Dimitrios Damigos

Depression and Anxiety Levels Increase Chronic Musculoskeletal Pain in Patients with Alzheimer's Disease

BACKGROUND/OBJECTIVES During the next decades a rapid increase is expected in the number of patients with dementia suffering from pain who often take less medication compared to normal elderly, due to several diagnostic barriers. Comorbid mood disorders result in great difficulties in pain assessment and further treatment. DESIGN Twenty five patients with Alzheimers disease, comorbid mood disorders, and chronic musculoskeletal pain (experimental group) and thirty one patients with Alzheimers disease and chronic musculoskeletal pain without comorbid mood disorders (control group) were examined. The assessment tools used were Geriatric Pain Measure, Patient Health Questionnaire, Pain Assessment in Advanced Dementia, Mini Mental State Examination and Pain Anxiety Symptom Scale. Statistical analysis was performed by SPSS v17.0, using the Pearson correlation and the multiple linear regression analysis. RESULTS The correlation between mood disorders and levels of pain intensity in the experimental group was found to be statistically higher than that in the control group (p<.001). Among all quantitative variables, highly significant correlation (p<.001) was observed between stress and depression symptomatology (r =.550, p<.001) in the experimental group. Normal regression analysis was used to assess possible differences between demographic data and PASS scores. Scores in fearful thinking and physiological responses scales of PASS were higher in female than male (p=.014), whereas scores in the cognitive anxiety scale of PASS have shown a highly significant positive correlation with years of education (p<.001). DISCUSSION It seems that depression and anxiety are associated with chronic musculoskeletal pain intensity in dementia, thus need to be taken into consideration by health professionals for patients management.

Environmental and stressful factors affecting the occurrence of kidney stones and the kidney colic

The first renal disease described from Hippocrates is nephrolithiasis with renal colic, which is the pain of stone passage and is also a common renal problem with easily recognizable characteristics. There has been much written about dietary factors, which have unequivocally been proved to play an important role in the formation of kidney stones. In this regard, it is of interest that the contribution of factors such as stressful events, life style, or occupation in the formation of kidney stones has not been well studied. This review examines the clinical evidence of the stressful events and other environmental factors affecting the occurrence of kidney stones.

Admission rates of patients with borderline personality disorder in a psychiatric unit in a General Hospital

This study examined the admission rates of patients with borderline personality disorder in a psychiatric unit within a General Hospital. The medical records of patients with DSM-IV borderline personality disorder who were admitted to the unit during the years 2004 and 2005 were retrospectively reviewed. The number of admissions of patients with borderline personality disorder was 78, involving 48 patients. The mean of admissions were 1.63 per patient. The comparison to the rest of the patient population (922 patients with a total of 1086 admissions) demonstrated that patients with borderline personality disorder were admitted more frequently than patients with major psychiatric disorders. The difference was statistically significant (P=0.042). The main reasons for admission were suicide attempts or threats and lack of out-patient facilities. The introduction of out-patient psychiatric facilities may contribute to the reduction of the admissions and to the better management of the disorder.

Higher levels of psychiatric symptomatology reported by health professionals working in medical settings in Greece

BackgroundPsychological distress in healthcare workers may vary across different specialties. The purpose of this study was to investigate the differences in the rate of anxiety and depression between medical and mental healthcare workers.MethodsThe sample was randomly selected and consisted of 229 workers from the medical health sector and 212 from the mental health sector, aged 39.8 ± 7.9 years old. Health workers from University and General Hospitals from all over Greece participated in the study. The Greek version of the Symptoms Rating Scale For Depression and Anxiety (SRSDA) was used. Statistics were processed with SPSS v. 17.0.ResultsThe medical health professionals showed statistically significantly higher scores in all the subscales in comparison with the mental health sector workers, independently of years serving in the department. The rates of a possible psychiatric disorder (score over cutoff points) were significantly elevated on the Beck-21, melancholy and asthenia subscales.ConclusionsMedical healthcare workers appear to suffer from psychological distress more than their colleagues in the mental sector.

An umbrella review of the literature on the effectiveness of psychological interventions for pain reduction

BackgroundPsychological interventions are widely implemented for pain management and treatment, but their reported effectiveness shows considerable variation and there is elevated likelihood for bias.MethodsWe summarized the strength of evidence and extent of potential biases in the published literature of psychological interventions for pain treatment using a range of criteria, including the statistical significance of the random effects summary estimate and of the largest study of each meta-analysis, number of participants, 95% prediction intervals, between-study heterogeneity, small-study effects and excess significance bias.ResultsThirty-eight publications were identified, investigating 150 associations between several psychological interventions and 29 different types of pain. Of the 141 associations based on only randomized controlled trials, none presented strong or highly suggestive evidence by satisfying all the aforementioned criteria. The effect of psychological interventions on reducing cancer pain severity, pain in patients with arthritis, osteoarthritis, rheumatoid arthritis, breast cancer, fibromyalgia, irritable bowel syndrome, self-reported needle-related pain in children/adolescents or with chronic musculoskeletal pain, chronic non-headache pain and chronic pain in general were supported by suggestive evidence.ConclusionsThe present findings reveal the lack of strong supporting empirical evidence for the effectiveness of psychological treatments for pain management and highlight the need to further evaluate the established approach of psychological interventions to ameliorate pain.

EPA-1594 - Regression model for subjective well being in patients with diabetes mellitus

Introduction Subjective well being (SWB) is really an umbrella term, that includes several different components and these components are somewhat independent, while Diabetes Mellitus (DM) is a chronic condition affected by many biopsychosocial factors. Objectives To measure the impact of SWB in adult patients with DM Aims To explore possible demographic, physical, and psychosocial correlates in SWB. Methods 293 DM patients(115(39.2%) males/178(60.8%) females), in two outpatients’ clinics in Athens-Greece took part in the study. Satisfaction with Life Scale(SWLS) was used for SWB, along with SF12 for health related quality of life Depression Anxiety Stress Scale(DASS), Life Orientation Test(GrLOT-R) for dispositional optimism and a questionnaire about sociodemographic characteristics. Statistical analysis was performed with SPSS 21. Results internal Almost half of the patients(54.5%) scored below average( Conclusions Our results indicates that SWB is affected equally from biological, psychological and societal variables, giving strong evidence to the biopsychosocial model of subjective health and suggests that multidisciplinary treatment with psychological screening should be applied in these patients in order to help and motivate them feel better.

P03-453 - Mental pain and suicide risk in women with major depression

Objectives Previous studies have provided evidence on the possible relationship between mental pain (psychache) and suicide. The aim of the present study was to investigate whether more intense psychache is related with higher suicide risk independently of the severity of depression. Methods Orbachs Mental Pain Scale was administered in 58 women with major depression: 24 inpatients and 34 outpatients. Severity of depressive symptoms was evaluated by the Beck Depression Inventory. Suicide Risk Scale was used for the assessment of suicide risk. Level of physical pain was measured by McGill Pain Questionnaire-Short form. Pearsons correlation was used to examine the relationship between variables and a multiple regression analysis was performed to examine the independent strength of the associations. Results Suicide risk was significantly and positively associated with the level of current psychache and the severity of depressive symptoms, and negatively with the age of onset of the illness. The levels of physical pain or worst-ever psychache were also correlated with suicide risk; however, these associations did not remain significant in the multiple regression models. Conclusions Higher levels of mental pain may be a factor of vulnerability to suicidal behaviour in major depression. Higher symptom severity and earlier onset of the illness may also contribute to suicide risk. The association between physical pain and suicide risk appears to be mediated by mental pain or other aspects of the illness.