Prevalence Of Pain Conditions Research Articles

The prevalence of pain in Huntington's disease in a large worldwide cohort

IntroductionPain could be an unknown non-motor symptom in Huntington's Disease (HD). The aim is therefore, to study the prevalence of pain interference, painful conditions and analgesic use across the different stages of HD and compare these levels to non-HD gene mutation carriers. MethodsA cross-sectional analysis of the Enroll-HD study was conducted in premanifest, manifest HD gene mutation carriers (n = 3989 and n = 7,485, respectively) and in non-HD gene mutation carriers (n = 3719). To investigate group differences, multivariable logistic regression analysis was performed with pairwise comparisons. ResultsIn the HD mutation carriers, the overall prevalence of pain interference was 34% (95% CI 31%–35%), of painful conditions 17% (95% CI 15%–19%) and analgesic use 13% (95% CI 11%–15%). Compared to non-mutation carriers, the prevalence of pain interference was significantly higher in the middle stage of HD (33% [95% CI 31%–35%] vs 42% [95% CI 39%–45%], P = 0,02), whereas the prevalence of painful conditions was significant lower in the late and middle stage of HD (17% [95% CI 16%–18%] vs 12% [95% CI 10%–14%], 15% [95% CI 13%–17%], P < 0,01]. No significant group difference was present in analgesic use. ConclusionsThe prevalence of pain interference increases as HD progresses, however, the prevalence of painful conditions and analgesics do not increase accordingly. Further studies are necessary to investigate the aetiology of pain in HD and the risk for undertreatment of pain.

Pregabalin prescribing patterns in Australian general practice, 2012-2018: a cross-sectional study.

BackgroundIn 2013 pregabalin was subsidised by Australia’s Pharmaceutical Benefits Scheme (PBS) for neuropathic pain. Since the subsidy, pregabalin prescribing has been increasing in Australia and so has related harm. There are concerns it is being prescribed for indications other than neuropathic pain, which have little evidence of efficacy.AimTo describe pregabalin prescribing in Australian general practice.Design & settingA cross-sectional study of patients attending 445 general practice sites in the national MedicineInsight database from March 2012–February 2018.MethodThe following aspects were calculated: the proportion of prescriptions that were for pregabalin per year; the prevalence of pain conditions in patients prescribed pregabalin; and same-day prescribing of pregabalin with opioids or benzodiazepines.ResultsPrescribing increased from 13 per 10 000 to 104 per 10 000 prescriptions between 2012–2013 and 2017–2018. A total of 1 891 623 patients were identified of whom 114 123 (6.0%) were prescribed pregabalin; 49.7% (n = 56 772) had a recorded diagnosis of neuropathic pain. Among people prescribed pregabalin without a recorded diagnosis of neuropathic pain, 43.5% (n = 24 927) had a diagnosis of back problems, 8.8% (n = 5073) chronic pain, and 26.4% (n = 30 146) had no pain diagnosis. Pregabalin was prescribed the same day as an opioid to 38.1% of patients (95% confidence interval [CI] = 37.1% to 39.1%) and a benzodiazepine to 13.1% of patients (95% CI = 12.5% to 13.7%). Patients with a diagnosis of chronic pain had the highest rate of same-day prescribing of pregabalin with an opioid (70.4%, 95% CI = 68.9% to 71.9%) or a benzodiazepine (25.8%, 95% CI = 24.2% to 27.4%)ConclusionSubstantial increases in pregabalin prescribing were identified in Australian general practice, but only half of patients had a neuropathic pain diagnosis recorded, the only approved indication for subsidy. High rates of same-day prescribing with opioids and benzodiazepines may put patients at increased risk of harm.

(265) The Relationship between Discrimination and Pain Tolerance and its Potential Mediation by Stress: Results from the Oklahoma Study of Native American Pain Risk (OK-SNAP)

Compared to other racial/ethnic minority groups, Native Americans (NAs) are more likely to report experiences of discrimination and also have the highest prevalence of pain conditions. Thus, there is a need to understand how and why these disproportionately high rates occur. Discrimination has been conceptualized within the biopsychosocial model as a chronic psychosocial stressor that can lead to dysfunction of regulatory processes, such as pain. A recent study found that perceived discrimination increased psychological distress that, in turn, led to increased chronic pain. To date, these relationships have not yet been evaluated in NAs. The present study examined perceived discrimination, stress, and pain tolerance in healthy, pain-free NAs (N=112) and NHWs (N=128). Discrimination was measured with the Everyday Discrimination Scale (EDS), stress was measured with the Perceived Stress Scale (PSS), and pain tolerance was measured in reaction to cold, heat, electrocutaneous, and ischemia pain stimuli. Results indicated NAs experienced more discrimination than NHWs (p

Characteristics of new depression diagnoses in patients with and without prior chronic opioid use

Chronic use (>90 Days) of opioid analgesics significantly increases the risk of development of new depression episodes (NDE). It is unclear whether depression that develops in this manner is similar to or different from NDE in persons not exposed to opioid analgesic use (OAU). MethodsVA patients were classified into two groups, those who did not receive an opioid and developed depression (non-OAU+NDE, n=4314) and those that had >90 days OAU and developed NDE (OAU+NDE, n=444). OAU+NDE patients were compared to non-OAU+NDE in terms of depression severity (PHQ-9 scores), incidence of PTSD, other anxiety disorders and substance use disorders after NDE, receipt of acute phase antidepressant treatment, dual antidepressant treatment, mood stabilizers and atypical antipsychotics. Prior to computing bivariate analysis, the prevalence of pain conditions and average maximum pain scores were equalized between the two groups using propensity scores and inverse probability of treatment weighting. ResultsControlling for pain, OAU+NDE patients had more depression symptoms (p=.012), more incident PTSD (p=.04) and opioid abuse/dependence and were more likely to receive 12 weeks of antidepressant treatment (p<.0001). Last, non-OAU+NDE were more likely to have incident diagnoses for any other anxiety disorder (p=.014). ConclusionsWithin the limitations of electronic medical record data, results indicate OAU+NDE patients have more depression symptoms, greater treatment adherence and different comorbid psychiatric conditions compared to non-OAU+NDE, independent of pain. Overall OAU related depression is as severe as non-OAU related depression and repeated depression screening in chronic opioid therapy may be warranted for pain patients, regardless of pain severity.

Hormones and Their Interaction with the Pain Experience

Sex differences in the prevalence of painful conditions appear after pubertyVariation in symptom severity across the menstrual cycle occurs in a number of clinical pain conditionsSex steroid hormones act at a number of sites in both the peripheral and central nervous systems and in both reproductive and non-reproductive tissuesSex steroid hormones have traditionally been thought to alter transcription; however, there is evidence that there are also non-genomic effectsSex steroid hormones can have organisational effects from as early as in uteroThe relationship between sex hormones and pain is complex.

The Severity of Chronic Pediatric Pain: An Epidemiological Study

This study was designed to (1) provide information on the prevalence of pediatric pain as well as other pain related characteristics in a sample of schoolchildren, and (2) study the suitability of a system to grade the severity of chronic pain problems among children. Participants in this cross-sectional study included 561 schoolchildren between the ages of 8 and 16 years. Besides collecting information about the presence of pain at the time of interview, and in the preceding 3 months, several characteristics of participants' pain experiences and several indicators of participants' quality of life were requested. Results showed that 37.3% had chronic pain, but only 5.1% had moderate or severe chronic pain problems. Gender and age differences were found in the prevalence of pain conditions. Children who had a chronic pain condition reported a worse quality of life, missed more days from school, and were more likely to use pain medication and seek medical care for pain relief. Our study shows that chronic pain is a highly prevalent condition in the community, one that can exert negative consequence for the child. But the prevalence of severe chronic pain cases is low. New studies are needed to further empirically test the proposed method of grading the severity of chronic pain in children. This article provides information on pain problems among schoolchildren. It also suggests a new grading system of chronic pediatric problems. This new system could help clinicians and researchers to diagnose pain problems in youth and design treatments suited to patients' characteristics and needs.

Co‐occurrence of chronic physical pain and psychiatric morbidity in a community sample of older people

Knowledge about co-occurrence of the most frequent chronic pain symptoms with psychiatric morbidity in older people is very limited. To study the association of psychiatric morbidity and painful physical conditions in people aged 60 years and over. Population-based random sample of 7,040 household residents, aged 60 years and over, in Brazil. The overall prevalence of pain conditions is 76%. Age-sex specific prevalence of chronic pain conditions such as back pain, joint, abdominal, chest, headaches, reported by respondents ranged from 11.6% up to 51.1%. In logistic regression models, chest pain, head pain, back pain, joint pain and abdominal pain emerged as predictors of psychiatric morbidity. The odds of psychiatric morbidity are also affected by income, ethnicity, origin (urban/rural), and marital status. The association of chronic painful conditions and psychiatric morbidity in late life is statistically strong in this surveyed population.

Epidemiology, co-morbidity, and impact on health-related quality of life of self-reported headache and musculoskeletal pain – a gender perspective

Background. Headache and musculo-skeletal pain are major public health problems. Substantial proportions of the general population report that they experience pain problems that affect their work, daily living and social life. Epidemiological studies have consistently shown that the prevalence of most pain conditions is higher in women than in men. Design. Cross-sectional survey in the county of Uppland, Sweden, 1995. Five thousand four hundred and four completed the questionnaire (response rate=68%). In these analyses for persons aged 20–64 years 4506 were included. Results. Back pain (22.7%) and shoulder pain (21.0%) were the most commonly reported medical problems in the population with pain in arms/legs (15.7%) in fifth and headache (12.5%) in eight place. Major gender differences were found. The prevalence of pain conditions, especially headache, was higher among women. Women reported more severe pain. Co-morbidity between pain conditions and psychiatric and somatic problems was higher among women. Health-related quality of life (SF-36) differed by gender and type of pain condition. The physical dimensions of HRQoL were more affected by headache among men; psychological dimensions were more affected among women. Among both men and women, pain conditions were associated with poorer socioeconomic conditions and life-style factors but there were gender differences. Education and unemployment were important only among men while economical difficulties, half-time work and being married were associated with pain among women. Obesity, early disability retirement, long time sick-leave and lack of exercise were associated with pain conditions generally. Factors associated with pain conditions were unevenly distributed between genders. Conclusion. There are major differences between men and women in the prevalence and severity of self-reported pain in the population. Biological factors may explain some of the differences but the main explanation is presumably gender disparities in work, economy, daily living, social life and expectations between women and men. Although improved working conditions are of importance, deeper societal changes are needed to reduce the inequities in pain experiences between women and men.

Gender differences in Pain: Role of anxiety

A review of the literature on gender and clinical pain reveals a disproportionate representation of women receiving treatment for many pain conditions and suggests that women report more severe pain, more frequent pain, and pain of longer duration than do men. Gender differences in pain perception have also been extensively studied in the laboratory, and ratings of experimentally induced pain also show some sex disparity, with females generally reporting lower pain thresholds and tolerance than males. However, there is little consensus on whether these apparent differences reflect the way men and women respond to pain, differing social rules for the expression of pain, or biologic differences in the way noxious stimuli are processed. In this paper, our working hypothesis is that the higher prevalence of chronic orofacial pain in women is a result of sex differences in generic pain mechanisms and of as-yet unidentified factors unique to the craniofacial system. We will review the evidence concerning gender differences in the prevalence of pain conditions, with a focus on orofacial pain conditions. Evidence and hypotheses concerning biologic and psychosocial factors that could influence prevalence rates will also be discussed.