Presença de risco de transtorno do estresse pós-traumático em policiais militares feridos por arma de fogo / Presence of risk of posttraumatic stress disorder in military police officers wounded by firearms / Presencia de riesgo de trastorno de estrés postraumático en policías militares heridos por armamiento de fuego

Este estudo teve como objetivo identificar o risco de desenvolvimento de transtorno de estresse pós-traumático (TEPT), bem como sua associação com pensamentos ou tentativas suicidas e a saúde mental de policiais militares feridos por arma de fogo, na Região Metropolitana de Belém (RMB), nos anos de 2017 a 2019. A pesquisa contou com a participação de 30 entrevistados, que responderam o Inventário Demográfico e a Lista de verificação de TEPT para o DSM-5 (PCL-5). Para análise dos dados, utilizou-se a técnica estatística Análise Exploratória de Dados e a técnica multivariada Análise de Correspondência. Os resultados revelaram a existência de risco de desenvolvimento do transtorno de forma parcial ou total em uma expressiva parcela da população entrevistada, tendo homens como maioria dos sintomáticos, com média de 38 anos, exercendo atividades operacionais e vitimados em via pública quando estavam de folga do serviço. O ferimento deixou a maioria com sequelas, com destaque para dores crônicas, limitações de locomoção e/ou mobilidade e perda parcial de um membro. E, ainda, policiais sintomáticos apresentaram comportamentos suicidas, relatando já terem pensado ou tentado tirar a própria vida. Desta forma, conclui-se que policiais militares são expostos constantemente a traumas inerentes a sua profissão. Quando há ameaça de vida, como nos casos de ferimentos por arma de fogo, são suscetíveis a sequelas físicas decorrente do ferimento, somadas a sequelas mentais tardias, como o surgimento de sintomatologias de TEPT e ideação suicida.(AU)

This study aimed to identify the risk of developing post-traumatic stress disorder (PTSD) and its associations around suicidal thoughts or attempts and mental health in military police officers injured by firearms, in the Metropolitan Region of Belem (RMB), from 2017 to 2019. The research had the participation of 30 respondents who answered the Demographic Inventory and the PTSD checklist for DSM-5 (PCL-5). For data analysis, we used the statistical technique Exploratory Data Analysis and the multivariate technique Correspondence Analysis. The results revealed the existence of risk of developing partial or total disorder in a significant portion of the interviewed population, with men as most of the symptomatic individuals, with mean age of 38 years, developing operational activities and victimized on public roads when they were off duty. The injuries left most of them with sequelae, especially chronic pain, limited locomotion and/or mobility, and partial loss of a limb. In addition, symptomatic officers showed suicidal behavior, such as reporting they had thought about or tried to take their own lives. Thus, we conclude that military policemen are constantly exposed to traumas inherent to their profession. When their lives are threatened, as in the case of firearm wounds, they are susceptible to physical sequelae resulting from the injury, in addition to late mental sequelae, such as the appearance of PTSD symptoms and suicidal ideation.(AU)

Este estudio tuvo como objetivo identificar el riesgo de desarrollo de trastorno de estrés postraumático (TEPT) y sus asociaciones con pensamientos o tentativas suicidas y la salud mental en policías militares heridos por armamiento de fuego, en la Región Metropolitana de Belém (Brasil), en el período entre 2017 y 2019. En el estudio participaron 30 entrevistados que respondieron el Inventario Demográfico y la Lista de verificación de TEPT para el DSM-5 (PCL-5). Para el análisis de datos se utilizaron la técnica estadística Análisis Exploratoria de Datos y la técnica multivariada Análisis de Correspondencia. Los resultados revelaron que existen riesgos de desarrollo de trastorno de estrés postraumático de forma parcial o total en una expresiva parcela de la población de policías entrevistados, cuya mayoría de sintomáticos eran hombres, de 38 años en media, que ejercen actividades operacionales y fueron victimados en vía pública cuándo estaban de día libre del servicio. La lesión dejó la mayoría con secuelas, especialmente con dolores crónicos, limitaciones de locomoción y/o movilidad y la pierda parcial de un miembro. Aún los policías sintomáticos presentaran comportamiento suicida, tales como relataran qué ya pensaron o tentaron quitar la propia vida. Se concluye que los policías militaran se exponen constantemente a los traumas inherentes a su profesión. Cuando existe amenaza de vida, como en los casos de heridas por armamiento de fuego, son expuestos a secuelas físicas transcurridas de la herida, sumado a secuelas mentales tardías, como el surgimiento de sintomatologías de TEPT y la ideación suicida.(AU)

Associations between postoperative analgesic consumption and distress tolerance, anxiety, depression, and pain catastrophizing: a prospective observational study

Abstract Background Patients' postoperative treatment might be affected by their psychological state. The study aimed to evaluate the effects of anxiety, coping ability (stress tolerance), depression, and pain catastrophizing on analgesic consumption in patients scheduled for sleeve gastrectomy. Methods This prospective observational study consisted of 72 patients. The Distress Tolerance Scale (DTS), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), and Pain Catastrophizing Scale (PCS) were completed in the preoperative period. In the postoperative period, pain intensity, as measured with the Visual Analogue Scale (VAS), and morphine consumption (mg) were evaluated after 2, 6, 8, and 24 hours. Total morphine consumption was recorded. Results The results revealed a strong negative correlation between distress tolerance and postoperative total morphine consumption (r = -0.702, p< 0.001). There was a strong positive correlation between total morphine consumption and pain catastrophizing (r = 0.801, p< 0.001). A moderate positive correlation was observed between total morphine consumption and anxiety and between total morphine consumption and depression (r = 0.511, p< 0.001; r = 0.556, p< 0.001, respectively). Linear regression revealed that distress tolerance, anxiety, depression, and pain catastrophizing are predictors of postoperative morphine consumption (β = 0.597, p< 0.001; β = 0.207, p= 0.036; β = 0.140, p= 0.208; β = 0.624, p< 0.001, respectively). Conclusions Distress tolerance, anxiety, depression, and pain catastrophizing can be predictive of postoperative analgesic consumption. In the estimation of postoperative analgesic consumption, distress tolerance, as well as anxiety, depression, and pain catastrophizing, were found to be important predictors.

Validation of the Brazilian version of the child pain catastrophizing scale and its relationship with a marker of central sensitization

Abstract Objectives The Pain Catastrophizing Scale-Child version (PCS-C) allows to identify children who are prone to catastrophic thinking. We aimed to adapt the Brazilian version of PCS-C (BPCS-C) to examine scale psychometric properties and factorial structure in children with and without chronic pain. Also, we assessed its correlation with salivary levels of Brain-Derived Neurotrophic factor (BDNF). Methods The Brazilian version of PCS-C was modified to adjust it for 7-12 years old children. To assess psychometric properties, 100 children (44 with chronic pain from a tertiary hospital and 56 healthy children from a public school) answered the BPCS-C, the visual analogue pain scale, and questions about pain interference in daily activities. We also collected a salivary sample to measure BDNF. Results We observed good internal consistency (Cronbach's value = 0.81). Parallel analysis retained 2 factors. Confirmatory factor analysis of our 2-factor model revealed consistent goodness-of-fit (IFI = 0.946) when compared to other models. There was no correlation between visual analogue pain scale and the total BPCS-C score; however, there was an association between pain catastrophizing and difficulty in doing physical activities in school (p= 0.01). BPCS-C total scores were not different between groups. We found a marginal association with BPCS-C (r= 0.27, p= 0.01) and salivary BDNF levels. Discussion BPCS-C is a valid instrument with consistent psychometric properties. The revised 2-dimension proposed can be used for this population. Children catastrophism is well correlated with physical limitation, but the absence of BPCS-C score differences between groups highlights the necessity of a better understanding about catastrophic thinking in children.

Aspectos psicológicos asociados a la cistitis intersticial / Psychological aspects associated with interstitial cystitis

La cistitis intersticial o síndrome de vejiga dolorosa es un padecimiento complejo asociado a dolor pélvico intenso con síntomas urinarios como urgencia, polaquiuria, dispareunia, incontinencia y nicturia, que afecta de manera importante la calidad de vida y las relaciones sociales y productivas del paciente. La evidencia muestra que el abordaje de los factores psicosociales que afectan a los pacientes con esta enfermedad es esencial. El tratamiento debe ir más allá de los síntomas clínicos y considerar los aspectos individuales de cada paciente, su salud mental, sus experiencias de vida y su comorbilidad, dado que los trastornos psicológicos como la ansiedad, la depresión y el estrés postraumático pueden influir en la manera en que se percibe el dolor, y están ligados con la gravedad y el empeoramiento de los síntomas. La literatura presenta a la intervención psicológica desde el enfoque cognitivo conductual como un medio para disminuir el dolor, la ansiedad y el catastrofismo, dando al paciente herramientas que le permitan obtener una sensación de control a partir del afrontamiento y mejorar su calidad de vida.

Interstitial cystitis or painful bladder syndrome is a complex condition associated with intense pelvic pain with urinary symptoms such as urgency, pollakiuria, dyspareunia, incontinence and nocturia that significantly affects the patient's quality of life, social and productive relationships. Evidence shows that addressing the psychosocial factors that affect patients with this disease is essential. Treatment should go beyond clinical symptoms and consider the individual aspects of each patient, their mental health, life experiences and comorbidities, since psychological disorders such as anxiety, depression and post-traumatic stress disorder can influence the way pain is perceived and are linked to the severity and worsening of symptoms. The literature presents psychological intervention from the cognitive-behavioral approach to reduce pain, anxiety and catastrophism, giving the patient tools that allow him to obtain a sense of control from coping tools that allow him to improve his quality of life.

Low back pain: biopsychosocial aspects of chronic and acute pain / Lombalgias: aspectos biopsicossociais da dor crônica e da dor aguda

Chronic low back pain is a highly prevalent pathology, which has unclear associations with psychosocial aspects. This study investigated differences between patients with chronic low back pain (n = 25) and acute low back pain (n = 20) and verified the effect of the variables assessed on the pain mean. The design was cross-sectional, and the instruments applied were: sociodemographic interviews, Brief Pain Inventory, Beck Depression Inventory II, Hamilton Anxiety Rating Scale, Personality Factor Battery, Social Support Scale and Pain Catastrophizing Scale. The chronic pain group had significantly higher means of pain intensity, anxiety and catastrophic thoughts. In the regression analysis, the factor Depression of the Personality Factor Battery and belonging to the chronic pain group were found as predictors of the mean pain in the sample studied. It is understood that psychological factors are associated with the pain condition and require further investigation.

A lombalgia crônica é uma patologia de alta prevalência, que apresenta associações não esclarecidas com aspectos psicossociais. O estudo investigou diferenças entre pacientes com dor lombar crônica (n = 25) e aguda (n = 20), bem como verificou o efeito das variáveis avaliadas na média de dor. O delineamento foi transversal, e os instrumentos aplicados foram: entrevista sociodemográfica, Inventário Breve de Dor, Inventário Beck de Depressão II, Escala de Ansiedade de Hamilton, Bateria Fatorial de Personalidade, Escala de Apoio Social e Escala de Pensamentos Catastróficos sobre Dor. O grupo de dor crônica apresentou médias significativamente mais altas na intensidade da dor, na ansiedade e nos pensamentos catastróficos. Na análise de regressão, o fator Depressão da Bateria Fatorial de Personalidade e o fato de pertencer ao grupo de dor crônica foram encontrados como preditores da média de dor na amostra estudada. Entende-se que fatores psicológicos mostram-se associados ao quadro, sendo necessárias maiores investigações.

Catastrophization is related to the patient and not to the severity of migraine / Catastrofização se relaciona ao paciente e não à gravidade da enxaqueca

ABSTRACT Background: Catastrophization is a psychological aspect of pain that alters its perception and expression. Objective: To investigate the feature of catastrophization in migraine. Methods: An online survey of individuals suffering from migraine attacks at least twice a month, for at least one year was carried out. Confidentiality was assured and participants gave details of their headache (including a visual analogue pain scale) and answered the Hospital Anxiety and Depression Scale and the Catastrophization Scale questionnaires. Results: The survey included 242 individuals with migraine attacks at least twice a month. The median scores observed in this group of individuals were 7 for pain, 11 for anxiety, 7 for depression, and 2 for catastrophization. Catastrophization had no correlation with the duration (p=0.78) or intensity (p=0.79) of the migraine. There was no correlation between catastrophization and headache frequency (p=0.91) or the monthly amount of headache medication taken (p=0.85). High scores for catastrophization (≥3.0) were identified in one third of the participants. These high scores were not associated with age, headache duration, pain severity, frequency of attacks, or traits of depression or anxiety. There was a moderate association between both depression and anxiety traits with catastrophization. Conclusions: Catastrophization seems to be a trait of the individual and appears to be unrelated to the characteristics of the migraine.

RESUMO Antecedentes: A catastrofização é um aspecto psicológico da dor, alterando sua percepção e expressão. Objetivos: Investigar o fenômeno da catastrofização na enxaqueca. Métodos: Pesquisa online com indivíduos que sofrem de crises de enxaqueca pelo menos duas vezes por mês, por pelo menos um ano. O sigilo foi assegurado. O participante dava detalhes de sua dor de cabeça (incluindo escala de dor analógica visual) e respondeu à Escala de Ansiedade e Depressão Hospitalar e à Escala de Catastrofização. Resultados: A pesquisa identificou 242 indivíduos com ataques de enxaqueca pelo menos duas vezes por mês. Os escores medianos observados neste grupo de indivíduos foram 7 para dor, 11 para ansiedade, 7 para depressão e 2 para catastrofização. Catastrofização não teve correlação com a duração (p=0,78) ou intensidade (p=0,79) da dor na crise de enxaqueca. Não houve correlação entre catastrofização e frequência de crises (p=0,91) ou quantidade mensal de medicação usada para tratar a cefaleia (p=0,85). Foram identificados escores elevados para catastrofização (≥3,0) em um terço dos participantes. Esses escores elevados não foram associados à idade, duração da dor de cabeça, gravidade da dor, frequência de ataques e traços de depressão ou de ansiedade. Houve moderada associação entre casos com concomitante depressão e ansiedade e catastrofização. Conclusões: A catastrofização parece ser um traço do indivíduo e parece não estar relacionada às características da enxaqueca.

El sentido de vida, una condición existencial / The meaning of life, an existential condition

El ser humano siempre ha estado en la constante búsqueda de sentido y preguntándose por su existencia. El hombre moderno además de encontrase en esa búsqueda, también se halla permeado por la angustia constante, está sometido a la cosificación de sí mismo, la hipeconectividad, el consumismo, la incertidumbre y la inmediatez, lo cual lo conduce de manera casi inminente al aburrimiento y el tedio, es decir, a la frustración existencial, llevándolo a enfrentarse con sus pseudosatisfactores y dejándolo de cara ante el vacío de su propia existencia y el cuestionamiento: ¿para qué estoy en el mundo?

Human beings have been in a constant search for meaning and wondering about its existence. The modern man, in addition to finding himself in this search, is also permeated by constant anguish, is subjected to the objectification of himself, hyper-connectivity, consumerism, uncertainty and immediacy, which leads him almost imminently to boredom, which is existential frustration, leading him to face his pseudo-satisfiers and leaving him face to face with the emptiness of his own existence and the question: what am I in the world for?

Catastrofização e atenção plena na disfunção temporomandibular: estudo correlacional / Catastrophization and mindfulness in temporomandibular disorder: correlational study

A catastrofização é um constructo multidimensional que apresenta três dimensões: magnificação, ruminação e desamparo, segundo a Escala de catastrofização da Dor (Pain Catastrophizing Scale - PCS), sendo um importante mediador da dor crônica pelo modelo de medo e evitação de Vlaeyen e Lipton e definindo a entrada no ciclo de cronificação da dor. Estudos que analisaram a relação entre catastrofização e mindfulness pela Five Facets Mindfulness Questionnaire (FFMQ), apontam essa intervenção como um possível mediador da catastrofização. Porém como essas facetas de mindfulness se associam com as subescalas da catastrofização ainda não foi estudado. O objetivo deste estudo observacional e transversal foi verificar como se dá a associação de mindfulness e catastrofização, principalmente como os níveis de mindfulness e suas facetas se relacionam com as subdimensões magnificação, ruminação e desamparo. O intuito do aprofundamento do conhecimento dessa relação é gerar subsídios para o desenvolvimento e aplicação de intervenções baseadas em mindfulness direcionadas para as subdimensões da catastrofização e ser assim mais diretivo e assertivo na abordagem, aprimorando a qualidade de vida da população com dor crônica com mais eficácia. Foram recrutadas mulheres entre 18 e 45 anos (N=52) que apresentavam Disfunção Temporomandibular crônica segundo critérios do Critério Diagnóstico para Desordens Temporomandibulares (Diagnostic Criteria for Temporomandibular Disorders - DC/TMD) e após a assinatura dos termos de consentimento livre e esclarecido foram aplicados os Questionários Sociodemográfico, Escala de Catastrofização da Dor (PCS) e Questionário das Cinco Facetas de Mindfulness (FFMQ). Apresentaram correlação significante e de forma inversa a subescala magnificação com as facetas não reagir e não julgar e com a pontuação total da FFMQ. A pontuação total da PCS apresentou correlação inversa com a faceta não reagir. As demais não apresentaram correlação. Na análise de regressão logística, foi constatado que a cada ponto obtido no domínio descrever positivo é esperado um aumento de 1,67 vezes na chance de ocorrência de desamparo e para cada comorbidade aumenta em 12,9 vezes a chance de apresentar desamparo. O presente estudo fornece a possível existência de associações entre as habilidades mensuradas enquanto facetas de mindfulness com as subdimensões da catastrofização, sendo necessário considerar essas relações na abordagem das intervenções baseadas em mindfulness para essa população. É possível que estratégias baseadas em mindfulness que desenvolvam o não julgar e o não reagir sejam benéficas para pessoas com dor crônica que apresentem catastrofização com altas pontuações na magnificação na redução do comportamento catastrófico. Da mesma forma, os resultados indicam que o uso de técnicas de mindfulness que aprimorem o descrever positivo pode ser prejudicial para os catastróficos com desamparo. Esse trabalho pode ajudar no estudo e desenvolvimento de intervenções baseadas em mindfulness que considerem essas relações tornando mais direcionada e eficaz a abordagem na população com dor crônica

Catastrophizing is a multidimensional construct that presents three dimensions: magnification, rumination and helplessness, according to the Pain Catastrophizing Scale - PCS, being an important mediator of chronic pain by the model of fear and avoidance by Vlaeyen and Lipton and defining the entry into the pain chronification cycle. Studies that analyzed the relationship between Catastrofization and Mindfulness using the Mindfulness Five Facets Questionnaire (FFMQ), point to this intervention as a possible mediator of catastrophization. However, how these facets of mindfulness are associated with the subscales of catastrophization has not yet been studied. The objective of this observational and cross-sectional study is to verify how the association of mindfulness and catastrophization occurs, especially as the levels of mindfulness and their facets are related to magnification, rumination and helplessness sub-dimensions. The aim of deepening the knowledge of this relationship is to generate subsidies for the development and application of treatment based on mindfulness directed at the sub-dimensions of catastrophization and thus be more directive and assertive in the approach, improving the quality of life of the population with chronic pain more effectively. Women between 18 and 45 years old (N = 52) who had chronic temporomandibular disorder were recruited according to the criteria of the Diagnostic Criteria for Temporomandibular Disorders (Diagnostic Criteria for Temporomandibular Disorders - DC / TMD) and after signing the free and informed consent terms, the Sociodemographic Questionnaires, Pain Catastrophization Scale (PCS) and the Five Facets of Mindfulness Questionnaire (FFMQ) were completed. The magnification subscale showed a significant and inverse correlation with the facets not reacting and not judging and with the total FFMQ score. Total evaluation of the PCS presented an inverse correlation with the facet not reacting. The others are not correlated. In the logistic regression analysis, it was found that for each point added in the domain describes positive, a 1.67-fold increase in the chance of helplessness is expected, and for each comorbidity the chance of having helplessness increases by 12.9 times. The present study offers the possible existence of associations between the skills measured as facets of mindfulness with the sub-dimensions of catastrophization, and it is necessary to consider these relationships when approaching mindfulness-based techniques for this population. It is possible that based on mindfulness that develop not judging and not reacting are beneficial for people with chronic pain who have catastrophization with high scores on magnification in reducing catastrophic behavior. Likewise, the results indicate that the use of mindfulness techniques that enhance the positive, can be harmful to catastrophic people with helplessness. This work can help in the study and development of enlightened mindfulness that considers these relationships making the approach in the population with chronic pain more targeted and effective

Efeitos da meditação associada a educação em neurociências da dor em adultos com fibromialgia: ensaio clínico controlado e randomizado / Effects of meditation associated with education in neurosciences of pain in adults with fibromyalgia: A randomized controlled trial / Efectos de la meditación asociada con la educación en neurociencia del dolor en adultos con fibromialgia: un ensayo clínico aleatorio controlado

OBJETIVO: analisar os efeitos do mindfulness associado com educação em neurociências da dor na percepção da dor, sono e capacidade funcional de adultos com fibromialgia. MÉTODO: trata-se de um estudo experimental controlado e randomizado cujos participantes foram divididos em dois grupos: grupo mindfulness e grupo mindfulness e educação em neurociência da dor. RESULTADOS: foram observadas melhorias de algumas variáveis relacionadas à dor, na capacidade funcional, ansiedade, depressão, qualidade do sono e na catastrofização. Não houve diferença na comparação intergrupos, porém existiram diferenças na comparação intra-grupos. CONCLUSÃO: intervenções baseadas na prática de mindfulness e educação em neurociências da dor se mostraram eficazes na melhora do quadro de pacientes com fibromialgia. Registro do Ensaio clínico: REBEC RBR-58pgs4.

OBJECTIVE: to analyze the influence of meditation associated with pain neuroscience education in pain perception, sleep and functional capacity of adults with fibromyalgia. METHOD: this is an experimental, controlled, randomized study whose participants were divided into two groups: mindfulness group and mindfulness group and education in pain neuroscience. RESULTS: improvements were observed in some variables related to pain, functional capacity, anxiety, depression, sleep quality and catastrophization. 270/5000. There was no difference in the intergroup comparison, but there were differences in the intra-group comparison. CONCLUSION: mindfulness-based interventions and education in pain neurosciences proved to be effective in improving the condition of patients with fibromyalgia. Clinical trial register: REBEC RBR-58pgs4

OBJETIVO: analizar los efectos de la atención plena asociada con la educación en neurociencias del dolor sobre la percepción del dolor, el sueño y la capacidad funcional de los adultos con fibromialgia. MÉTODO: este es un estudio experimental, controlado, aleatorizado cuyos participantes se dividieron en dos grupos: grupo de atención plena y grupo de atención plena y educación en neurociencia del dolor. RESULTADOS: se observaron mejoras en algunas variables relacionadas con el dolor, la capacidad funcional, la ansiedad, la depresión, la calidad del sueño y la catastrofización. No hubo diferencias en la comparación intergrupal, pero sí hubo diferencias en la comparación intragrupo. CONCLUSIÓN: las intervenciones basadas en la práctica de la atención plena y la educación en neurociencias del dolor demostraron ser efectivas para mejorar la condición de los pacientes con fibromialgia. Registro del ensayo clínico: REBEC RBR-58pgs4

Impact of catastrophizing on pain during orthodontic treatment

ABSTRACT Objective: This study proposed to investigate the influence of catastrophizing and others factors related to pain during orthodontic treatment. Methods: 27 patients with 0.022 x 0.028-in Straight-wire brackets were evaluated during alignment and leveling phase with nickel-titanium wires. Visual Analog Scales measured the intensity of orthodontic pain at six moments after a clinical appointment: 6 first hours; 1, 2, 3, 5, and 7 days. Multiple linear regression and stepwise approach assessed the influence of the following variables on pain: catastrophizing, sex, age, duration of treatment, clinical appointment time (morning or afternoon), and wire diameter. Results: The highest pain intensity was reported 24 hours after activation. These data were used to analyze factors associated with pain level. Age (r = 0.062, p= 0.7586), sex (p= 0.28), catastrophizing (r = -0.268, p= 0.1765), and orthodontic wire diameter (r = 0.0245, p= 0.2181) were not correlated with orthodontic pain in the univariate statistics. Catastrophizing was included in the multiple regression model because it was of great interest. Duration of orthodontic treatment (r = 0.6045, p= 0.0008) and the time when orthodontic appliance was activated (p= 0.0106) showed statistical significant associations with pain, and were also included in the multivariate regression, which showed that about 32% of orthodontic pain could be explained by the duration of treatment (R2= 0.32, p= 0.0475). Catastrophizing (R2= 0.0006, p= 0.8881) and clinical appointment time were not significantly associated with pain (R2= 0.037, p= 0.2710). Conclusions: Pain after activation of fixed orthodontic appliance is not associated with catastrophizing as well as age, sex, orthodontic wire diameter, and period of activation.

RESUMO Objetivo: O presente estudo propôs-se a investigar a influência da catastrofização e outros fatores relacionados à dor durante o tratamento ortodôntico. Métodos: Foram selecionados 27 pacientes em tratamento com braquetes Straight-wire, slot 0,022" x 0,028", na fase de alinhamento e nivelamento com fios de níquel-titânio. Usando Escalas Visuais Analógicas, mensurou-se a intensidade da dor em seis momentos após a ativação do aparelho: primeiras 6 horas; após 1, 2, 3, 5 e 7 dias. Por meio de regressão linear múltipla e regressão stepwise, avaliou-se a influência das seguintes variáveis sobre a dor: catastrofização, sexo, idade, tempo de tratamento, turno de atendimento (manhã ou tarde) e diâmetro do fio ortodôntico. Resultados: A maior intensidade de dor foi relatada 24 horas após a consulta de ativação do aparelho. Assim, esses dados foram usados para analisar os fatores associados ao nível de dor. Na análise estatística univariada, idade (r = 0,062, p= 0,7586), sexo (p= 0,28), catastrofização (r = -0,268, p= 0,1765) e diâmetro do fio ortodôntico (r = 0,0245, p= 0,2181) não estavam associados à dor. Apesar disso, a catastrofização foi incluída no modelo de regressão múltipla, por ser uma variável de maior interesse nesse estudo. A duração do tratamento ortodôntico (r = 0,6045, p= 0,0008) e o turno no qual o aparelho foi ativado (p= 0,0106) mostraram associação estatisticamente significativa com a dor e também foram incluídos na regressão multivariada, que mostrou que cerca de 32% da ocorrência de dor no tratamento ortodôntico poderiam ser explicados pelo tempo de tratamento (R2= 0,32, p= 0,0475). Catastrofização (R2= 0,0006, p= 0,8881) e turno de ativação do aparelho (R2= 0,037, p= 0,2710) não tiveram influência significativa sobre a ocorrência de dor. Conclusão: A dor após a ativação do aparelho não está associada à catastrofização, bem como à idade, sexo, diâmetro do fio ortodôntico e turno de atendimento.

Pain catastrophizing is associated with the Val66Met polymorphism of the brain-derived neurotrophic factor in fibromyalgia

Abstract Background: Fibromyalgia (FM) is a musculoskeletal chronic pain syndrome that impacts negatively patient's daily lives. Its pathogenesis is characterized by a complex relationship between biological and psychosocial factors not fully understood yet. Pain catastrophizing is associated with FM and is an important predictor of outcomes. This study aimed to answer two questions: (i) whether the allele and genotype frequencies of BDNF Val66Met (rs6265) polymorphism differs between FM patients and healthy controls (HC); and (ii) if the BDNF Val66Met polymorphism is a factor that predicts pain catastrophizing in FM. Methods: In a cross-sectional design, 108 FM patients and 108 HC were included. FM patients responded to the Brazilian Portuguese version of the Pain Catastrophizing Scale (BP-PCS) to assess pain catastrophizing, as well as other validated tools for anxiety (The State-Trait Anxiety Inventory - STAI), depression (Beck Depression Inventory II -BDI-II) and functional aspects (Fibromyalgia Impact Questionnaire - FIQ; Central Sensitization Inventory validated and adapted for Brazilian population - CSI-BP; Pittsburgh Sleep Quality Index - PSQI; and Resilience Scale). All subjects were genotyped for the BDNF Val66Met polymorphism. Results: Val allele was significantly more frequent in FM patients compared to the control group (p < 0.05). Also, FM patients with Val/Val genotype showed more pain catastrophizing thoughts, and this genotype was significantly associated with magnification and rumination dimensions of BP-PCS (p < 0.05). Furthermore, there were significant differences in levels of anxiety and symptoms of depression, years of education, and the functional situation between the FM and control groups. Conclusions: The findings show an association of BDNF Val66Met polymorphism with pain catastrophizing in FM, which opens new avenues to comprehend the interplay between molecular genetic characteristics and neuroplasticity mechanisms underpinning FM.(AU)

Mal-estar na sociedade de risco: um debate interdisciplinar sobre sustentabilidade / Malaise in the risk society an interdisciplinary debate on sustainability

Partindo da percepção de uma proliferação do uso da palavra sustentabilidade e uma série de variações que direcionam para a noção de Desenvolvimento Sustentável estabelecida pelo ONU em 1987, este trabalho procura analisar os documentos provenientes dessa institução, especificamente a Conferência de Estocolmo de 1972; o Relatório de Brundtland - Nosso Futuro Comum; a Eco92 de 1992; a Rio+10 de 2002; a Rio+20 de 2012; os Objetivos de Desenvolvimento do Milênio (ODM) de 2000; e os Objetivos do Desenvolvimento Sustentável (ODS) de 2015. Dentro de abordagem metodológica psicanaliticamente orientada em que participam os momentos transferência-construção-ensaio, a tese toma o relatório Nosso Futuro Comum como ponto de partida para pensar o mal-estar na sociedade de risco, cujos pressupostos teóricos iniciais são o mal-estar da psicanálise e as definições da teoria social de risco de Ulrich Beck. O caminho metológico permitiu a construção do contexto que remete às Guerras Mundiais como importantes eventos que tornariam possível a institucionalização do conceito de Desenvolvimento Sustentável. Além das condições para seu nascimento, a tese se debruça também para uma análise dos efeitos de sua aplicação. Esse percurso permitiu compreender a influência de um mundo assombrado por um catastrofismo que começa a ser transformado nas décadas de 1970 e 1980, vindo a se consolidar em uma perspectiva gerencial em 1990, movimento que pode ser depreendido dos documentos analisados. O trabalho evidencia o conflito colocado entre a finitude e o ilimitado presentes na crise ambiental e como o discurso econômico, prevalente em nossa sociedade, mostra-se incapaz de lidar com os problemas atuais e do tempo por vir. A análise sugere a necessidade de pensar não somente em uma sociedade de riscos, mas também em uma sociedade de refúgios.

Starting from the perception of a proliferation of the use of the word sustainability and a series of variations that lead to the concept of Sustainable Development established by the UN in 1987, this work examines the documents coming from that institution, specifically the Stockholm Conference of 1972; the Brundtland Report - Our Common Future; Eco92 of 1992; Rio + 10 of 2002; Rio + 20 of 2012; the Millennium Development Goals (MDGs) of 2000; and the Sustainable Development Objectives (SDO) of 2015. Within the psychoanalytically oriented methodological approach in which transfer-construction-essay moments take part, the thesis takes the report Our Common Future as a starting point for thinking of malaise in the society of risk, whose initial theoretical assumptions are the malaise of psychoanalysis and the definitions of the social theory of risk of Ulrich Beck. The metological path allowed the construction of the context that refers to the World Wars as important events that would make possible the institutionalization of the concept of Sustainable Development. In addition to the conditions for its birth, the thesis also examines the effects of its application. This path allowed us to understand the influence of a world haunted by a catastrophism that began to be transformed in the 1970s and 1980s, becoming consolidated in a managerial perspective in 1990, a movement that can be seen from the documents analyzed. The work shows the conflict between the finitude and the limitless present in the environmental crisis and how the economic discourse prevalent in our society proves incapable of dealing with the current problems and the time to come. The analysis suggests the need to think not only of a society of risks, but also of a society of refuges.

Effects of pain catastrophizing and anxiety on analgesic use after surgical removal of impacted mandibular third molars

BACKGROUND: In dentistry, pain is a factor that negatively affects treatments and drug use. The aim of this study was to evaluate the correlations of the postoperative analgesic use with pain catastrophizing and anxiety in patients who underwent removal of an impacted mandibular third molar.METHODS: We recruited 92 patients who underwent the extraction of impacted mandibular third molar. In this study, the Pederson index was used to preoperatively determine the difficulty of surgical extraction. Patients were asked to note the number of analgesics used for 7 postoperative days. Patients were divided into two groups based on the Pain Catastrophizing Scale: low and high score groups. State-Trait Anxiety Inventory-trait and State-Trait Anxiety Inventory-state questionnaires were used to determine the anxiety levels of the patients. The obtained data were examined to evaluate the correlations of pain catastrophizing and anxiety with the postoperative analgesic use.RESULTS: In this study, 92 patients, including 60 women and 32 men, were recruited. The analgesic use was higher in women than in men but with no significant difference (P > 0.05). Pain Catastrophizing Scale scores were higher in women than in men but with no significant difference (P > 0.05). The analgesic use was higher in patients with high pain catastrophizing than in those with low pain catastrophizing but with no significant difference (P > 0.05). State-Trait Anxiety Inventory-trait scores were higher in women than in men but with no significant difference. However, state-Trait Anxiety Inventory-state scores were significantly higher in women than in men (P < 0.05).CONCLUSION: The postoperative analgesic use may be higher in patients who catastrophize pain than in others. Knowing the patient's catastrophic characteristics preoperatively would contribute to successful pain management and appropriate drug selection.

Cognitive Emotion Regulation Strategies in Post-Traumatic Stress Disorder / 우울ㆍ조울병

The purpose of this study was to investigate the specific cognitive emotion regulation strategies affecting the development and maintenance of post-traumatic stress symptoms by reviewing the related literature. A literature search was conducted using Google Scholar, PubMed, DBPia, and RISS for investigating the relationship between cognitive emotion regulation strategies and post-traumatic stress symptoms in people with post-traumatic stress disorder (PTSD) or in those who had experienced severe trauma. Catastrophizing and rumination were associated with more post-traumatic stress symptoms and higher psychological distress. On the other hand, positive reappraisal, refocus on planning, and acceptance were associated with fewer post-traumatic stress symptoms and lower psychological distress. We propose that catastrophizing and rumination contribute to both the development and maintenance of post-traumatic stress symptoms. Therefore, in the prevention and treatment of PTSD symptoms, catastrophizing and rumination need to be targeted and positive reappraisal needs to be increased.

Acceptance versus catastrophizing in predicting quality of life in patients with chronic low back pain

BACKGROUND: The aim of this study was to investigate the relationship between pain catastrophizing, acceptance, and quality of life in relation to chronic low back pain in Jakarta, the capital city of Indonesia. We also analyze the effect of personality in catastrophizing and acceptance. METHODS: A total of 52 chronic low back pain patients were enrolled as participants from 2 hospitals in Jakarta (43 females, 9 males, mean age 54.38 years). Participants completed a set of self-reported questionnaires: the NEO Five Factor Inventory (NEO-FFI), Chronic Pain Acceptance Questionnaire-Revised (CPAQ-R), Pain Catastrophizing Scale (PCS), and Pain Discomfort Module (PDM). RESULTS: This study showed that acceptance increased the patient's quality of life by giving physical relief from pain. In contrast, pain catastrophizing decreased the quality of life, and increased the patients' tendency to get frustrated, irritated, and anxious about the pain. From a personality perspective, the trait neuroticism may lead to a higher level of pain catastrophizing. CONCLUSIONS: This study showed that catastrophizing, compared with acceptance, had a greater impact on the patient's life by reducing its quality.

Tradução, adaptação transcultural e avaliação preliminar da pain catastrophizing scale-parents para uso no brasil / Translation, cross-cultural adaptation and preliminary evaluation of the brazilian versionof the pain catastrophizing scale-parents

RESUMO Objetivo: No Brasil, não há escala que avalie a catastrofização dos pais sobre a dor das crianças. O objetivo deste estudo foi traduzir e adaptar transculturalmente o Pain Catastrophizing Scale-Parents para a língua portuguesa do Brasil e avaliar preliminarmente as propriedades psicométricas de pais/outros parentes de crianças com e sem dor de dente. Métodos: Foi realizado um estudo transversal com 237 pais/outros parentes de 237 crianças. A adaptação transcultural da escala para o português brasileiro foi feita conforme a abordagem universalista. Para avaliar a confiabilidade e a validade da escala, os pais/outros parentes fizeram um relato sobre a dor de dente da criança e preencheram as versões brasileiras da Escala de Catastrofização da Dor-Pais e o Questionário de Desconforto Dentário. Resultados: Houve equivalência semântica com a versão original após pequenas modificações. O alfa de Cronbach para os 13 itens da escala foi 0,83 e os respectivos coeficientes de correlação intraclasse do teste-reteste variaram de 0,63 a 0,97. Os escores obtidos na Escala de Catastrofização da Dor-Pais e no Questionário de Desconforto Dentário apresentaram baixa correlação (rho=0,25; p<0,001). O escore total da Escala de Catastrofização da Dor-Pais diferiu significativamente (p<0,001) em crianças com dor de dente à noite (mediana: 30,0; percentil 25-75: 25,0-35,5) quando comparado com o daquelas sem dor de dente (25,5; 20,0-31,0). Conclusões: A versão brasileira da Escala de Catastrofização da Dor-Pais apresentou características aceitáveis nesta avaliação preliminar e pode ser utilizada no Brasil tanto na prática clínica quanto em pesquisas.

ABSTRACT Objective: In Brazil, there is no scale to assess parental catastrophizing about their child's pain. This study aimed to translate and cross-culturally adapt the Pain Catastrophizing Scale-Parents to the Brazilian Portuguese language, as well as to preliminarily evaluate its psychometric properties among parents/guardians of children with and without a toothache. Methods: A cross-sectional study was conducted with 237 parents/other relatives of 237 children. Across-cultural adaptation of the scale into Brazilian Portuguese was carried out according to the universalistic approach. To assess the reliability and validity of the scale, parents/other relatives reported on the child's toothache and filled out the Brazilian versions of the Pain Catastrophizing Scale-Parents and the Dental Discomfort Questionnaire. Results: There was semantic equivalence with the original version after minor modifications. TheCronbach's alpha for the 13 items of the scale was 0.83, and the respective test-retest intraclass correlation coefficients ranged from 0.63 to 0.97. The scores obtained from the Pain Catastrophizing Scale-Parents and the Dental Discomfort Questionnaire had a low correlation (rho=0.25; p<0.001). Thetotal score of the Pain Catastrophizing Scale-Parents differed significantly (p<0.001) in children with a toothache at night (median: 3.0, 25-75 percentile: 25.0-35.5) compared to those who did not have a toothache at night (25.5; 20.0-31.0). Conclusions: The Brazilian version of the Pain Catastrophizing Scale-Parents was acceptable in this preliminary evaluation and can be used in Brazilian clinical and research practice.

Evaluación del catastrofismo en pacientes con lumbalgia crónica en la unidad de dolor de un hospital universitario / Evaluation of pain catastrophizing in chronic back pain patientsof a university hospital pain unit

El catastrofismo es la percepción mental, negativa y exagerada, respecto a la experiencia del dolor, tanto real como anticipada. Comprende tres dimensiones: rumiación, magnificación y desesperanza. Sus consecuencias son: dolor más intenso, mayor consumo de analgésicos, disminución de las actividades diarias, incapacidad laboral, mayor sensibilidad al dolor, interferencia en el uso de estrategias de afrontamiento y peor pronóstico general. El objetivo de este estudio fue evaluar el nivel de catastrofismo ante el dolor en pacientes con lumbalgia crónica que consultan en nuestro hospital universitario, utilizando la escala de catastrofismo del dolor en su versión en español. La muestra fue de 69 pacientes, se encontró una correlación lineal positiva entre nivel total de catastrofismo y sus tres dimensiones con la intensidad del dolor y la interferencia que éste produce sobre las actividades diarias, medidas a través del inventario abreviado del dolor. Los niveles de catastrofismo encontrados fueron altos, mayores a 30, la intensidad del dolor y su interferencia fueron elevados (mayor de 6). Este es el primer estudio de evaluación del catastrofismo en pacientes con dolor crónico en nuestro país. Los niveles de catastrofismo encontrados obligan a ofrecer en nuestra unidad medidas de intervención que logren reducirlo, de modo de lograr mejores resultados de los tratamientos farmacológicos o intervencionistas que se indican en los pacientes con lumbalgia crónica.

Pain catastrophizing is a cognitive state characterized by a negative and exaggerated perception about actual or anticipating pain. It is conformed for three factors: rumiation, magnification and helplessness. Its consequences in pain perception are increase in pain intensity and analgesic consumption, interference in daily and labor activities, hiperalgesia, interference in coping strategies and general poor clinical prognosis of pain states. The aim of this study was to evaluate pain catastrophizing in chronic back pain outpatients in a university hospital pain unit, utilizing the spanish version of the pain catastrophizing scale. Sixty-nine patients with chronic back pain with or without lumbosacral radicular pain were included. A positive lineal correlation between total catastrophism and its three factors with pain intensity and pain daily activities interference. Pain intensity and interference evaluated by the brief pain Inventory were high (more than 6) and also was the total catastrophism (more than 30). This is the first study in our country about pain catastrophizing in chronic pain patients. The high levels of catastrophism observed in this study must be treated with specific psychological interventions, in order to reduce them in such a way that pharmacological and interventional pain treatments results could be improved.

Relación de los factores psicoemocionales en la intensidad del dolor y la funcionalidad en usuarios adultos con lumbalgia crónica inespecífica de las comunas de Coquimbo y La Serena / Relationship of psycho-emotional factors in pain intensity and functionality in adult users with non-specific chronic low back pain in the commune of Coquimbo and La Serena

Introducción: el dolor es una experiencia multidimensional que considera los tres ejes de la salud: el biológico, el psicológico y el social. Cuando el daño estructural no es la causa esencial del dolor experimentado, tal como sucede en la lumbalgia crónica inespecífica (LCI), se hace necesario considerar los ejes no biológicos para un abordaje integral. Por lo tanto, el objetivo de este estudio es analizar la relación entre los factores psicoemocionales con la intensidad del dolor y la funcionalidad de las personas con LCI. Materiales y métodos: el tipo de estudio es no-experimental, cuantitativo y correlacional. La muestra corresponde a un n=55 usuarios de los CESFAM Sergio Aguilar, de la comuna de Coquimbo y Juan Pablo II, de la comuna de La Serena. Se aplicaron cuestionarios sobre los factores psicoemocionales: kinesofobia, catastrofismo y autoeficacia, y las variables de limitación de la funcionalidad e intensidad del dolor. Los instrumentos utilizados fueron: escala de tampa para kinesofobia (TSK 11), escala de catastrofismo del dolor (PCS), cuestionario sobre la percepción de autoeficacia, escala de funcionalidad o incapacidad por dolor lumbar Oswestry y escala visual análoga (EVA), respectivamente. Resultados: hubo una relación entre las variables catastrofismo-limitación de la funcionalidad (rho=0,537, p<0,005), catastrofismo-intensidad del dolor (rho=0,437, p=0,001), kinesofobia-limitación de la funcionalidad (rho=0,418, p=0,002) y autoeficacia-limitación de la funcionalidad (rho=-0,518, p<0,005), siendo estas correlaciones significativas estadísticamente. Discusión: los tres factores psicoemocionales se relacionan con la funcionalidad. No obstante, solo el catastrofismo se relaciona con la intensidad del dolor. Por ende, es relevante que el kinesiólogo considere en su intervención terapéutica estos factores para enfocar el posterior abordaje kinésico con una visión e interacción multidisciplinar.

Introduction: pain is a multidimensional experience that considers the three axes of health: biological, psychological and social. When structural damage is not the essential cause of the pain experienced, as it happens in non-specific chronic low back pain (NSCL), it is necessary to consider the non-biological axes for an integral approach. Therefore, the objective of this study is to analyze the relationship between psychoemotional factors with pain intensity and functionality of persons with NSCL pain. Materials and Methods: the type of study is non-experimental, quantitative and correlational. The sample corresponds to n=55 users of the CESFAM Sergio Aguilar, of the commune of Coquimbo and Juan Pablo II, of the commune La Serena. Questionnaires were applied on psychoemotional factors: kinesophobia, catastrophism and self-efficacy, and the variables of limitation of the functionality and intensity of pain. With the instruments: Tampa scale for kinesophobia (TSK 11), pain catastrophism scale (PCS), self-efficacy perception questionnaire, Oswestry functionality scale and analogous visual scale (EVA) respectively. Results: there was a relationship between the variables catastrophism - limitation of the functionality (rho=0,537, p<0,005), catastrophism - intensity of pain (rho=0,437, p=0,001), kinesophobia - limitation of the functionality (rho=0,418, p=0,002) and self-efficacy-limitation of the functionality (rho = - 0,518, p<0,005), these correlations being statistically significant (p<0,005). Discussion:tThe three psychoemotional factors are related to functionality. However, only catastrophism is related to pain intensity. Therefore, it is relevant that the physical therapist considers these factors in his therapeutic intervention, in order to focus the subsequent kinesthetic approach with a multidisciplinary vision and interaction.

The importance of psychological testing in predicting the effectiveness of lumbar spine surgery / A importância do teste psicológico na previsão da eficácia da cirurgia da coluna lombar / La importancia de las pruebas psicológicas en la predicción de la efectividad de la cirugía de la columna lumbar

ABSTRACT Objective: The result of treatment of patients with degenerative disc diseases is partly determined by the psychological characteristics of the patients. The aim of this study was to examine the correlations between the psychological scales scores in patients with degenerative lumbar disc diseases and the effectiveness of surgical treatment. Methods: The efficacy of the operation and patients' satisfaction were compared with the preoperative psychological characteristics, according to the questionnaires and scales (BBQ Symonds, Zung Scale, FABQ, PCI, BBQ Catastrophization). Results: In patients with neurogenic intermittent claudication syndrome without significant pain, the operative treatment depended significantly on the value of the BBQ Symonds scale (p = 0.016). In patients with severe radicular pain in the lower extremity, the effectiveness of the operation depended significantly on the value of the subscale "protection" of the PCI questionnaire (p = 0.04), the ODI index filled out before the operation (p = 0.0). In patients with lumbar syndrome, the effectiveness of operation depended significantly on the value of the PCI questionnaire as a whole (p = 0.042) and its subscores "rest" (p = 0.028), the index of the Oswestry filled out before the operation (p = 0.035). Conclusion: The effectiveness of the operation of degenerative lumbar disc diseases is associated with the results of preoperative psychological testing. It has been established that the BBQ Symonds scale, PCI protection and rest subscales, and the ODI questionnaire are the most significant; these psychological scales have the power to predict the effectiveness of surgical treatment. Level of Evidence II; Therapeutic Study - Investigating the Results of Treatment.

RESUMO Objetivo: O resultado no tratamento de pacientes com doenças degenerativas do disco é parcialmente determinado pelas características psicológicas dos pacientes. O objetivo do estudo foi examinar as correlações entre as escalas de índice psicológico em pacientes com doenças degenerativas do disco lombar e a eficácia do tratamento cirúrgico. Métodos: A eficácia da operação e a satisfação dos pacientes foram comparadas com as características psicológicas pré-operatórias, de acordo com os questionários e escalas (BBQ Symods, Zung Scale, FABQ, PCI, Catastrofización de BBQ). Resultados: Em pacientes com a síndrome de claudicação neurogênica intermitente sem dor significativa, o tratamento cirúrgico dependeu significativamente do valor da escala BBQ Symods (p = 0,016). Em pacientes com dor radicular grave no membro inferior, a eficácia da operação dependeu significativamente do valor da "proteção" da subescala do questionário de ICP (p = 0,04), preenchido antes da operação pelo índice ODI (p = 0,0). Nos pacientes com síndrome lombar, a eficácia da operação dependia significativamente do valor do questionário PCI como um todo (p = 0,042) e seu subscore "repouso" (p = 0,028) e o índice do Oswestry preenchido antes da operação (p = 0,035). Conclusão: A efetividade do funcionamento das doenças degenerativas do disco lombar está associada aos resultados dos testes psicológicos pré-operatórios. Foi estabelecido que a escala BBQ Symods, subescalas de proteção e descanso de PCI e o questionário de ODI são mais significativos; essas escalas psicológicas têm poder preditivo em relação à eficácia do tratamento cirúrgico. Nível de Evidência II; Estudo Terapêutico - Investigação dos resultados do tratamento.

RESUMEN Objetivo: El resultado del tratamiento de pacientes con enfermedades degenerativas del disco está parcialmente determinado por las características psicológicas de los pacientes. El objetivo del estudio fue examinar las correlaciones entre las escalas de índice psicológico en pacientes con enfermedades degenerativas del disco lumbar y la efectividad del tratamiento quirúrgico. Métodos: Se comparó la eficacia de la operación y la satisfacción de los pacientes con las características psicológicas preoperatorias según los cuestionarios y escalas (BBQ Symonds, Zung Scale, FABQ, PCI, Catastrofización de BBQ). Resultados: En pacientes con síndrome de claudicación neurogénica intermitente sin dolor significativo, el tratamiento quirúrgico dependió significativamente del valor de la escala BBQ Symonds (p = 0,016). En pacientes con dolor radicular severo en la extremidad inferior, la efectividad de la operación dependió significativamente del valor de la subescala "protección" del cuestionario PCI (p = 0,04), el índice ODI llenado antes de la operación (p = 0,0). En pacientes con síndrome lumbar, la efectividad de la operación dependió significativamente del valor del cuestionario PCI como un todo (p = 0,042) y sus subcategorías "reposo" (p = 0,028), el índice de Oswestry llenado antes de la operación (p = 0,035). Conclusión: La efectividad de la operación de las enfermedades degenerativas del disco lumbar se asocia con los resultados de las pruebas psicológicas preoperatorias. Se ha establecido que la escala de BBQ Symonds, las subescalas de protección y reposo PCI y el cuestionario ODI son los más significativos; estas escalas psicológicas tienen poder predictivo en relación con la efectividad del tratamiento quirúrgico. Nivel de Evidencia II; Estudio Terapéutico - Investigación de los resultados del tratamiento.