Chronic Pain and Mental Health Disorders

Hooten, W. Michael

doi:10.1016/j.mayocp.2016.04.029

Cited by 387 publications

(202 citation statements)

References 167 publications

(206 reference statements)

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“…Venlafaxine, a serotonin-norepinephrine reuptake inhibitor (NSRI) that controls equally depression and chronic pain [31, 32] was selected to combine clonazepam. Venlafaxine inhibits serotonin and norepinephrine reuptake leading to enhanced descending inhibition of centrally sensitized pain and has been used to treat pain conditions comorbid with depression [33].…”

Section: Discussionmentioning

confidence: 99%

Refractory burning mouth syndrome: clinical and paraclinical evaluation, comorbidities, treatment and outcome

2017

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BackgroundBurning Mouth Syndrome (BMS) is a chronic pain condition characterized by persistent intraoral burning without related objective findings and unknown etiology that affects elderly females mostly. There is no satisfactory treatment for BMS. We aimed to observe the long-term efficacy of high velanfaxine doses combined with systemic and topical administered clonazepam in a particular subgroup of BMS patients who do not respond to current clinical management.ResultsEight (66.1 ± 6.2 years old females) out of 14 BMS patients fulfilled the inclusion criteria and were treated with venlafaxine (300 mg/d) and clonazepam (5 mg/d) for 35.4 ± 12.1 (mean ± SD) months. The average duration of the symptoms at baseline was 4.3 ± 1.4 years and the overall mean daily pain intensity score was 8.6 ± 1.3 (VAS); pain was in tongue and within the oral mucosa, accompanying by oral and facial dysesthesia. In five patients tasting was abnormal. All patients had positive history of concomitant primary headache. The average score of Hamilton Rating scale for Anxiety and Depression was 21 ± 4.2, and 26.1 ± 2.9, respectively. Previous ineffective treatments include anticonvulsants and anti-depressants. All patients responded (more than 50% decrease in VAS) after three months treatment (mean VAS 3.2 ± 2.2) with no remarkable adverse events.ConclusionBMS deserves bottomless psychiatric evaluation and management when current available treatments fail. Treatment with venlafaxine combined with topical and systemic clonazepam may be effective in refractory BMS cases but further investigation in a large-scale controlled study is needed to confirm these results.

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Section: Discussionmentioning

confidence: 99%

Refractory burning mouth syndrome: clinical and paraclinical evaluation, comorbidities, treatment and outcome

2017

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“…37 As an aside, it is interesting to note that the coexpression of pain and depression reflects the spinofugal pathways activated during chronic pain, which project to higher-order systems responsible for not only the sensory discriminative but also the affective-motivational component of a chronic pain phenotype. 24 , 40 , 51 Indeed, the negative impact of the synergistic effect of the pain-depression complex, as well as other psychological conditions, such as anxiety and pain catastrophizing (PC), during perioperative stages in patients waiting for TKA surgeries has been described. 19 , 31 , 39 , 58 Lingard et al (2004) reported that mental health status, among other preoperative variables, was associated with poor functional outcome and persistent pain after TKA.…”

Section: Effects Of Delayed Surgical Repair On Comorbiditiesmentioning

confidence: 99%

Unintended consequences of COVID-19 safety measures on patients with chronic knee pain forced to defer joint replacement surgery

Cisternas

Ramachandran

Yaksh

et al. 2020

PR9

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“…Individuals with chronic pain often present with comorbid mental health problems including depression, anxiety, substance use and personality disorders (Dersh, Polatin, & Gatchel, 2002), and most commonly with high levels of depression and anxiety (Demyttenaere et al, 2007;Hooten, 2016). There is now a growing body of evidence which finds high rates of comorbidity between chronic pain, traumatic exposure and post-traumatic stress disorder (PTSD), including in individuals seeking treatment for chronic pain (Fishbain, Pulikal, Lewis, & Gao, 2017;Siqveland, Hussain, Lindstrøm, Ruud, & Hauff, 2017).…”

Section: Introductionmentioning

confidence: 99%

Treatment outcomes in group‐based cognitive behavioural therapy for chronic pain: An examination of PTSD symptoms

Åkerblom

Perrin

Fischer

et al. 2020

European Journal of Pain

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Background The relevance of post‐traumatic stress disorder (PTSD) symptoms to outcomes of cognitive behavioural therapy (CBT) for chronic pain is unclear. This study examines whether (a) traumatic exposure or the severity of PTSD symptoms at pre‐treatment predicts the outcomes (pain intensity/interference), (b) participation in this treatment is associated with reduced PTSD symptoms and (c) any observed changes in PTSD symptoms are mediated by changes in psychological mechanisms that have been shown to be of importance to PTSD and chronic pain. Methods Participants were 159 chronic pain patients who were consecutively admitted for a multidisciplinary, group‐based CBT program at the Pain Rehabilitation Unit at Skåne University Hospital. A self‐report measure of traumatic exposure and PTSD symptoms was administered before and after treatment, and at a 12‐month follow‐up, along with measures of depression, anxiety, pain intensity, pain interference, psychological inflexibility, life control and kinesiophobia. Results Traumatic exposure and PTSD symptom severity did not predict pain intensity or interference at 12‐month follow‐up. There were no overall significant changes in PTSD symptom severity at post‐treatment or follow‐up, but 24.6% of the participants showed potential clinically significant change at follow‐up. Psychological inflexibility mediated the changes that occurred in PTSD symptoms during treatment. Conclusions Neither traumatic exposure nor baseline symptoms of PTSD predicted the treatment outcomes examined here. Despite improvements in both comorbid depression and anxiety, participation in this pain‐focused CBT program was not associated with improvements in comorbid PTSD. To the extent that changes in PTSD symptoms did occur, these were mediated by changes in psychological inflexibility during treatment. Significance Pain‐focused CBT programs yield clinically meaningful improvements in pain and comorbid symptoms of depression and anxiety, but may have little effect on comorbid PTSD. This raises the issue of whether current pain‐focused CBT programs can be modified to improve outcomes for comorbid conditions, perhaps by better targeting of psychological flexibility, and/or whether separate treatment of PTSD may be associated with improved pain outcomes.

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Chronic Pain and Mental Health Disorders

Cited by 387 publications

References 167 publications

Refractory burning mouth syndrome: clinical and paraclinical evaluation, comorbidities, treatment and outcome

Refractory burning mouth syndrome: clinical and paraclinical evaluation, comorbidities, treatment and outcome

Unintended consequences of COVID-19 safety measures on patients with chronic knee pain forced to defer joint replacement surgery

Treatment outcomes in group‐based cognitive behavioural therapy for chronic pain: An examination of PTSD symptoms

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