Introduction

Fear of pain is highly predictive of dental anxiety. There are Portuguese validations of instruments to evaluate fear of dental treatment but an instrument for measuring fear of dental pain is lacking. The short-Fear of Dental Pain Questionnaire (s-FDPQ; van Wijk et al. 2006) presented adequate reliability and validity, although it consists of only 5 items.

Objectives

To analyze the psychometric properties of the s-FDPQ Portuguese version, namely construct validity, internal consistency and concurrent validity.

Methods

A community sample of 227 adults (55.7% women; mean age= 43.65±15.952; range:18-88) completed the Portuguese versions of s-FDPQ and other validated questionnaires to evaluate dental anxiety (Modified Dental Anxiety Scale/MDAS and Dental Fear Survey/DFS).

The total sample was randomly divided in two sub-samples: sample A (n=113) was used to exploratory factor analysis/EFA; sample B (n=114) to confirmatory factor analysis/CFA.

Results

EFA resulted in two components. CFAs revealed that the unifactorial model, found by van Wijk presented a poor fit. The bifactorial model, excluding one item, presented acceptable fit indexes (X2/df=3.418; CFI=.992; GFI=.983; TLI=.951; p[RMSEA≤.01]=.076). Cronbach alphas were α=.874 for F1 Injection and Drill and α=.943 for F2 Extraction. F1 and F2 scores significantly and highly correlated with total and dimensional scores of MDAS and DFS (all coefficients r≥.50, p<.001).

Conclusions

This study provides preliminary evidence for the validity and reliability of the Portuguese version of sFDPQ, which dimensions will be used in an ongoing research project on the relationship between dental pain, trauma and anxiety.

Introduction

Opioid induced hyperalgesia(OIH) is a reaction of enhanced pain perception related to the use of these drugs in the absence of disease progression or withdrawal syndrome and its different to tolerance because lack of improvement with escalation.

Objectives

To describe a case showing the difficulty of differentiating Somatic Symptom Disorder (SSD) vs OIH

Methods

Illustrative case

Results

We present a case of a 45 year-old woman who was hospitalized to reduce the total opioid dose that she was taking for a severe generalized pain that limited her mobility, mostly in cervical and lumbar spine since any organic cause for her symptoms was ruled out. She also was diagnosed of Fibromyalgia and anxious-depressive syndrome in the past. She had prescribed Oxycodone at a maximum 230 mg/day for several years in growing doses without improvement. We prescribed buprenorphine and tapered-off oxycodone, without having abstinence symptoms and experiencing a significant improvement in pain and mobility. At discharge, she was taking buprenorphine/naloxone. The final diagnosis was Opioid induced disorder and SSD. At follow-up, where she described worsening of pain and peripheral oedema, in relation to the buprenorphine, leading to its suspension, with relief of oedema but not of pain. She is having significant depressive symptoms but had not returned to her previous state when she was not able to move.

Conclusions

Chronic opioid prescription has risks of perpetuating pain, like in the OIH. Patients with psychiatric comorbidity could have more risk of having problematic use of legal opioids and differentiating both conditions may be difficult if present together.

Introduction

This is a 32-year-old man treated in the emergency room after a severe autolytic attempt through deep cuts in both wrists. Unemployed, dysfunctional family, daily cannabis user and occasionally cocaine. Orchiectomy underwent testicular torsion complication a year ago.

Objectives

The present case aims to show the phantom limb pathology beyond what is known limited to limb losses but also to other visceral parts of the body, as in this case to testicular pain after orchiectomy, as well as the influence on psychopathology.

Methods

Case report and literature review

Results

Within a few weeks of this intervention, the patient began treatment with analgesics, reaching abuse, as well as treatment with antidepressant and gabapentin, diagnosing the phantom limb patient. Despite this, he expressed poor control of pain, high anxiety and feelings of hopelessness. Cannabis use increased, recognizing an evasive use. He described a continuous sensation of tingling and swelling with severe pain.

In these crises he presented self-harm ideation recognizing having consumed more cannabis and some alcohol the hours before the attempt. Dysfunctional personality traits were observed such as low tolerance for frustration, and acceptance of current problema.

Conclusions

It is known that phantom limb syndrome appears largely from limb amputations. Outside these, related to orchiectomies, studies shows that about 50% have some phantom-type experience, with 25% being those who report extracted testicle pain. In this case, it is impressive that personality traits and social support were risk factors for pain management

Introduction

Burning mouth syndrome (BMS) is a chronic condition characterized by a burning sensation of the oral cavity and is often associated with taste disturbances and xerostomia. Idiopathic or primary BMS can occur spontaneously and without any identifiable precipitating factors.

Objectives

The existence of multiple factors related to this pathology, which are involved in the appearance or maintenance is a wide field of study today.

Methods

A 67-year-old woman complained of burning pain in the tongue and oral mucosa, taste disorder, and sensory impairment. Slight improvement after treatment with Gabapentine 300mg (1-0-0). Carrier of dental prostheses, in good condition since years before the beginning of the pain. The pain is constant, with sharp characteristics. Improves when eating , the ability to taste is preserved.

Subsequently, treatment with 2% lidocaine rinse (3-4 times / day) is tested, with temporary pain relief. Lorazepam 1mg (1-0-0), without improvement. Patient in follow-up by the Neuropsychiatry consultation for 3 years, due to major depressive disorder in treatment with Quetiapine 100mg (0-0-1).

Results

In the first consultation the treatment is modified, adding Duloxetine 60 mg and Alprazolam 0.5mg and reducing the dose of Quetiapine to 75 mg and then 50mg. After two months, she has completely removed the quetiapine, and completely disappearing the burning mouth sensation, improving his affective clinic in the same way.

Conclusions

It is a multifactorial pathology. In many cases, correcting or eliminating these etiologic agents does not improve or stop the initial symptoms, but sometimes, it does.

Introduction

Introduction: Previous studies indicated that gestational weight gain-related disorders share many similarities with feeding and eating disorders (EDs).

Objectives

Objectives: To examine the association of prepregnancy Body Mass Index (BMI), defined according to 2009 Institute of Medicine (IOM), and its shift across gestation with symptoms of feeding and EDs, defined by EDE-Q.

Methods

Methods: This prospective cohort study took place at the Division of Perinatal Medicine of Policlinico Abano Terme, Italy, from Jannuary 2015 to October 2015. The sample included 655 healthy at term puerperae. We correlated gestational BMI in different women categories to EDE-Q Global score and Restrain, Eating concern, Shape concern, and Weight concern subscales, by Spearman’s correlation test.

Results

Results: Among 655 women, 59 (9.0%) were categorized as underweight, 463 (70.7%) normal weight, 98 (15.0%) overweight, and 35 (5.3%) as obese in prepregnancy period. At the end of gestation, underweight women category disappeared, normal weight women lightened to one third, overweight women tripled, and obese women doubled. At the same time, EDE-Q global scores increased from normal weight (0.25 ± 0.41), to overweight (0.47 ± 0.58), and to obese (0.72 ± 0.70) puerperae. In addition, EDE-Q global scores were significantly correlated with gestational BMI increase in Global score (rho = 0.326; p < .001) and in the four subscales: Restrain (rho = 0.161; p < .001), Eating concern (rho = 0.193; p < .001), Shape concern (rho = 0.335; p < .001), and Weight concern (rho = 0.365; p < .001), respectively.

Conclusions

Conclusions: It was found that the shift of woman BMI across an uncomplicated pregnancy is a warning indicator of unhealthy eating and feeding symptoms.

Introduction

Approximately 10-23% of people suffer from chronic pain. There is a specific program to improve self-compassion, (MSC) developed by Neff and Germer, that is used in different clinical issues. Art Therapy, and which distinguish it from other therapies, is the active performing with materials, by means of the visual and concrete character of the process. Also, another relevant characteristic is the obtaining of an output in form of art making. In our study we decide to integrate MSC and art therapy. With both tecniques is possible to pay attention in a more specific and localy way.

Objectives

The aim of this study is to compare the effectiveness of MSC program, and MSC program with art therapy in order to improve Quality of Life, emotional regulation and Self-Care in chronic pain.

Methods

We conducted a RCT with 2 arms of treatments in a chronic pain patients sample of Hospital Universitario La Paz, Madrid. Group interventions, 8 sessions, weekly. We collected data of anxiety, depression, catastrophizing, pain interference self-compassion, and quality of life.

Results

Patients with chronic pain who participated in the art therapy group reported greater satisfaction with the treatment. There was a significant abandonment of patients

Conclusions

These results are promising in order to find other effective interventions to this prevalent clinical problem. By active performing and experiencing with art materials, by the visual and concrete character of the process as well as by the result of art making

Introduction

The approach to the treatment of chronic pain must be interdisciplinary, addressing the multiple dimensions of pain experience. Psychological interventions such as cognitive behavioural therapy (CBT) have shown good results over emotional distress and general functioning. New approaches such Mindful Self-Compassion (MSC) are gathering empirical evidence. We have found MSC is as effective as CBT in improving quality of life, self-care, and emotional well-being. Nevertheless, we do not know if results are maintained in long term.

We identified that paper-and-pencil retrospective assessments display low ecological validity and increase recall bias. Ecological momentary assessment (EMA) method has not previously been used as indicator of daily functioning.

Objectives

To study if pain interference reduction achieved is maintained in the long-term.

To implement a measure of pain interference that minimizes recall biases and maximizes ecological validity. Thus, we will include an EMA of pain interference.

Methods

A parallel-group, single-blinded, randomized, controlled trial that will explore the short-, medium- and long-term effects of an 8-week group intervention (MSC) against an active comparator (CBT).

EMA will be performed as a daily functioning measurement.

Results

We have demonstrated that MSC is as effective as CBT in order to improve quality of life, daily functioning and emotional distress.

We will get results about maintenance in the long term. We will obtain results to study acceptibility and efficiency of EMA method to measure daily functioning.

Conclusions

COPE project consists of implementing an evidenced-based, person-centred, group intervention adjuvant to usual medical care that improves functioning and quality of life of people with late-stage chronic pain conditions.

Introduction

Anxiety and depression are psychological comorbidity in chronic pain patients, which significantly affect the patient's daily functioning. Although considerable attention has been devoted to explain why depression and anxiety are frequent comorbid with chronic pain, little empirical work has been conducted on interventions that target depression and anxiety and chronic pain.

Objectives

The present study was designed to test an individualized yoga therapy for chronic pain and psychological distress.

Methods

A total of 62 chronic pain patients with anxiety and depression were included and randomized to either weekly yoga treatment for 8 weeks or to a control group that participated in weekly group sessions focused on chronic pain management. Outcome measures included pain, anxiety and depression assessed at baseline and 8-weeks post intervention.

Results

Results showed significant decreases in pain scores along with depressive symptoms and anxiety. Control group had a slight decrease in pain and psychological distress but did not reach significance change.

Conclusions

Study concludes that an individualized yoga treatment can be effective for chronic pain patients having comorbid emotional distress.

Introduction

Pain is said to be one of the most feared and distressing symptoms of cancer and one that disrupts all aspects of life. The purposes of this study were to determine the relationships between depression and quality of life and pain.

Objectives

The purposes of this study were to determine the relationships between depression and quality of life and pain.

Methods

A total of 96 hospitalized colon cancer patients, 65 with pain and 31 without pain were studied. Three standard instruments were used to measure depression (the HADS), quality of life (the SF-36) and pain beliefs (the IMD).

Results

We observed that colon cancer patients with pain reported significantly lower levels of emotional functioning (p=0.033), role functioning (p<0.1) and global quality of life. Among patients with pain, higher scores on pain permanence and pain consistency were positively and significantly associated with higher depression. Higher scores on pain were negatively and significantly associated with global quality of life (p<0.5).

Conclusions

This study has demonstrated the effect of cancer pain on patients' quality of life and emotional status and has supported the multidimensional notion of the cancer pain experience in cancer patients.

Introduction

Chronic pain is a big burden for patients, society and the economy. In the literature, a large amount of evidence of significant effects of emotions on pain perception.

Objectives

The article presents the results of the observation of patients with somatic diseases and comorbid mental disorders with chronic pain. Control group - 20 patients, with somatic diseases and chronic pain syndrome.

Methods

Clinical interview, "Questionnaire symptoms of PTSD forced migrants", Impact of Event Scale Revised (IES-R), Zung Self-Rating Depression Scale (ZDS), HADS; The McGill Pain Questionnaire (MPQ) The West Haven-Yale Multidimensional Pain Inventory (WHYMPI), Pain Catastrophising Scale (PCS)

Results

The results showed that 32.0 % of observed patients have anxiety disorders (13.5 %), depressive disorders (10.3 %), PTSD (8.2 %). No significant correlation between anxiety disorders, depressive disorders, PTSD and frequency of acute pain, but strong positive correlation present with chronic pain syndrome and mental disorders at all (r=0,62, р≤0,01). Most significant correlation between catastrophising attitude of pain and chronicity of pain syndrome (r=0,82, р≤0,005), and frequency of catastrophising attitude of pain match more higher in of patients with somatic diseases and comorbid mental disorders (≤0,01). Multimodalmultidisciplinary treatment increases the patient's compliance and effectiveness of treatment (28.0% more consent for consultation, 42.0% more often for psychotherapy, more reliably reducing psychopathological symptoms (22, 0%).

Conclusions

High risk of chronicity of pain syndrome in patients with different somatic diseases associated with mental disorders, us well anxiety disorders, depressive disorders and PTSD, and positive correlation with catastrophising attitude of pain has been detected in those patients.