Psychiatric morbidity, pain perception, and functional status of chronic pain patients in palliative care

Abstract

Context:Psychological factors, such as that exist when we experience pain, can profoundly alter the strength of pain perception.Aim:The study aims to estimate the prevalence of psychiatric disorders, and its association with perception of pain and functional status in chronic patients in palliative care.Materials and Methods:The sample was selected via simple randomisation and post consent were assessed using (1) a semi- structured questionnaire to elicit socio-demographic information and medical data (2) Brief Pain Inventory (3) ICD-10 Symptom Checklist (4) ICD-10-Diagnostic Criteria for Research (DCR) (5) Montgomery Asberg Depression Rating Scale (MADRS) (6) Covi Anxiety Rating Scale (7) Karnofsky Performance Status Scale. Data was analysed using independent sample t test and chi square test.Results:The psychiatric morbidity was 67% with depression and adjustment disorders being the major diagnosis. There was a significant association between psychiatric morbidity pain variables (P = 0.000). Psychiatric morbidity significantly impaired activity, mood, working, walk, sleep, relationship, and enjoyment. There was no association between aetiology of pain, type of cancer, treatment for primary condition and treatment for pain and psychiatric morbidity. The functional status of cancer patients was also poorer in patients with psychiatric morbidity (P = 0.008).Conclusion:There is a high prevalence of psychiatric illness in chronic pain patients of any aetiology. Psychiatric morbidity is associated with increased pain perception, impairment in activity and poor functional status.

Interface between social support, quality of life and depression in users eligible for palliative care

“…Specifically in the context of PC, studies indicate that the prevalence of psychiatric diseases is strongly associated with pain level and the functional capacity of patients. It is believed that psychological morbidity significantly impairs the patient's activity, mood, sleep, and relationships, which reinforces the importance of assessing mental health in these individuals (7) . Regarding comparison tests that suggest a higher level of social support in patients with the presence of caregiver, no studies with similar results were found that have been performed in patients under PC; however, it is suggested that due to the fact that the diagnosis of a chronic disease causes life threatening, uncertain and stressful feelings in patients, the role of family members becomes paramount by encouraging psychological adjustment, as well as by helping to manage the symptoms caused by the disease (21) .…”

“…We also propose to evaluate the relationships between QoL, social support, depression and the variables of functional capacity, age, gender, education and presence of caregiver, number of children, occupation, marital status, diagnosis and individual income. Studies such as this become relevant, since few studies are available in the literature on psychosocial aspects in PC (7)(8)(9) . Moreover, we believe that identifying the influence of psychosocial aspects can minimize emotional, spiritual and social suffering in these individuals, in addition to contributing to establishing real public health needs in face of the challenges that PC poses to the health system.…”

Chemotherapy-induced acute psychosis in a patient with malignant germ cell tumour

“…Paraneoplastic syndrome previously reported in patients with ovarian teratoma6 can be excluded because of the good response of the cancer to chemotherapy. Common psychiatric disorders such as adjustment disorder, delirium and depression were also considered 7 8. However, the history and clinical symptoms were not compatible with functional psychiatric disorders.…”

Neuroticism prospectively predicts pain among adolescents: Results from a nationally representative sample

“…Pain is a major health problem in adolescents associated with increased healthcare costs and psychiatric morbidity [1,2]. Prevalence estimates of child and adolescent headaches and stomachaches, the two most common sites for pain among adolescents [3,4], vary from 8% to 83% and from 4% to 53%, respectively.…”