Psychiatric disorders as assessed with SCID in chronic pain patients: the anxiety disorders precede the onset of pain

Knaster, Peter; Karlsson, Hasse; Estlander, Ann-Mari; Kalso, Eija

doi:10.1016/j.genhosppsych.2011.09.004

Cited by 118 publications

(94 citation statements)

References 37 publications

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“…The precise relationship between emotionality and pain remains unclear. Previous studies suggest a reciprocal relationship between chronic pain and negative affect and support the concept of a selfperpetuating cycle of events that may underpin the chronic nature of such comorbid disorders (Knaster et al, 2011). Therefore, investigation of the neurobiological mechanisms of pain, and its modulation by negative affect, will inform the identification of new therapeutic targets for improved treatment of pain.…”

Section: Introductionmentioning

confidence: 81%

“…A clinical study in 2012 reported that 77% of subjects with chronic pain along with generalised anxiety disorder reported the onset of anxiety disorder prior to chronic pain suggesting that the affective component may predispose to the development of chronic pain (Knaster et al, 2012). Furthermore, a study by Keogh and Cochrane reported that pain threshold was reduced in patients with anxiety disorders (Keogh and Cochrane, 2002).…”

Section: Hyperalgesia Associated With Negative Affective Statementioning

confidence: 99%

See 1 more Smart Citation

Genotype-dependent responsivity to inflammatory pain: A role for TRPV1 in the periaqueductal grey

Madasu

Okine

Olango

et al. 2016

Pharmacological Research

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Section: Introductionmentioning

confidence: 81%

Section: Hyperalgesia Associated With Negative Affective Statementioning

confidence: 99%

Genotype-dependent responsivity to inflammatory pain: A role for TRPV1 in the periaqueductal grey

Madasu

Okine

Olango

et al. 2016

Pharmacological Research

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“…Approximately 25% to 55% of patients with chronic pain meet the diagnostic criteria for Major Depressive Disorder (MDD) [12,[15][16][17][18][19]. Not only is the prevalence of comorbid depression and chronic pain high, but psychological factors such as depression also contribute significantly to variance in acute and chronic pain [20].…”

Section: Introductionmentioning

confidence: 99%

Sleep Problems are Associated With Chronic Pain Over and Above Mutual Associations With Depression and Catastrophizing

Roberts

Drummond

2016

The Clinical Journal of Pain

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Pain, mood problems and sleeping difficulties are often comorbid and contribute to reduced physical function and quality of life for those suffering from chronic pain. However, the way in which these factors interact is unclear. Until recently it was thought that the effect of sleep on pain and physical function was simply a result of its common association with mood problems. However, a growing body of research suggests that sleep may have a unique contribution.Objectives: The aim of this study was to determine whether sleep disturbances were associated with pain and poor physical function independent of psychological distress in patients attending a tertiary pain medicine unit.Method: 101 patients with chronic pain completed a set of questionnaires measuring pain, sleep and mood, and also completed a selection of physical assessments conducted by a physiotherapist.Results: 75.2% of participants had insomnia and 84.3% reported the presence of at least one sleep problem. Significant positive correlations with pain were detected for depression, catastrophizing, insomnia, short sleep duration and poor sleep quality. Sleep duration had a significant independent association with pain after accounting for depression and catastrophizing. Sleep duration also had an independent association with physical function after accounting for pain and catastrophizing.Conclusions: Given that sleep has an important and unique contribution to pain and physical function, it is important that sleep disturbances are addressed both in the assessment and treatment of chronic pain.

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“…47 What opioids and gabapentinoids have in common is their anxiolytic and dissociative effects, addressing comorbid issues often associated with chronic pain. [48][49][50] Improvements in a patient's quality of life may not be mediated entirely through pain relief but linked to pregabalin's effects on sleep disturbance and anxiety. 51 Consequently, judging the effectiveness of gabapentinoids for pain control may be diffi cult as they may have positive consequences on a comorbid anxiolytic element.…”

Section: Resultsmentioning

confidence: 99%

Gabapentin and Pregabalin: Do the Benefits Outweigh the Harms?

Morrison

Sandilands

Webb

2017

Journal of the Royal College of Physicians of Edinburgh

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Gabapentin and pregabalin prescribing in Scotland has increased substantially over recent years. Evidence suggests that prescribers may be advocating the use of these medicines off-label to avoid prescribing opioid analgesics. The evidence to support gabapentin and pregabalin use in non-neuropathic pain disorders indicates they are less effective than several other licensed non-opioid analgesics. Notably, patients may not bene t from gabapentin and pregabalin but remain at risk of adverse drug reactions. Furthermore, greater availability has resulted in increased diversion of gabapentin and pregabalin; creating problems within the opioid misuse population and prison service. As a consequence, both gabapentin and pregabalin may soon be controlled under the Misuse of Drugs Act 1971. Prescribers should be aware of the very limited clinical evidence for use of gabapentin and pregabalin outside their licensed indications, as well as their capacity to do harm.

show abstract

Psychiatric disorders as assessed with SCID in chronic pain patients: the anxiety disorders precede the onset of pain

Cited by 118 publications

References 37 publications

Genotype-dependent responsivity to inflammatory pain: A role for TRPV1 in the periaqueductal grey

Genotype-dependent responsivity to inflammatory pain: A role for TRPV1 in the periaqueductal grey

Sleep Problems are Associated With Chronic Pain Over and Above Mutual Associations With Depression and Catastrophizing

Gabapentin and Pregabalin: Do the Benefits Outweigh the Harms?

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