Aspekte einer liaisonpsychiatrischen Betreuung von Patienten einer universitären Schmerzambulanz

Brinkers, Michael; Pfau, Giselher; Schneemilch, C.

doi:10.1007/s00482-018-0267-9

Cited by 5 publications

(3 citation statements)

References 40 publications

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“…In a publication from our study group, we could show that neuropathic pain has an incidence of 8.2% for F3 depression as opposed to lower back pain (14.0%) and muscle-joint pain (15.0%) in a population of 485 outpatients assessed over a consecutive 6-month period [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

“…Another aspect needs to be added: Our study is the first to emphasize the bipolar efficacy spectrum of analgetically effective psychiatric drugs. As CRPS patients have comorbidity with F3 depression, these patients should be treated with dual active psychotropic drugs, that is, serotonin-noradrenaline reuptake inhibitors (SNRIs) as opposed to selective serotonin reuptake inhibitors (SSRIs) [ 30 ]. In the treatment of depression and pain, SNRIs have a direct analgetic influence on pain and the pain is reduced indirectly by increasing the threshold for neuralgia.…”

Section: Discussionmentioning

confidence: 99%

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Psychiatric Disorders in Complex Regional Pain Syndrome (CRPS): The Role of the Consultation-Liaison Psychiatrist

Brinkers

Rumpelt²,

Lux

et al. 2018

Pain Research and Management

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Background Complex regional pain syndrome (CRPS) is a multifactorial disorder with complex aetiology and pathogenesis. At the outpatient pain clinic of Magdeburg University Hospital, all patients, without exception, are subject to permanent psychiatric care delivered by a consultation-liaison psychiatrist. In CRPS, psychological stabilization and treatment of the neuropathic aspects are equally important. The aim of this single-center retrospective study was to determine mental/psychiatric defects impairing pain processing at the time of investigation and show the effects of treating mental disorders and neuropathic pain with the same psychotropic drugs. Method On admission, the consultation-liaison psychiatrist examined the mental state of every patient in a semistructured interview according to AMDP (working group for methods and documentation in psychiatry). Due to the model of the Department of Anaesthesiology, we are able to compare the group of CRPS patients with all other outpatients treated for pain. Results The medical treatment of psychiatric dysfunction leads to an analgesic effect. Only every second CRPS patient had an additional psychiatric diagnosis, and 15.6% were diagnosed with depressive mood disorders and show a higher prevalence of depressive symptoms than the general population and exceed the mean for all patients treated in our pain clinic. Conclusions In neuropathies, treatment of the neuropathic pain has a modulating effect on mental disorders. As CRPS patients are frequently affected by depressions, and owing to the connection between depression and suicidal tendencies, patients should be seen by a consultation-liaison psychiatrist, and nonpsychiatrists should pay special attention to this patient group.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Psychiatric Disorders in Complex Regional Pain Syndrome (CRPS): The Role of the Consultation-Liaison Psychiatrist

Brinkers

Rumpelt²,

Lux

et al. 2018

Pain Research and Management

View full text Add to dashboard Cite

show abstract

“…Under the condition that patients were interviewed using a structured or semistructured interview to obtain a diagnosis according to the diagnostic manual (DSM III-V/ ICD-10), the following distribution can be found: on the one hand, acute tumor patients 15-50% [20][21][22][23][24] and LCSs 56% [25], and, on the other hand, chronic pain patients without cancer around 70% [26][27][28][29].…”

Section: Introductionmentioning

confidence: 99%

The Incidence of Mental Disorders Increases over Time in Patients with Cancer Pain: Data from a Retrospective Cohort Study

Brinkers

Pfau

Toepffer

et al. 2021

Pain Research and Management

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Background. It is well known that cancer patients more seldom have a psychiatric disorder than noncancer patients with chronic pain. Conversely, earlier studies have suggested that, at the psychiatric level, long-term cancer survivors (LCSs) have more in common with noncancer patients affected by chronic pain. Materials and Methods. We investigated 89 cancer patients with acute pain (Acute Cancer Pain Patients, ACPPs) treated at a university outpatient chemotherapy department and compared these with 61 LCSs (living >5 yr after the first diagnosis) admitted by general practitioners for the treatment of noncancer pain. Upon administration, each patient was psychiatrically assessed by a liaison-psychiatrist conducting a semistructured interview. In a second step, we compared the LCS patients with hitherto treated noncancer patients suffering from chronic pain and ACPPs with data published by Derogatis in 1983. Results. In a comparison of LCSs with ACPPs, LCSs have more patients with brain organic disorders and more addictions. The largest cancer group within the LCSs is patients with urogenital (Uro) cancer (44.3%), while within the ACPPs, these are patients with cancer of the gastrointestinal (GI) tract (ACPP-GI, 57.2%). As far as the distribution of mental disorders is concerned, long-term cancer survivors show some similarities to noncancer patients. The data of ACPPs are similar to those of cancer patients, published by Derogatis. Discussion. The higher values of addiction and brain organic disorders, in particular, and the slight differences for psychic disorders in general of LCSs vs. ACPPs may result from the different cancer types and a longer survival time for urogenital tract cancer compared to GI cancer. In an additional examination, we compared patients with acute cancer of the GI tract (ACPP-GI, n = 50) with those of the urogenital tract (ACPP-Uro, n = 43). ACPP-Uro had the lowest percentage of patients with psychiatric disorders in general (ACPP-Uro 37.2%, ACPP-GI 50.0%, all LCSs 65.6%, and LCS-Uro 74.1%) and addiction, in particular (ACPP-Uro 2.3%, ACPP-GI 4.0%, and LCSs 13.1%). Conclusion. Cancer patients can develop a process of chronification with an increase in the prevalence of mental disorders. For urogenital cancer, an increase in the probability to develop mental disorders is a function of time.

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Der Begriff „Funktion/funktionell“ in der manuellen Medizin und Psychosomatik bzw. inneren Medizin

Brinkers

Pfau

2020

Manuelle Medizin

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Aspekte einer liaisonpsychiatrischen Betreuung von Patienten einer universitären Schmerzambulanz

Abstract: The constant presence of a liaison psychiatrist allows for timely, specialised care of pain patients in terms of a multimodal therapeutic approach.

Cited by 5 publications

References 40 publications

Psychiatric Disorders in Complex Regional Pain Syndrome (CRPS): The Role of the Consultation-Liaison Psychiatrist

Psychiatric Disorders in Complex Regional Pain Syndrome (CRPS): The Role of the Consultation-Liaison Psychiatrist

The Incidence of Mental Disorders Increases over Time in Patients with Cancer Pain: Data from a Retrospective Cohort Study

Der Begriff „Funktion/funktionell“ in der manuellen Medizin und Psychosomatik bzw. inneren Medizin

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