Effects of Cognitive-Behavioral Therapy on Empathy in Patients with Chronic Pain

OBJECTIVE: Cognitive-behavioral therapy (CBT) is effective in patients with chronic pain. However, the efficacy of CBT for impaired empathy has not been studied in this population. We investigated the effect of CBT on empathy in patients with chronic pain. METHODS: Patients with severe chronic pain were recruited. Empathy was assessed before and after CBT using the Interpersonal Reactivity Index (IRI). The patients underwent eight sessions over the course of 1 month conducted. Additional symptoms were assessed using the Short-Form McGill Pain Questionnaire (SF-MPQ), Beck Depression Inventory, Beck Anxiety Inventory, World Health Organization Quality of Life Scale Abbreviated Version, and the Scale for Suicide Ideation. RESULTS: A total of 26 participants were included. Pre-CBT pain severity assessed using the SF-MPQ was significantly correlated with the IRI-empathic concern subscale score (p=0.021), and the relationship remained significant after adjusting for sex, age, education level, and marital status. After CBT, the IRI-perspective-taking subscale scores (p=0.004) increased significantly and the IRI-personal distress subscale scores (p=0.013) decreased significantly in all participants. The SF-MPQ scores increased significantly (p=0.021). CONCLUSION: CBT improved empathy in patients with chronic pain independent of its effect on pain, suggesting that CBT is useful for improving interpersonal relationships in patients with chronic pain.

Effects of Mind-Body Training on Cytokines and Their Interactions with Catecholamines

OBJECTIVE: Mind-body training (MBT) may control reactions to stress and regulate the nervous and immune systems. The present study was designed to assess the effects of MBT on plasma cytokines and their interactions with catecholamines. METHODS: The study group consisted of 80 subjects who practice MBT and a control group of 62 healthy subjects. Plasma catecholamine (norepinephrine, NE; epinephrine, E; and dopamine, DA) and cytokine (TNF-alpha, IL-6, IFN-gamma, and IL-10) levels were measured, and the differences between the MBT and control groups and the interactions of cytokines with catecholamines were investigated. RESULTS: A significant increase in IL-10+IFN-gamma was found in females of the MBT group compared with controls. Also, a significant increase of IL-10 (anti-inflammatory cytokine) in the MBT group was shown in a specific condition in which TNF-alpha and IL-6 (pro-inflammatory cytokines) are almost absent (≤1 ng/L) compared with controls. In the MBT group, significant positive correlations were found between IL-10 and the NE/E ratio and between IL-10 and the DA/E ratio, whereas the control group did not show any such correlations. CONCLUSION: MBT may increase IL-10, under specific conditions such as a decrease of pro-inflammatory cytokines or E, which may regulate the stress response and possibly contribute to effective and beneficial interactions between the nervous and immune systems.

Impaired Empathic Abilities among Patients with Complex Regional Pain Syndrome (Type I)

OBJECTIVE: The aims of this study were to evaluate differences in empathic abilities between patients with complex regional pain syndrome (CRPS) Type I and healthy control subjects (HCs) and to assess correlations between empathic abilities and multidimensional aspects of pain. METHODS: Empathic ability was measured in 32 patients with CRPS Type I and in 36 HCs using the Interpersonal Reactivity Index (IRI). A comprehensive assessment of pain was conducted in the patient group using the West Haven-Yale Multidimensional Pain Inventory (WHYMPI). Psychiatric symptoms were assessed using the Beck Depression and Anxiety Inventories (BDI and BAI), and quality of life was evaluated using the WHO Quality of Life (WHOQOL-BREF) questionnaire. RESULTS: Patients with CRPS showed impaired cognitive and emotional empathic abilities compared with HCs. Significantly lower levels of perspective taking and empathic concern and higher levels of personal distress on the IRI were exhibited by the patient group. Perspective taking and personal distress were associated with affective distress and poor quality of life in social contexts (BDI, BAI, and WHOQOL). However, empathic concern was positively correlated with pain severity and social support from others (WHYMPI). CONCLUSION: A tendency toward self-oriented distress in social cognition was exhibited among patients with CRPS Type I. Impaired empathic ability was shown to have potentially negative effects on subjective emotional outcomes and social performance in the lives of patients. Interventions to improve emotional awareness and theory of mind would be beneficial for enhancing social functioning in patients with CRPS Type I.

Symptom Prevalence and Work-related Risk Factors of Acute Pesticide Poisoning among Korean Farmers in Gyeong-gi Province / 農村醫學 地域保健

OBJECTIVE: The purpose of this study was to measure the symptom prevalence of acute pesticide poisoning among farmers in Gyeong-gi province and to investigate the occupational risk factors. METHODS: The subjects were 663 farmers using pesticide directly or indirectly and the survey was performed during 2013. 7. 11 - 2014. 8. 27. The data were analyzed by SPSS 21.0. RESULTS: The prevalence of acute pesticide poisoning was 6.63% and dizziness was the most common symptom. Acute pesticide poisoning was related with 'days of pesticide use per year','lifetime pesticide application days', 'the number of pesticide mixture' and 'type of farming'. CONCLUSION: It is necessary to manage and educate the pesticide poisoning-vulnerable group more systematically. Afterward additional study is needed to investigate the farming safety behavior and delicate amount of pesticide exposure.