INTRODUCTIONAnxiety sensitivity has been proposed as a psychological vulnerability factor for post-traumatic stress disorder (PTSD). Studies have also supported the protective role of resilience for overcoming the negative effects of trauma exposure. Given the linkages between anxiety sensitivity, resilience, trauma exposure and post-traumatic stress, this study explored the potential moderating roles of anxiety sensitivity and resilience on the association between trauma history and PTSD symptoms in a sample of individuals with chronic pain.

MATERIALS AND METHODSA total of 100 patients with chronic pain were recruited from a large public hospital. Patients who had pain lasting for more than 3 months and a pain intensity rating of at least 4/10 were included. The study participants were administered measures of PTSD symptoms (PTSD Checklist - Civilian Version), resilience (Brief Resilient Coping Scale) and anxiety sensitivity (Anxiety Sensitivity Index).

RESULTSAn analysis of outcome measures indicated that anxiety sensitivity and resilience were independently associated with PTSD symptoms, where βs were 0.57 and -0.23, respectively. The relationship between trauma and PTSD symptom severity was also moderated by anxiety sensitivity. Trauma history was associated with higher PTSD symptom severity only in those with high anxiety sensitivity. However, contrary to the hypotheses, resilience did not serve as a moderator.

CONCLUSIONThere are potential benefits of PTSD interventions that increase resilience and decrease anxiety sensitivity in individuals with chronic pain, especially for those who have experienced a traumatic event. Given that the presence of PTSD symptomatology in chronic pain populations negatively impact patient well-being, it would be important for clinicians to assess, monitor and treat PTSD in individuals with chronic pain.

Anxiety ; epidemiology ; psychology ; Chronic Pain ; epidemiology ; psychology ; Humans ; Psychological Trauma ; epidemiology ; psychology ; Resilience, Psychological ; Risk Factors ; Severity of Illness Index ; Singapore ; epidemiology ; Stress Disorders, Post-Traumatic ; epidemiology ; psychology

OBJECTIVETo explore the effect of preoperative anxiety level on postoperative pain sensation in partially edentulous patients undergoing surgery for implant denture.

METHODSEighty partially edentulous patients receiving implant denture were examined for preoperative anxiety level using State Trait Anxiety Inventory (STAI) and Modified Dental Anxiety Scale (MDAS) questionnaires before implantation surgery. The Visual Analogue Scale (VAS) and Present Pain Intensity (PPI) Questionnaire were used to assess the pain sensation in patients immediately after the operation. The correlations of preoperative state anxiety, trait anxiety, and dental anxiety with postoperative VAS score were analyzed. According to the assessment results of STAI, the patients were divided into little or no (score range 20-37) anxiety group (L group), moderate (38-44) anxiety group (M group), and high (45-80) anxiety group (H group) to analyze the effect of state anxiety and trait anxiety levels on postoperative pain sensation.

RESULTSSignificantly positive correlations were found between preoperative state anxiety, trait anxiety and dental anxiety among the patients (P<0.01). Postoperative VAS score was positively correlated with trait anxiety score (P<0.01) and differed significantly between different trait anxiety groups (P<0.01). Compared with the patients in M and L groups, those in H group showed a significantly higher VAS score after the operation (P<0.05).

CONCLUSIONThe preoperative trait anxiety level is associated with postoperative pain sensation in partially edentulous patients receiving implant denture, suggesting the necessity of preoperative anxiety intervention in clinical practice.

Adult ; Aged ; Anxiety ; epidemiology ; Dental Implantation ; psychology ; Dentition ; Female ; Humans ; Male ; Middle Aged ; Pain Measurement ; Pain, Postoperative ; epidemiology ; Surveys and Questionnaires ; Tooth Diseases ; psychology

Bruxism is defined as 'diurnal or nocturnal parafunctional activity including clenching, bracing, gnashing, and grinding of the teeth'. Bruxism and clenching are two of the most common contributing factors in patients with temporomandibular disorders and craniofacial pain disorders. Even though many studies report the high prevalence of bruxism, its cause is still not clear. Occlusal interference has been regarded as a major etiologic factor. Nowadays, psychological stress and sleeping disorders are generally regarded as major possible etiologic factors. More than likely, the cause is multifactoral and overlapping, which makes it difficult for the practitioner to apply comprehensive and effective management strategies. Although dentists and psychologists generally believe that effective treatment is best achieved with a better understanding of the etiology of a given disorder, for now treatment for this type of disorder must proceed without a clear understanding of etiology. To overcome this obstacle, evidence-based comprehensive management protocols based on accumulated scientific findings should be provided. In this presentation, epidemiology, etiology, and the characteristics of bruxism are reviewed. Diagnostic procedures and management strategies focused on occlusal appliances and behavioral approaches are also discussed.
Braces ; Bruxism* ; Dentists ; Diagnosis* ; Epidemiology ; Facial Pain ; Humans ; Prevalence ; Psychology ; Stress, Psychological ; Temporomandibular Joint Disorders

OBJECTIVETo compare the prior coronary angiography (CAG) psychological status in chest pain patients with and without coronary artery disease (CAD).

METHODSNinety-nine patients with chest pain and scheduled for CAG were selected by cluster sampling method. The mental status was measured by Hamilton Anxiety Rating Scale (HAMA) and Hamilton Depression Rating Scale-17 (HAMD-17) 24 hours before CAG, and the risk factors for CAD were also determined.

RESULTSThere were 43 patients with HAMA score > or = 14, 18 patients with HAMD-17 score > or = 14 and 16 patients with both scores > or = 14. CAD was diagnosed in 46 patients by CAG. HAMA score was significantly higher in patients without CAD than patients with CAD (14.1 +/- 7.1 vs. 11.1 +/- 6.7, P < 0.05).

CONCLUSIONSIncidences of anxiety and depression were high in chest pain patients prior CAG and incidence of anxiety prior CAG was significantly higher in chest pain patients without CAD compared to chest pain patients with CAD.

Adult ; Aged ; Chest Pain ; diagnostic imaging ; psychology ; Coronary Angiography ; psychology ; Coronary Artery Disease ; psychology ; Cross-Sectional Studies ; Depressive Disorder ; epidemiology ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Stress, Psychological

Disability questionnaires are used for clinical assessment, outcome measurement, and research methodology. Any disability measurement must be adapted culturally for comparability of data, when the patients, who are measured, use different languages. This study aimed to conduct cross-cultural adaptation in translating the original (English) version of the Oswestry Disability Index (ODI) into Korean, and then to assess the reliability of the Korean versions of the Oswestry Disability Index (KODI). We used methodology to obtain semantic, idiomatic, experimental, and conceptual equivalences for the process of cross-cultural adaptation. The KODI were tested in 116 patients with chronic low back pain. The internal consistency and reliability for the KODI reached 0.9168 (Cronbach's alpha). The test-retest reliability was assessed with 32 patients (who were not included in the assessment of Cronbach's alpha) over a time interval of 4 days. Test-retest correlation reliability was 0.9332. The entire process and the results of this study were reported to the developer (Dr. Fairbank JC), who appraised the KODI. There is little evidence of differential item functioning in KODI. The results suggest that the KODI is internally consistent and reliable. Therefore, the KODI can be recommended as a low back pain assessment tool in Korea.
Sensitivity and Specificity ; Risk Factors ; Risk Assessment/methods ; Reproducibility of Results ; *Questionnaires ; Pain Measurement/*methods ; Middle Aged ; Male ; Low Back Pain/classification/*diagnosis/*epidemiology/psychology ; Korea/epidemiology ; Humans ; Female ; *Disability Evaluation ; *Cross-Cultural Comparison ; Aged ; Adult ; *Activities of Daily Living

The complex regional pain syndromes (CRPS I and CRPS II), also known as reflex sympathetic dystrophy and causalgia, have been recognized for the past 2,500 years. Despite its long history, the diagnosis and treatment of CRPS are still challenging. These syndromes can be characterized by discrete sensory, motor, and autonomic findings, but many patients with CRPS continue to suffer for years without the diagnosis. Although much progress has been made in the understanding of CRPS, many questions still remain unanswered. CRPS is probably a disease of the central nervous system. Yet, peripheral inflammatory processes, abnormal sympathetic- afferent coupling, and adrenoreceptor pathology may also be part of the picture. A close multidisciplinary approach amongst the pain medicine consultants, psychologist, physical and occupational therapists, and neurologist is necessary to achieve the maximum treatment outcomes. If conventional treatment (e.g. pharmacotherapy) fails to show a significant response within 12 weeks, an interventional technique such as spinal cord stimulation (SCS) needs to be tried. The current concepts of CRPS could be replaced by a new mechanism-based term or group of terms in the near future leading to improved clinical guidelines. This article reviews the different aspects of CRPS including its definition, classification, epidemiology and natural history, clinical presentation, pathophysiology and management.
Causalgia ; Central Nervous System ; Classification ; Complex Regional Pain Syndromes ; Consultants ; Diagnosis* ; Epidemiology ; Humans ; Natural History ; Pathology ; Psychology ; Reflex Sympathetic Dystrophy ; Spinal Cord Stimulation

The objective of this study was to examine the prevalence and risk factors for widespread pain and its influence on quality of life in residents of Korean communities. A rural and an urban community were selected, and 5,037 subjects were surveyed. Participants were asked if they had pain, aching, or stiffness in any of their joints on most days. Widespread pain was defined as pain above the waist, below the waist, on both sides of the body and in the axial region. The prevalence of widespread pain was 12% (16.2% and 5.5% in females and males, respectively). It was more frequent among females and increased with age in both genders. Age, female gender, and the presence of hand or knee arthritis were significantly associated with widespread pain after multivariate analysis. Except for mental health, all the items in the SF-12 were adversely affected in the widespread pain group after adjustment for confounding factors. Our findings show that the prevalence of widespread pain among residents of Korean communities is comparable to that reported among Caucasians. The significantly worse quality of life among subjects with widespread pain suggests that it may cause major health issues in the aging population.
Adult ; Age Factors ; Aged ; Demography ; Female ; Health Status ; Humans ; Male ; Middle Aged ; Odds Ratio ; Pain/*epidemiology/psychology ; Prevalence ; *Quality of Life ; Republic of Korea/epidemiology ; Risk Factors ; Rural Population ; Sex Factors ; Urban Population