses to pain in the future. Likewise, previous pain experiences cause psychological symptoms and elevated pain sensitivity in the chronic pain population, whereas patients with no recent pain experience show low pain sensitivity and few psychological symptoms (Phillips et al, 2022). Given that our results underpin the influence of a previous pain experience, it also supports that timely clinical interventions that alleviate the current state of pain have not only immediate clinical benefits but also long-term benefits by preventing the exacerbation of pain and psychological problems caused by a previous pain experience.…”

Section: Discussionmentioning

confidence: 99%

“…One factor that influences pain experience is past pain experiences, which are related to the biological and psychosocial responses to pain (Rollman et al, 2004). For example, patients who had experienced pain in the past reported higher pain sensitivity than patients who had a pain-free experience, even if they no longer experienced pain at the moment (Phillips et al, 2022). Additionally, past pain experiences that were highly intense contribute to high reactivity to pain (Rollman et al, 2004).…”

Section: Introductionmentioning

confidence: 99%

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Does past/current pain change pain experience? Comparing self-reports and pupillary responses

Yoo

Cho²,

Cho³

2023

Front. Psychol.

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IntroductionFor decades, a substantial body of research has confirmed the subjective nature of pain. Subjectivity seems to be integrated into the concept of pain but is often confined to self-reported pain. Although it seems likely that past and current pain experiences would interact and influence subjective pain reports, the influence of these factors has not been investigated in the context of physiological pain. The current study focused on exploring the influence of past/current pain on self-reporting and pupillary responses to pain.MethodsOverall, 47 participants were divided into two groups, a 4°C–10°C group (experiencing major pain first) and a 10°C–4°C group (experiencing minor pain first), and performed cold pressor tasks (CPT) twice for 30 s each. During the two rounds of CPT, participants reported their pain intensity, and their pupillary responses were measured. Subsequently, they reappraised their pain ratings in the first CPT session.ResultsSelf-reported pain showed a significant difference (4°C–10°C: p = 0.045; 10°C–4°C: p < 0.001) in the rating of cold pain stimuli in both groups, and this gap was higher in the 10°C–4°C group than in the 4°C–10°C group. In terms of pupillary response, the 4°C–10°C group exhibited a significant difference in pupil diameter, whereas this was marginally significant in the 10°C–4°C group (4°C–10°C: p < 0.001; 10°C–4°C: p = 0.062). There were no significant changes in self-reported pain after reappraisal in either group.DiscussionThe findings of the current study confirmed that subjective and physiological responses to pain can be altered by previous experiences of pain.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Does past/current pain change pain experience? Comparing self-reports and pupillary responses

Yoo

Cho²,

Cho³

2023

Front. Psychol.

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“…• тривалою астенізацією [2][3][4][5]. СЕІ є одним із визначальних типових клініко-патогенетичних синдромів формування і тяжкості хронічного панкреатиту (ХП) [1,5].…”

Section: Discussionunclassified

Efficiency of Complex Correction of Endotoxicosis in Chronic Pancreatitis During Renewal Treatment

Zoriana

Liliia

2022

FMEP

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Clinical manifestations and features of endogenous intoxication syndrome (EIS) in severe and critical conditions are described in the literature. EIS is one of the defining typical clinical and pathogenetic syndromes of the formation and severity of chronic pancreatitis (CP). The objective: to analyze the EIS parameters by CP in patients outside of exacerbation and their impact on the quality of patient’s life and the dynamics under the influence of the proposed treatment programs with the inclusion of ginkgo biloba drugs and bioregulatory therapy. Materials and methods. 100 patients with diagnosis of CP who had outpatient treatment took part in the study. The age of the patients ranged from 25 to 73 years old, the average age was 51.0±1.1 years. EIS was determined based on the concentration of medium molecular weight peptides with maximum absorption at the wavelength 254 nm and 280 nm and circulating immune complexes. Patients’ quality of life was assessed using the SF-36 questionnaire. The patients were divided into three 3 groups. The persons in the 1st group (n=34) received generally accepted treatment (GAT) in accordance with the clinical diagnosis and the protocol proposed by the Ministry of Health of Ukraine (Order No. 638 of 09/10/2014), the patients in the 2nd group (n=33) received GAT together with a course of ginkgo biloba (memoplant), the individuals in the 3rd group (n=33) received the GAT with a course of memoplant and bioregulatory therapy (BRT). Results. In the examined patients with CP a decrease in all indicators of the quality of life according to the SF-36 was found, the parameters of the role (33.7±3.4) and emotional (37.0±3.9) functioning scales decreased mostly, the average value of physical health was 51,1±7.2, psychological one – 45.1±3.9. An increase in EIS indicators was determined, which were reliably correlated with indicators of quality of life. In the patients who received GAT and ginkgo biloba the more significant dynamics of EIS regression were established at the levels of the studied indicators, however, their normalization to the control level was observed only in the 3rd group of patients who received an additional course of BRT (p<0.001). Conclusions. The results of the study determined a negative impact of EIS on parameters of quality of life according to the SF-36 in patients with CP, which justifies the necessity for the correction. A more severe EIS according to the levels of the studied indicators was found among people with excessive and reduced body weight (p<0.05), which indicates a more severe course of the inflammatory process. According to the dynamics of EIS the indicators in patients with CP it is possible to claim a higher efficiency of therapy with additional prescription to the generally accepted treatment of ginkgo biloba and a course of bioregulatory therapy.

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“…Як свідчить аналіз вітчизняної та зарубіжної літератури, у пацієнтів із ХП часто спостерігаються тривожнодепресивні розлади. Для їх виявлення рекомендують застосовувати опитувальники Спілбергера -Ханіна, Айзенка, HADS [9,[11][12][13][14]. Вони дозволяють оцінити рівень особистісної тривожності (ОТ), що є стійкою індивідуальною рисою, реактивної тривожності (РТ), що є мінливою ознакою і визначається в даній конкретній ситуації, нейротизму (емоційна лабільність, збудженість, схильність до психопатології в емоційній сфері), тривоги й депресії.…”

Section: 2022unclassified

Effect of autonomic dysfunction on the exocrine function of the pancreas in chronic pancreatitis

Sabat

Бабинец

2023

GASTRO

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Background. The article evaluates the impact of autonomic dysfunction according to the heart rate variability data and the Spielberger-Khanin questionnaire on the exocrine function of the pancreas in chronic pancreatitis (CP). The aim is to evaluate the exocrine function of the pancreas depending on the heart rate variability and survey using the Spielberger-Khanin questionnaire. Materials and methods. One hundred outpatients with a diagnosis of CP who were treated in Ternopil healthcare institutions were examined. The presence of exocrine pancreatic insufficiency was determined by the level of fecal α-elastase. The psycho-emotional state was assessed using the Spielberger-Khanin questionnaire. Statistical and spectral indicators of heart rate variability were analyzed: the range of variation, the amplitude of the mode, stress index, indicator of activity of regulatory systems, total spectrum power, absolute and percentage values of very low frequency (VLF), low frequency (LF), high frequency power (HF), the LF/HF ratio. A correlation analysis was performed of the obtained heart rate variability data, the Spielberger-Khanin questionnaire data with the degree of exocrine pancreatic insufficiency in terms of the level of fecal α-elastase. Results. The average value of reactive anxiety on the Spielberger-Khanin questionnaire is 44.33 ± 0.89, personal anxiety is 43.19 ± 0.82, which corresponds to the upper limit of the moderate level. A negative correlation was found between these parameters and the level of fecal α-elastase (r = –0.482, p < 0.01, and r = –0.555, p < 0.01, respectively). Based on the heart rate variability of patients with CP, a tendency among them to sympathicotonia was detected, which was accompanied by a significant increase in the amplitude of the mode, stress index, the LF/HF ratio and a decrease in the range of variation compared to the control group. In contrast to the healthy individuals, the humoral-metabolic effect of heart rhythm regulation prevailed in those with CP (VLF — (48.66 ± 1.21) %) and the share of the nervous component (LF — (31.69 ± 0.67) %, HF — (19.65 ± 0.75) %) decreased, there was a significant decrease in the total power of the spectrum compared to the control group (1546.25 ± 44.18 versus 3155.65 ± 211.38). The indicator of the activity of regulatory systems in patients with CP (6.91 ± 0.12) was at the upper limit of the intense load of regulatory systems, which reflects a significant impairment of adaptation among them and reliably differs from the control level (3.90 ± 0.31). A significant correlation was found between the total power of the spectrum, indicator of the activity of regulatory systems and the level of fecal α-elastase (r = 0.511, p < 0.01, and r = –0.398, p < 0.01, respectively). Conclusions. During the study, it was found that with a deterioration in the psycho-emotional state (according to the data of the Spielberger-Khanin questionnaire), exocrine insufficiency of the pancreas in patients with CP increased: there was a correlation between the content of fecal α-elastase and the level of reactive and personal anxiety. Positive statistically significant correlations between the amplitude of the mode, stress index with the duration of the course of CP indicate compensatory activation of the sympathetic division of the autonomic nervous system. It was also proved that exocrine insufficiency (according to the content of fecal α-elastase) worsened with an increase in sympathicotonia (according to the stress index). A decrease in the functional reserve in patients with СР was revealed: a significant decrease in the total power of the spectrum was found compared to that of the control group; against this background, there was a decrease in the adaptive potential, deterioration in the psycho-emotional state, which resulted in an increase in exocrine pancreatic insufficiency. The obtained data motivate to improve the generally accepted comprehensive therapy of patients with chronic pancreatitis with the additional inclusion in it of agents to stabilize the autonomic nervous system.

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Pain Sensitivity and Psychiatric Comorbidities in Chronic Pancreatitis Patients With and Without Pain: Past Experience Matters

Cited by 7 publications

References 35 publications

Does past/current pain change pain experience? Comparing self-reports and pupillary responses

Does past/current pain change pain experience? Comparing self-reports and pupillary responses

Efficiency of Complex Correction of Endotoxicosis in Chronic Pancreatitis During Renewal Treatment

Effect of autonomic dysfunction on the exocrine function of the pancreas in chronic pancreatitis

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