The Case for Pain Insomnia Depression Syndrome (PIDS): A Symptom Cluster in Chronic Nonmalignant Pain

Collen, Mark

doi:10.1080/15360280802251231

Cited by 10 publications

(6 citation statements)

References 52 publications

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“…Depression, insomnia, and pain were proposed as a syndrome in people with chronic non-malignant pain because of their frequent co-occurrence. 16 The depression-pain syndrome was proposed when a psychological origin could not be identified. 17 Similarly, the constellation of depression, fatigue, and pain might suggest a fatigue syndrome (associated with pain and depression), or a pain syndrome (that causes fatigue and depression).…”

Section: Symptom Interrelationshipsmentioning

confidence: 99%

Review: Symptom clusters: myth or reality?

2010

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Clinical experience suggests that many symptoms occur together. In this paper, we examine the rationale and evidence base for symptom clusters in different medical fields, particularly the cluster phenomenon in cancer. Cancer symptom clusters are a reality. Various symptoms that cluster clinically have also been verified statistically. Specific clusters such as nausea-vomiting, anxiety-depression, and cough-dyspnea are evident on both clinical observation and in research investigation. Fatigue-pain and fatigue-insomnia-pain have also been demonstrated statistically as clusters. Another proposed cluster 'depression-fatigue-pain' seems relevant to clinical practice. Other clusters may serve only as theoretical models that illustrate possible common biological etiologies in cancer; they need to be validated in future research. Analysis of the literature is complicated by considerable inconsistencies across studies. Discrepancies between clinically defined and statistically obtained clusters raise important questions. We must consider the analytical techniques used, and how methodology might influence cluster occurrence and composition. Further research is warranted to establish universally accepted statistical methods and assessment tools for symptom cluster research.

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Section: Symptom Interrelationshipsmentioning

confidence: 99%

Review: Symptom clusters: myth or reality?

2010

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“…1,2 Various methods have been utilized to assess insomnia, the most common sleep-wake disturbance, along with other cancer-specific symptoms; self-report of such experiences has been incorporated in research and clinical practice. 3 …”

Section: Introductionmentioning

confidence: 99%

Patient and Clinician Communication of Self-reported Insomnia During Ambulatory Cancer Care Clinic Visits

et al. 2014

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Background Insomnia, the most commonly reported sleep wake disturbance in people with cancer, has an adverse affect on quality of life including emotional well being, distress associated with other symptoms, daily functioning, relationships and ability to work. Objective The aim of this study was to describe the content of discussions between clinicians and 120 patients with self-reported insomnia and to examine the associations of socio-demographic, clinical and environmental factors with insomnia. Interventions/Methods A secondary analysis was conducted with self reported symptom data, socio- demographic, clinical and environmental factors. Recordings of clinician and patient discussions during clinic visits were examined by conducting a content analysis. Results Severe insomnia was more likely to be reported by women, minority and lower income individuals. Seven major topics were identified in the discussions. The clinicians did not always discuss insomnia; discussion rates differed by diagnosis and clinical service. Conclusions Reporting of insomnia by the patient and clinician communication about insomnia may have differed by demographic and clinical characteristics. Clinicians attended to insomnia about half the time with management strategies likely to be effective. Explanations may be that insomnia had a low clinician priority for the clinic visit or lack of clear evidence to support insomnia interventions. Implications for Practice A better understanding is needed about why insomnia is not addressed even when reported by patients; it is well known that structured assessments and early interventions can improve quality of life. Research is warranted to better understand potential disparities in cancer care.

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“…There are rational reasons to use opioids in the setting of chronic pain because some chronic pain conditions respond to opioid therapy and because there are, indeed, risks to the undertreatment of chronic pain. These risks include the following: fatigue and decreased exercise tolerance [53]; mood changes and an increased stress response, including depression, suicidal thoughts, anxiety, and fear [54–56]; sleep disturbances and insomnia [57]; disability [56]; and obesity [58]. To balance the argument, one may reply that there are risks to opioids, especially regarding the side effects of chronic opioid use.…”

Section: Opioid Prescribing For Chronic Painmentioning

confidence: 99%

A Physician-Driven Solution—The Association for Medical Ethics, The Physician Payment Sunshine Act, and Ethical Challenges in Pain Medicine

Perret¹,

Rosen

2011

Pain Med

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The practice of contemporary pain medicine is laced with a number of significant ethical challenges. Considerable difficulties include the overutilization of interventional procedures, the application of under-evidenced treatment modalities, and potentially superfluous opioid prescribing. As with many other fields in medicine, including orthopedic surgery, relationships with industry are both common and pervasive, and influence our medical practice through education, publications, and research. This article highlights these ethical challenges and broaches several physician-driven solutions: The Association for Medical Ethics, the Physicians Payment Sunshine inspired by it, and other non-legislative reforms are discussed.

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The Case for Pain Insomnia Depression Syndrome (PIDS): A Symptom Cluster in Chronic Nonmalignant Pain

Cited by 10 publications

References 52 publications

Review: Symptom clusters: myth or reality?

Review: Symptom clusters: myth or reality?

Patient and Clinician Communication of Self-reported Insomnia During Ambulatory Cancer Care Clinic Visits

A Physician-Driven Solution—The Association for Medical Ethics, The Physician Payment Sunshine Act, and Ethical Challenges in Pain Medicine

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