Male Pain Patients Research Articles

CSF monoamine metabolites in chronic pain

Metabolites of selected neurotransmitters (5-HIAA, HVA and DOPAC) and beta-endorphin were measured in the CSF of 39 chronic pain patients and compared to controls. Twelve of the pain patients also fulfilled criteria for major depression. The concentration of 5-HIAA was increased in female but not male pain patients; there was no significant difference in the CSF concentrations of HVA and DOPAC. The presence of depression did not influence the concentrations of neurotransmitters. No correlation was found between the concentrations of monoamine metabolites and beta-endorphin. However, there was a positive correlation between 5-HIAA and HVA in controls and chronic pain patients without depression but not in depressed patients. It is concluded: chronic pain states are associated with elevation of CSF 5-HIAA in female patients; depression abolishes a positive correlation between 5-HIAA and HVA.

Pain-patient MMPI subgroups: the psychological dimensions of pain.

Two-hundred-forty male pain patients were given the MMPI and an extensive pain history questionnaire. A hierarchical clustering procedure was used, and three distinct profiles emerged. One profile was essentially "normal," while a second profile revealed the "hypochondriasis" configuration, and a third was highly elevated on scales which reflect a "psychopathological" type of profile. A discriminant analysis yielded functions correctly classifying over 90% of the subjects in each group. Although the three groups did not significantly differ on age, education, income, IQ, assertiveness, type of pain, or years of pain duration, they did differ on the pain history questions relating to pain severity and pain impact on their lives. The psychopathological group reported significantly more distress than the hypochondriasis group, and the hypochondriasis group reported significantly more distress than the normal group. The implications for pain treatment are discussed.

Oesophageal function and chest pain in male patients with recent acute myocardial infarction.

Oesophageal function and symptoms were investigated in 52 male patients 2-6 months after an acute myocardial infarction. Oesophageal function was tested by manometry, pH recording and acid perfusion test. Signs of oesophageal dysfunction (OD) were found in 17 patients (33%). This frequency did not differ significantly from that in a random male population sample, but was lower than in a group of male coronary care unit patients with no signs of a new or earlier myocardial infarction at discharge from hospital (p less than 0.05). All but two patients affirmed chest pain by questionnaire. At a verbal interview, 38 patients (73%) had a history of angina pectoris after discharge from hospital. Thirty-five (92%) of these patients had an ischaemic ECG reaction and/or recurrence of their anginal chest pain during the exercise test, one of them also had evidence of oesophageal origin of his chest pain. There were no signs of OD in the remaining three patients with a history of angina pectoris. Therefore, OD does not constitute a common problem in the differential diagnosis of anginal chest pain in patients with recent myocardial infarction.