Misbruik en chronische pijn

Houdenhove, Boudewijn Van; Houdenhove, L. Van

doi:10.1007/978-90-313-7316-1_157

Cited by 2 publications

(2 citation statements)

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“…Today, life stress and traumatization in a person"s life history are generally recognized as established pro-nociceptive risk factors. There is ample evidence in the literature showing an association between childhood neglect, experience of violence, and overactive life style, on the one hand and development of the fibromyalgia syndrome, on the other [21][22][23]. In a rat model it was recently shown that stress hormones induce a switch of intracellular signaling in the primary afferent nociceptive nerve fibers resulting in hyperalgesia [24].…”

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confidence: 99%

Hypersensitivity and hyperalgesia in somatoform pain disorders

Egloff

Cámara

Känel

et al. 2014

General Hospital Psychiatry

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Objective: In psychiatry, pain disorders not explained by structural lesions have been classified for decades as somatoform pain disorders, the underlying concept being somatization. In a parallel move, somatic medicine has defined an expanding group of similar pain disorders, known as functional pain syndromes. Functional pain syndromes are characterized by enhanced pain sensitivity. The aim of our study was to investigate the proportion of patients with somatoform pain disorders who also meet the criteria of functional pain syndromes and the extent to which patients with somatoform pain disorders also show enhanced pain sensitivity.Methods: Data on pain sensitivity in 120 hospitalized patients were obtained by means of two algometric methods. The group of patients with somatoform pain disorders was further divided into two subsets: patients with and those without a co-diagnosis of a functional pain syndrome. Patients with nociceptive pain served as control group.Results: Of the 120 in-patients selected, 67 fulfilled the criteria of a somatoform pain disorder of which 41 (61%) also met the co-diagnosis of a functional pain syndrome. Patients with somatoform pain disorder differed from controls in that they showed enhanced pain sensitivity, irrespective of whether a functional pain syndrome was concomitantly present (p<0.001).Conclusions: Somatoform pain disorders show considerable overlap with functional pain syndromes, including enhanced pain sensitivity. This suggests the relevance of integrating somatosensory aspects of pain into a modified understanding of somatoform pain disorders. A C C E P T E D M A N U S C R I P TACCEPTED MANUSCRIPT 3 BackgroundFor decades, pain disorders not or not adequately explained by structural somatic injury (or any other physiological processes such as inflammation) have been classified as somatoform pain disorders especially if they occur in the context of depression, anxiety disorders, or psychosocial stress. Under the DSM-IV section on somatoform disorders, somatoform pain disorder is defined as "pain disorder associated with psychological factors" (307.80) [1]. In its definition of 'persistent somatoform pain disorder' (F45.40), ICD-10 even explicitly attributed a causal significance to the psychological factors [2]. The rationale of DSM-IV and ICD-10 in categorizing somatoform pain disorders relies on the traditional concept of somatization. In the psychoanalytical theory, somatization was conceived as an experience of "bodily symptoms" caused by (repressed) psychological distress. As a consequence, somatoform pain disorders were classified as "mental disorders". Patients, therefore, were referred to psychiatric care.In a parallel move, somatic medicine defined an increasing group of so-called functional somatic syndromes [3,4] or, more specifically functional pain syndromes [5]. In 1990, The American College of Rheumatology, for instance, recognized fibromyalgia as a clinical entity. For the first time, hyperalgesia (with respect to the tender points) was proposed ...

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confidence: 99%

Hypersensitivity and hyperalgesia in somatoform pain disorders

Egloff

Cámara

Känel

et al. 2014

General Hospital Psychiatry

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“…The patients receive a diagnosis and treatment in an ‘evidence-based’ manner. 13–17 Treatment of patients based only on medication is therefore eliminated. Patients are informed of this process of operation through an information leaflet.…”

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confidence: 99%

Can a care pathway help streamline the care process for patients with chronic fatigue syndrome?

Verhelst

Nachtergaele

Hindryckx

et al. 2011

International Journal of Care Pathways

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In this paper, the authors show how the implementation of a care pathway can streamline the care for chronic fatigue syndrome (CFS). The methodology of seven phases is used as a guide to develop, implement and evaluate the CFS care pathway. Some patients have already completed the care pathway. With the help of these case studies, a few strengths and weaknesses of the care process can be formulated. The development and implementation of the care pathway result in a structured process. Patients are diagnosed and treated based on an evidence-based method. The care path also leads to an enhancement of the interdisciplinary cooperation. Nevertheless, the criteria for inclusion and exclusion of patients are taken into account insufficiently. Moreover, family doctors should be involved more often. In the future, it is also important to pay more attention to the role of the family members during the treatment. The entire steering group now needs to engage in a discussion about the test pathway and then subsequently put it to use in daily practice. Additional challenges for the steering group include the objective evaluation and the continuous follow-up of the care pathway.

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Misbruik en chronische pijn

Cited by 2 publications

References 34 publications

Hypersensitivity and hyperalgesia in somatoform pain disorders

Hypersensitivity and hyperalgesia in somatoform pain disorders

Can a care pathway help streamline the care process for patients with chronic fatigue syndrome?

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