Impact Of Chronic Pain Research Articles

O IMPACTO DA DOR CRÔNICA NA QUALIDADE DE VIDA DAS CRIANÇAS O PAPEL DO ENFERMEIRO NO MANEJO DA DOR

The impact of chronic pain on children's quality of life and the role of nurses in pain management is the central approach of this study, which was carried out through a literature review. The aim is to analyze how chronic pain affects children's physical, emotional and social development, as well as to assess the importance of nurses in identifying and treating this pathology. The review aims to strengthen the improvement of nursing practices and enhance the multidisciplinary approach in the hospital environment. Scientific articles and recent publications on the subject were used to support the discussions. The main results indicate that the proper management of chronic pain in children, led by nurses, is indispensable for minimizing the negative impacts on the child's quality of life, and that continuous and personalized interventions are necessary. The research also highlights the importance of adequate training for professionals and the implementation of protocols that consider both the physical and emotional aspects of pain, reinforcing the need for a holistic, effective, interdisciplinary approach guided by nurses.

Impact of chronic pelvic pain on quality of life in diverse young adults.

To examine the relationship between quality of life (QoL) and chronic pelvic pain (CPP), including an evaluation of whether differences exist between reported races and coping mechanisms used. We used a cross-sectional survey design and analyzed data using descriptive and inferential statistics. We administered two surveys: the World Health Organization Quality of Life-BREF (26 items) and the Impact of Female Chronic Pelvic Pain Questionnaire (8 items). We recruited young adults aged 18-25 who menstruate from college campuses in a large metropolitan area in the Midwest region of the United States, utilizing flyers, online social media platforms, and snowball sampling techniques. Out of the 585 respondents, 153 (26%) reported "yes," and 95 (16%) were "unsure" they had CPP. Those with CPP and unsure reported using various coping mechanisms for pain. They had lower scores in all four domains (physical health, psychological, social relationship, and environment) and statistically significant lower scores in three domains (physical health, social relationship, and environment) on the World Health Organization Quality of Life-BREF when compared to those who said "no." Respondents identifying as Black, Indigenous, or People of Color had statistically significantly lower QoL in the physical health and environment domains compared to white respondents. Young adults with CPP experience a significantly lower QoL than those without CPP, and racial differences further widen this gap. Future research should explore coping mechanisms that could benefit young adults' daily lives.

A Systematic Review on the Neuropsychological Assessment of Patients with LBP: The Impact of Chronic Pain on Quality of Life

Background and objective: Low back pain (LBP) is most common pain syndrome in Europe, affecting approximately 50% of European citizens. LBP is a complex condition that negatively affects many aspects of an individual’s life such as work productivity, mobility, and mental health. The aim of this study is to assess the impact of pain associated with chronic LBP on patients’ quality of life. Methods: Clinical studies reviewed in our search with no time restrictions were identified from PubMed, Web of Science, Scopus, and Cochrane Library databases. Of the initial 1929 studies, only 15 met inclusion criteria. Results: Results of our study indicate that chronic pain has a negative impact on numerous functions and areas in which the individual is involved and that this condition leads to reduced performance. Conclusions: LBP is a debilitating condition for patients, negatively affecting quality of life. Future studies should focus on validating a standardized assessment that examines all aspects affected by LBP through a customized questionnaire.

Impact of chronic low back pain on implicit motor imagery assessed by a new laterality judgment task

It is clear that implicit motor imagery (IMI) is impaired by chronic pain in peripheral regions (hand, feet), but unclear in axial regions (neck, shoulder, back). Previous IMI tasks displayed small-amplitude movements of axial regions, which limits person-centered IMI processes mobilization. This study aimed to assess the impact of chronic low back pain (CLBP) on IMI processes with a new task displaying large-amplitude whole-body movements mobilizing the lumbar spine. Twenty patients with CLBP and twenty age-matched controls performed a laterality judgment task on four distinct whole-body movements (trunk flexion, trunk rotation, capoeira, kickboxing). Participants viewed images from four different body viewpoints (back, left, right and front), randomly presented. Mixed ANOVAs were used to compare judgment accuracy and response times between groups and conditions. In participants with CLBP, response times were longer than in controls. The response times of participants with CLBP were also associated with DN4 scores, a self-reported questionnaire assessing neuropathic pain. We validated the use of a person-centered IMI because, for all participants, the accuracy decreased and the response times increased for images presented in the front viewpoint, i.e. when a 180° turn in IMI was required, compared to other viewpoints. The laterality judgment task proposed here confirmed that CLBP impacts IMI processes, and that the nature of pain (neuropathic or mechanical) needs to be considered because it seems to modulate IMI processes. PerspectivesA laterality judgment task with large-amplitude lumbar movements is key to show that CLBP alters processing speed of sensorimotor information originating from the painful region. This task could become an objective tool, transferable in clinical settings, for assessing the impact and the progression of CLBP on motor control processes.

Development of Machine Learning Algorithms Using EEG Data to Detect the Presence of Chronic Pain.

Chronic pain impacts more than one in five adults in the United States (US) and the costs associated with the condition amount to hundreds of billions of dollars annually. Despite the tremendous impact of chronic pain in the US and worldwide, the standard of care for diagnosis depends on subjective self-reporting of pain state, with no effective objective assessment procedure available. This study investigated the application of signal processing and machine learning to electroencephalography (EEG) data for the development of classification algorithms capable of differentiating subjects in pain from pain free subjects. In this study, nineteen (19) channels of EEG data were obtained from subjects in an eyes closed resting state, and ultimately data from 186 participants were used for algorithm development, including 35 healthy controls and 151 chronic pain patients. Signal processing was applied to identify noise free segments of EEG data and 6375 quantitative EEG (qEEG) measures were calculated for each subject. Various machine learning methodologies were applied to the data, with Elastic Net chosen as the optimal methodology. The final classifier developed using Elastic Net contained 34 qEEG features with non-zero weights. The classifier was able to differentiate pain versus no pain subjects with an accuracy of 79.6%, sensitivity of 82.2%, and specificity of 66.7%. The features used in the classifier were evaluated and found to align well with contemporary literature regarding changes in neurological characteristics associated with chronic pain.

How Well Can We Measure Chronic Pain Impact in Existing Longitudinal Cohort Studies? Lessons Learned

Multiple large longitudinal cohorts provide opportunities to address questions about predictors of pain and pain trajectories, even when not anticipated in the design of the historical databases. This focus article uses 2 empirical examples to illustrate the processes of assessing the measurement properties of data from large cohort studies to answer questions about pain. In both examples, data were screened to select candidate variables that captured the impact of chronic pain on self-care activities, productivity, and social activities. We describe a series of steps to select candidate items and evaluate their psychometric characteristics in relation to the measurement of pain impact proposed. In the UK Biobank, a general lack of internal consistency of variables selected prevented the identification of a satisfactory measurement model, with lessons for the measurement of chronic pain impact. In the English Longitudinal Study of Ageing, a measurement model for chronic pain impact was identified, albeit limited to capturing the impact of pain on self-care and productivity but lacking coverage related to social participation. In conjunction with its Supplementary Material, this focus article aims to encourage exploration of these valuable prospectively collected data to support researchers to make explicit the relationships between items in the databases and constructs of interest in pain research and to use empirical methods to estimate the possible biases in these variables. PerspectiveThis focus article outlines a theory-driven approach for fitting new measurement models to data from large cohort studies and evaluating their psychometric properties. This aims to help researchers develop an empirical understanding of the gains and limitations connected with the process of repurposing the data stored in these datasets.

Is there a role for capsaicin in Cancer pain management?

Advances in oncological therapies have resulted in an increase in the number of patients living with and beyond cancer. The personal and societal impact of chronic pain in the survivor population represents an area of significant unmet need. Capsaicin (a TRPV1 agonist) may provide analgesia with limited systemic side effects. This review looks to summarise the most recent evidence regarding the use of capsaicin in the management of cancer pain. Various international guidelines have recently endorsed the use of high concentration capsaicin patches in the treatment of chronic painful chemotherapy induced peripheral neuropathy. Numerous studies support the use of capsaicin in the treatment of peripheral neuropathic pain. This promising data is predominantly yielded from pain secondary to herpes zoster and diabetic neuropathy, with an expanding but small evidence base for its utility in other neuropathic pains. Emerging data suggests that treatments are better tolerated and provide analgesia more rapidly when compared with systemic treatments. Whilst randomised controlled trial data in the treatment of cancer pain are lacking, recent large cohort studies, and international guidelines, support the use of high concentration capsaicin patches in a wide variety of neuropathic pain secondary to cancer treatments.

Impact of chronic pain and depressive symptoms on the quality of life of adults with Chiari Malformation type I: A comparative study.

Chiari Malformation type I (CM-I) is a neurological disorder characterized by cerebellar tonsillar herniation. Chronic pain, particularly headaches, is a prevalent symptom in CM-I patients, significantly impacting their quality of life. The objective of this study was to evaluate the perceived quality of life in adults with CM-I and examine the influence of chronic pain and comorbid symptoms on their well-being. 26 CM-I patients (8 with decompressive surgery) and 26 matched healthy controls were recruited. Participants completed the following questionnaires: WHOQOL-BREF, HDI, NDI, OLBPDQ and HADS. CM-I patients exhibited significantly lower scores across all domains of quality of life when compared to healthy controls. Chronic pain, including headache, neck pain, and low back pain, was more pronounced among CM-I patients and demonstrated a significant correlation with depressive symptoms. Notably, after controlling for chronic pain, the differences in quality of life between CM-I patients and controls diminished. The results suggest that chronic pain, especially headaches, and comorbid depressive symptoms exert a substantial impact on the quality of life of CM-I patients. Surgical intervention alone may not fully address these issues, highlighting the importance of considering psychological interventions as part of the comprehensive treatment. Further research with larger samples and pre-post-surgery assessments is needed to validate these findings and explore the potential benefits of psychological therapies in enhancing the quality of life for CM-I patients.

Chronic pain after traumatic brain injury: a collaborative care approach.

Chronic pain is common after traumatic brain injury (TBI), frequently limits daily activities, and is associated with negative outcomes such as decreased community participation. Despite the negative impact of chronic pain, few people with TBI receive effective treatment. This paper describes a collaborative care (CC) intervention, TBI Care, adapted specifically to treat chronic pain in people living with TBI, emphasizing expert clinician input, cognitive behavioral therapy (CBT) techniques, and other non-pharmacological approaches for decreasing pain interference. 79 participants engaged in the CC intervention from two academic medical rehabilitation clinics with weekly assessments of pain intensity, interference, and medication use. Participant feedback on the intervention was gathered by interview with the care manager (CM) at the last treatment session and/or booster session. Provider feedback was gathered by a confidential survey post intervention. Ninety percent of participants received at least 11 of the target 12 sessions with a care manager (CM), the majority occurring over the phone. Participants endorsed an average of 7 pain locations. All participants received pain education, skills in self-monitoring, goal setting/behavioral activation and relaxation training. Pain interference scores (impact on activity and enjoyment), tracked weekly by the CM, significantly decreased across sessions. 89% of participants received recommendations for CBT skills, 65% received referrals for additional treatments targeting pain interference, and 43% received care coordination. 75% of participants reported 6 or more medications/supplements at both the first and last session, with changes recommended primarily for headache treatment. Feedback from participants and providers was positive. TBI Care, a novel patient-centered CC approach, was flexibly delivered, tailored to the needs of those living with TBI and chronic pain, with a high level of participant engagement, and satisfaction among participants and providers. This approach, prioritizing pain self-management strategies and other non-pharmacological approaches, along with optimizing pharmacological treatment, led to significant reductions in self-reported pain interference and intensity during the intervention. Using a CC model in TBI is feasible and successfully improved access to evidence-based treatments for chronic pain as well as outcomes for pain interference and intensity. ClinicalTrials.gov, identifier NCT03523923.

Relationship Between Treatment Hours of Selected Disciplines And Change in Pain Impact During the Year Following Referral to an Interdisciplinary Pain Management Center: A Latent Class Analysis.

Introduction: Pain management clinics differ in treatments offered, and little evidence exists regarding which combinations of therapies result in best outcomes. This study analyzed clinical encounters and pain outcomes data for associations between treatment composition and outcomes. Methods: Retrospective observational study of 2,142 predominantly active-duty US service members referred to an interdisciplinary pain management center between 2014 and 2021. Latent class analysis was used to identify treatment groups with distinct outcome patterns during the year following initial assessment. The primary outcome measure was the National Institutes of Health Task Force on Research Standards for Chronic Low-Back Pain impact score. Results: Four distinct treatment groups were identified: 1 group engaged in conventional medical therapies alone (n = 726, median 3.5 treatment hours), and 3 groups used a combination of conventional, psychological, rehabilitative, and complementary therapies, with different levels of treatment hours: low (n = 814, median 15.7 h), medium (n = 177, median 40.1 h), and high (n = 425, median 72.5 h). All groups showed significant improvement in pain impact score from baseline up to 9 months but not at 12 months following initial assessment. At the 6-month time point, the group with high multimodal treatment hours had the most improvement in pain impact (-3.1 [95% CI -3.8, -2.4]) compared with the group using only conventional therapies (-1.0 points [95% CI -1.8, -0.1]) or with low multimodal treatment hours (-1.3 points [95% CI -1.9, -0.7]). There were no between-group differences at the 9- or 12-month time points. Conclusion: These results suggest that a combination of pain therapy approaches results in greater reduction in pain impact than the use of conventional medical treatment alone for up to 6 months after initiating therapy and that there may be a threshold of treatment hours that must be exceeded to achieve this benefit. Clinical trial registration: As this study is not a clinical trial, no registration was required.

Chronic pain in breast cancer survivors is linked with an impairment on emotion-based decisions and fatalistic time orientation

AbstractAfter breast cancer diagnosis, individuals have to cope with various psychological, social, and physical consequences. One such consequence is chronic pain, which can persist even after the completion of active treatments and detrimentally impact quality of life. The published literature highlights the impact of chronic pain on cognitive functions and on decision-making processes. However, little is known about the imbalance in decision-making among cancer survivors suffering from chronic pain. This study aims to explore the cognitive impairment associated with risky decision-making in breast cancer survivors experiencing chronic pain, using the Iowa Gambling Task (IGT). Sixty women voluntarily participated in this prospective, cross-sectional study. Among them, twenty had a history of breast cancer and exhibited a significant level of chronic pain, twenty had previously received a cancer diagnosis but did not experience chronic pain, and twenty had not been diagnosed with cancer. The results revealed that women with chronic pain tend to make significantly more disadvantageous choices in the IGT compared to the other groups. Moreover, participants with chronic pain tend to believe that circumstances will change regardless of their efforts to achieve something. This way of thinking may contribute to reinforcing the observed imbalance in decision-making. Our hypothesis suggests that chronic pain may trigger a “Cascade Effect”, exerting multiple influences on decision-making and behaviors. The cognitive overload provoked by chronic pain in breast cancer survivors may not only affect individual cognitive functions, but also have a “Cascade Effect” on other psychological dimensions.

Unveiling the impact of chronic back pain: do not forget sacroiliac joint dysfunction

Unveiling the impact of chronic back pain: do not forget sacroiliac joint dysfunction

Adaptive and Compensatory Neural Signatures in Fibromyalgia: An Analysis of Resting-State and Stimulus-Evoked EEG Oscillations.

This study aimed to investigate clinical and physiological predictors of brain oscillatory activity in patients with fibromyalgia (FM), assessing resting-state power, event-related desynchronization (ERD), and event-related synchronization (ERS) during tasks. We performed a cross-sectional analysis, including clinical and neurophysiological data from 78 subjects with FM. Multivariate regression models were built to explore predictors of electroencephalography bands. Our findings show a negative correlation between beta oscillations and pain intensity; fibromyalgia duration is positively associated with increased oscillatory power at low frequencies and in the beta band; ERS oscillations in the theta and alpha bands seem to be correlated with better symptoms of FM; fatigue has a signature in the alpha band-a positive relationship in resting-state and a negative relationship in ERS oscillations. Specific neural signatures lead to potential clusters of neural adaptation, in which beta oscillatory activity in the resting state represents a more adaptive activity when pain levels are low and stimulus-evoked oscillations at lower frequencies are likely brain compensatory mechanisms. These neurophysiological changes may help to understand the impact of long-term chronic pain in the central nervous system and the descending inhibitory system in fibromyalgia subjects.

Examining the Relationship Between Chronic Pain and Mortality in U.S. Adults

Chronic pain (CP) significantly impacts quality of life and increases noncommunicable disease risk, with recent U.S. data showing a 6.3% incidence rate, surpassing diabetes, depression, and hypertension. International studies suggest higher mortality in CP populations, yet prior U.S. data are inconclusive. To investigate CP's mortality risk, we analyzed National Health Interview Survey and National Death Index data. We hypothesized that individuals with CP and high-impact CP (HICP [≥1 activity limitation]) would exhibit higher mortality rates. National Health Interview Survey provided demographics, pain reporting, lifestyle, and psychosocial data matched with National Death Index mortality records. Chi-square analyses explored the relationships between CP/HICP and demographics, lifestyle factors, psychosocial variables, and mortality. Cox proportional hazards models assessed mortality risk between groups. The weighted sample was 245,899,776; 20% reported CP and 8% HICP, both groups exhibiting higher mortality rates than pain-free individuals (CP: 5.55%, HICP: 8.79%, total: 2.82%). Hazard ratios indicated nearly double the mortality risk for CP and 2.5 times higher risk for HICP compared to those without these conditions. Adjusting for lifestyle and psychosocial factors reduced mortality risk but remained elevated compared with non-CP individuals. Heart disease, malignant neoplasms, and chronic lower respiratory diseases accounted for a higher percentage of deaths in CP cases. CP individuals showed higher rates of smoking, alcohol consumption, obesity, inactivity, depression, anxiety, emotional problems, and sleep disturbances. CP and HICP significantly influence mortality outcomes, leading to excess deaths compared with pain-free individuals. Given the relationship between pain, lifestyle, psychosocial variables, and mortality, further investigations are needed into CP causation and prevention strategies. PerspectiveThis article presents evidence regarding the relationship between CP, HICP, and mortality. Additional findings are discussed regarding the impact of demographics, lifestyle, and psychosocial variables on mortality in those with versus without CP and HICP. These findings are crucial for informing future research, prevention, and healthcare management strategies.

Functional Patterns and Postural Balance in Young Women With Chronic Non-Specific Low Back Pain and Healthy Individuals

Introduction In the case of chronic low back pain, changes occur at the central nervous system level. It leads to functional limitations, muscle activity, and motor control impairments.Objectives The aim of the study was to analyze the impact of chronic low back pain on the quality of performance functional patterns and postural balance in young women.Material and methods The study involved 60 women with an average of 21.571.07. In Group 1 (n=30), participants reported chronic low back pain, Group 2 (n=30) was the control group. To assess functional efficiency, the Functional Movement Screen was used. Postural stability was evaluated using the FreeMED Posture Base pedobarographic platform. Pain level was determined using the VAS scale, and pelvic anterior tilt was measured using the BROM II.Results In the group of women with chronic low back pain, significantly lower levels of functional efficiency were observed. The length distance covered by the CoP, the area of an ellipse containing the trajectory of the CoP, and the average velocity of the CoP were greater compared to the group of women without pain. In Group 1, significantly greater asymmetry in foot pressure distribution was noted.Conclusions Individuals reported chronic low back pain demonstrate poorer quality of performance functional patterns and postural stability compared to healthy ones. Detecting movement disorders may contribute to a physiotherapist's planning of a therapeutic program that includes the specific movement deficits of patients. It can directly impact the reduction or delay of pain occurrence.

Effects of Chronic Pain Following Unilateral Ureteral Obstruction on Hippocampal CA1 Pyramidal Neurons in Male Wistar Rats

Background: Chronic pain can adversely affect cognitive functions such as learning, memory, and attention. However, the precise mechanisms underlying cognitive impairment in chronic pain remain elusive. Objectives: This study aims to investigate the impact of chronic pain induced by unilateral ureteral obstruction (UUO) on hippocampal neurons. Methods: In the current case-control study, 27 male Wistar rats (230 - 280 g) were randomly assigned to three groups: 1-sham, 2-UUO, and 3-UUO treated with naloxone (i.p.; 1 mg/kg for 5 days). Following transcardial perfusion, the rats' brains were removed, and histological studies were performed to count the number of neurons using an optical microscope. Concurrently, TNF-α and NGF levels were measured in brain tissue homogenate. Results: The mean number of neurons in the CA1 region of the animals in the UUO group was 68.11 ± 1.34, which showed a significant decrease compared to the mean number of neurons in the sham-operated group (114.1 ± 1.77; P < 0.0001). In contrast, the mean number of neurons in the CA1 region of the UUO with naloxone group showed a significant increase compared to the animals in the UUO group (73.44 ± 1.37; P < 0.0001). TNF-α was 264.3 ± 2.6 pg/mL in the UUO animals and decreased significantly in the UUO animals treated with naloxone (P = 0.001). However, NGF was 115.2 ± 2.9 pg/mL in UUO animals and increased significantly in the UUO with naloxone group (P < 0.01). Conclusions: Unilateral ureteral obstruction, through inducing chronic pain and inflammation, resulted in neurodegeneration in the CA1 region of the hippocampus. The use of naloxone, an opioid antagonist, immediately after the surgery was able to provide neuronal protection and an anti-inflammatory effect.

Examining tools for assessing the impact of chronic pain on emotional functioning in children and young people with cerebral palsy: stakeholder preference and recommendations for modification

PurposeTo firstly identify tools for assessing the impact of chronic pain on emotional functioning in children and young people with cerebral palsy (CP), and secondly identify suggestions to improve their relevance, comprehensiveness, comprehensibility and feasibility for the CP population. Improving assessment of the impact of pain on emotional functioning can enhance quality of life by improving access to interventions for pain-related physical disability, anxiety and depression.MethodsEthics approval was granted through the Women’s and Children’s Health Network Human Research Ethics Committee (2022/HRE00154). A mixed methods study with people with lived experience and clinicians, and guided by the Consensus-based Standards for Measurement Instruments (COSMIN), was undertaken. An online survey identified the highest rated tools for validation and/or modification for young people with CP and chronic pain. Focus groups and interviews investigated content validity and feasibility of the tools identified as highest rated.ResultsThe Fear of Pain Questionnaire for Children-SF (FOPQ-C-SF) and Modified Brief Pain Inventory (mBPI) were the highest rated for pain coping and multidimensional assessment (respectively) from the online survey (n = 61) of eight tools presented. Focus group and interview data (n = 30), including 58 unique modification suggestions, were coded to six categories: accessibility, comprehensibility, feasibility, relevance, presentation and comprehensiveness.ConclusionPotential modifications have been identified to improve the appropriateness and feasibility of the FOPQ-C-SF and mBPI for children and young people with CP. Future research should implement and test these modifications, prioritising the involvement of people with lived experience to ensure their needs are met alongside clinicians.

The impact of chronic pain on brain gene expression.

Chronic pain affects one fifth of American adults, contributing significant public health burden. Chronic pain mechanisms can be further understood through investigating brain gene expression. We tested differentially expressed genes (DEGs) in chronic pain, migraine, lifetime fentanyl and oxymorphone use, and with chronic pain genetic risk in four brain regions (dACC, DLPFC, MeA, BLA) and imputed cell type expression data from 304 postmortem donors. We compared findings across traits and with independent transcriptomics resources, and performed gene-set enrichment. We identified two chronic pain DEGs: B4GALT and VEGFB in bulk dACC. We found over 2000 (primarily BLA microglia) chronic pain cell type DEGs. Findings were enriched for mouse microglia pain genes, and for hypoxia and immune response. Cross-trait DEG overlap was minimal. Chronic pain-associated gene expression is heterogeneous across cell type, largely distinct from that in pain-related traits, and shows BLA microglia are a key cell type.

Evaluating the effectiveness of neurofeedback in chronic pain management: a narrative review.

The prevalence and impact of chronic pain in individuals worldwide necessitate effective management strategies. This narrative review specifically aims to assess the effectiveness of neurofeedback, an emerging non-pharmacological intervention, on the management of chronic pain. The methodology adopted for this review involves a meticulous search across various scientific databases. The search was designed to capture a broad range of studies related to neurofeedback and chronic pain management. To ensure the quality and relevance of the included studies, strict inclusion and exclusion criteria were applied. These criteria focused on the study design, population, intervention type, and reported outcomes. The review synthesizes the findings from a diverse array of studies, including randomized controlled trials, observational studies, and case reports. Key aspects evaluated include the types of neurofeedback used (such as EEG biofeedback), the various chronic pain conditions addressed (like fibromyalgia, neuropathic pain, and migraines), and the methodologies employed in these studies. The review highlights the underlying mechanisms by which neurofeedback may influence pain perception and management, exploring theories related to neural plasticity, pain modulation, and psychological factors. The results of the review reveal a positive correlation between neurofeedback interventions and improved pain management. Several studies report significant reductions on pain intensity, improved quality of life, and decreased reliance on medication following neurofeedback therapy. The review also notes variations in the effectiveness of different neurofeedback protocols and individual responses to treatment. Despite the promising results, the conclusion of the review emphasizes the need for further research. It calls for larger, well-designed clinical trials to validate the findings, to understand the long-term implications of neurofeedback therapy, and to optimize treatment protocols for individual patients.

Patterns and prevalence of psychiatric morbidity among individuals with rheumatoid arthritis.

Rheumatoid arthritis (RA) is a chronic autoimmune disorder that affects the joints, causing inflammation, pain, and potential joint damage. Patients with RA are at high risk of developing psychiatric morbidity; it is important to recognize these psychiatric manifestations. The relationship between psychiatric symptoms and RA is complex and can involve various factors, including the impact of chronic pain, inflammation, medications, and the overall burden of managing a chronic illness.Aim of the study was to systematically investigate and analyze the patterns and prevalence of psychiatric morbidity among individuals diagnosed with RA, with the aim of identifying common mental health conditions, understanding the interplay between RA and psychiatric disorders, and providing valuable insights for improved holistic patient care. This was a prospective, observational cross-sectional study conducted over a period of three years in patients with RA. Psychiatric morbidity was assessed using International Classification of Diseases-10 criteria and Mini-Plus by dedicated psychiatrists. The diagnosis of RA was confirmed using the 2010 American College of Rheumatology/European Alliance of Associations for Rheumatology (ACR/EULAR) diagnostic criteria for RA and the disease activity was calculated by Disease Activity Score with 28-joint count (DAS28) using the calculator from the RheumaHelper application. The data were analyzed using SPSS, version 23.0. A total of 1,000 patients with RA were included in this study. Nearly two-thirds of the patients were female (64.8%). The majority of patients belonged to the age group of 41 to 54 years. Total 47.5% of the patients were unemployed, 27.0% were salaried, 19.0% were businessman, while 6.5% of the patients were students. More than half of the patients (53.2%) had moderate disease activity. Major depressive disorder was the most commonly observed comorbidity (41.0%), followed by somatoform disorder (28.5%), and generalized anxiety disorder was found in 13.5%. No psychiatric manifestations were found in 17% of studied individuals. Psychiatric morbidity is associated with RA and there is a need for psychiatric services to be made available to these patients.