Personality disorders and response to outpatient treatment of chronic pain

1996 ◽  
Vol 3 (3) ◽  
pp. 219-234 ◽  
Author(s):  
Timothy R. Elliott ◽  
Warren T. Jackson ◽  
Molly Layfield ◽  
Debra Kendall
Keyword(s):  
Chronic Pain ◽  
Personality Disorders ◽  
Outpatient Treatment

scholarly journals Intimate Partner Violence

2013 ◽  
Vol 58 (6) ◽  
pp. E1-E15 ◽  
Author(s):  
Donna E Stewart ◽  
Harriet MacMillan ◽  
Nadine Wathen
Keyword(s):  
Mental Health ◽  
Substance Abuse ◽  
Chronic Pain ◽  
Personality Disorders ◽  
Mental Health Professionals ◽  
Low Income ◽  
Well Being ◽  
Health Problems ◽  
Pain Syndromes ◽  
Chronic Pain Syndromes

• IPV is an underrecognized problem that occurs in all countries, cultures, and socioeconomic groups. • IPV has an enormous impact on personal health, and economic and social well-being. • IPV may occur in heterosexual and LGBTQ relationships and may be perpetrated by either sex. • Canadian data from 1999 show about equal proportions of men and women had been victims of physical (seven and eight per cent, respectively) and psychological (18 and 19 per cent, respectively) IPV in the previous five years. • Exposure to IPV has deleterious effects on children and other family members. • Some populations are at greater risk or have special needs for IPV. These include immigrant women, Aboriginal women, LGBTQ communities, people with ALs, pregnant women, dating adolescents, older people, alcohol and other substance abusing people, low-income people, and those without a current partner (that is, IPV perpetrated by a former partner). • Mental health problems associated with IPV include depression, anxiety disorders, chronic pain syndromes, eating disorders, sleep disorders, psychosomatic disorders, alcohol and other substance abuse, suicidal and self-harm behaviours, nonaffective psychosis, some personality disorders, and harmful health behaviours, such as risk taking and smoking. As IPV is a major determinant of mental health, it is of vital importance to mental health professionals. • Physical health problems associated with IPV include death, a broad range of injuries, reproductive disorders, gastrointestinal disorders, chronic pain syndromes, fibromyalgia, poor physical functioning, and lower health-related quality of life. Sexually transmitted diseases, unwanted pregnancies and physical inactivity are also increased. • Children's exposure to IPV may have short- and long-term health impacts on the child, especially mental health effects. • Perpetrators of IPV most frequently have personality disorders, but substance abuse and other types of mental illness or brain dysfunction may also occur.

Specialized multimodal outpatient treatment for children with chronic pain: Treatment pathways and long-term outcome

2011 ◽  
Vol 15 (9) ◽  
pp. 976-984 ◽  
Author(s):  
Tanja Hechlerl ◽  
Annick Martinl ◽  
Markus Blankenburgl ◽  
Sandra Schroederl ◽  
Joachim Kosfelderl ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Outpatient Treatment ◽  
Pain Treatment ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Treatment Pathways ◽  
Chronic Pain Treatment

Chronic pain and the psychiatrist

2001 ◽  
Vol 13 (1) ◽  
pp. 21-28
Author(s):  
B. Van Houdenhove
Keyword(s):  
Substance Abuse ◽  
Chronic Pain ◽  
Differential Diagnosis ◽  
Mental Disorders ◽  
Personality Disorders ◽  
Essential Role ◽  
Point Of View ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual

SUMMARYChronic pain is a phenomenon with important psychiatric aspects from a diagnostic as well as a therapeutic point of view. The place of chronic pain in the different versions of the Diagnostic and Statistical Manual of Mental Disorders, and the differential-diagnosis are critically discussed. The comorbidity with depression, anxiety disorders, substance abuse and personality disorders is extensively treated. Finally, the essential role of the psychiatrist in the multidisciplinary therapeutic approach of these patients is emphasised.

Psychiatric (axis I) and personality (axis II) disorders in patients with burning mouth syndrome or atypical facial pain

2011 ◽  
Vol 2 (4) ◽  
pp. 155-160 ◽  
Author(s):  
Tero Taiminen ◽  
Laura Kuusalo ◽  
Laura Lehtinen ◽  
Heli Forssell ◽  
Nora Hagelberg ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Personality Disorders ◽  
Psychiatric Disorders ◽  
Orofacial Pain ◽  
Burning Mouth Syndrome ◽  
Atypical Facial Pain ◽  
Obsessive Compulsive ◽  
Axis I ◽  
Chronic Pain Conditions ◽  
Chronic Course

AbstractBackground and aimsBurning mouth syndrome (BMS) and atypical facial pain (AFP) are often persistent idiopathic pain conditions that mainly affect middle-aged and elderly women. They have both been associated with various psychiatric disorders. This study examined current and lifetime prevalence of psychiatric axis I (symptom-based) and II (personality) disorders in patients with chronic idiopathic orofacial pain, and investigated the temporal relationship of psychiatric disorders and the onset of orofacial pain.MethodForty patients with BMS and 23 patients with AFP were recruited from Turku university hospital clinics. Mean age of the patients was 62.3 years (range 35–84) and 90% were female. BMS and AFP diagnoses were based on thorough clinical evaluation, and all patients had undergone clinical neurophysiological investigations including blink reflex and thermal quantitative tests. Current and lifetime DSM-IV diagnoses of axis I and II disorders were made on clinical basis with the aid of SCID-I and II-interviews. The detected prevalence rates and their 95% confidence intervals based on binomial distribution were compared to three previous large population-based studies.ResultsOf the 63 patients, 26 (41.3%) had had an axis I disorder that preceded the onset of orofacial pain, and 33 (52.4%) had had a lifetime axis I disorder. Rate of current axis I disorders was 36.5%, indicating that only about 16% of lifetime disorders had remitted, and they tended to run chronic course. The most common lifetime axis I disorders were major depression (30.2%), social phobia (15.9%), specific phobia (11.1%), and panic disorder (7.9%). Twelve patients (19.0%) had at least one cluster C personality disorder already before the emergence of orofacial pain. Patients with cluster C personality disorders are characterized as fearful and neurotic. None of the patients had cluster A (characterized as odd and eccentric) or B (characterized as dramatic, emotional or erratic) personality disorders. The most common personality disorders were obsessive–compulsive personality (14.3%), dependent personality (4.8%), and avoidant personality (3.2%). The majority of the patients (54%) had also one or more chronic pain conditions other than orofacial pain. In almost all patients (94%) they were already present at the onset of orofacial pain.ConclusionsOur results suggest that major depression, persistent social phobia, and neurotic, fearful, and obsessive–compulsive personality characteristics are common in patients with chronic idiopathic orofacial pain. Most psychiatric disorders precede the onset of orofacial pain and they tend to run a chronic course.ImplicationsWe propose that the high psychiatric morbidity, and comorbidity to other chronic pain conditions, in chronic idiopathic orofacial pain can be best understood in terms of shared vulnerability to both chronic pain and specific psychiatric disorders, most likely mediated by dysfunctional brain dopamine activity.

scholarly journals Evaluating the Cost of Drugs used in the Outpatient Treatment of Chronic Pain

2010 ◽  
Vol 60 (4) ◽  
pp. 399-405
Author(s):  
Roberto Vlainich ◽  
Paola Zucchi ◽  
Adriana Machado Issy ◽  
Rioko Kimiko Sakata
Keyword(s):  
Chronic Pain ◽  
Outpatient Treatment ◽  
Cost Of Drugs ◽  
The Cost

Something Doesn’t Seem Right

2021 ◽  
pp. 35-42
Author(s):  
Daniel M. Doleys ◽  
Nicholas D. Doleys
Keyword(s):  
Chronic Pain ◽  
Clinical Practice ◽  
Borderline Personality Disorder ◽  
Pain Management ◽  
Personality Disorder ◽  
Personality Disorders ◽  
Borderline Personality ◽  
Residential Placement ◽  
Controlled Substances ◽  
Female Patients

This case depicts a situation wherein the facts do not seem to fit. In a hurried and busy clinical practice, one is glad to encounter what seems to be a pleasant patient. Patients with personality disorders, especially those with a borderline personality disorder (BPD), can be very deceptive. Their overall manner is often very congenial, until their expectations or requests are not met. Their presentation may be very different to the staff versus the clinician. Self-destructive (mutilation) behavior can be seen in the more severe cases. Female patients can be very disarming. Their objective, in the chronic pain setting, relates more to issues of control and manipulation than to receiving effective pain management. Treatment can be intensive and involve residential placement. Use of controlled substances can be very dangerous. Patient with BPD are best referred to a specialist.

Chronic pain and personality disorders

Pain Forum ◽  
1997 ◽  
Vol 6 (1) ◽  
pp. 10-11 ◽  
Author(s):  
Peter B. Polatin
Keyword(s):  
Chronic Pain ◽  
Personality Disorders
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