Changes in Pain Perception following Psychotherapy: The Mediating Role of Psychological Components.

Chronic pain is frequently associated with significant psychological issues, such as depression or anxiety. Psychological treatments, such as psychotherapy, can often alleviate both psychological and pain symptoms. However, there is limited research about the association between psychological symptoms and perceived pain in the context of psychotherapeutic interventions. We conducted a retrospective study that analyzed, in a hospital context, how changes in psychological functioning and well-being were associated with pain reduction. Thirty-seven records of patients with chronic pain attending psychotherapy in a public hospital were included. All patients were assessed before psychotherapy, as well as after 6 and 10 months, with self-reported questionnaires about pain, anxiety, depression, and psychological functioning. Results indicate that reductions in anxiety, depression, psychological problems, risk factors, and well-being are strongly related with a reduction in pain, further confirming the hypothesis that psychological morbidity is associated with pain severity.

[Psychological evaluation and support in patients with left ventricular assist devices: preliminary data at 6-month follow-up]. / Valutazione e supporto psicologico del paziente portatore di dispositivo di assistenza ventricolare sinistra: dati preliminari a 6 mesi.

BACKGROUND: Heart disease has an impact on patient's identity and self-perception. Taking into account the wide literature about psychological aspects before and after heart transplant, it clearly emerges that there is a lack of data and results for patients up to implantation of ventricular assist devices (VAD). The aim of the present study was to explore quality of life and factors correlated with psychological adjustment in patients supported with VAD. METHODS: From February 2013 to August 2014, 18 patients (17 male, mean age 57 years) under clinical evaluation before and after VAD implantation were enrolled. During interviews, patients were assessed with EuroQoL-5D questionnaire to monitor improvement of quality of life before implantation and at 3 and 6 months; critical issues, needs and point of views of patients have been described. RESULTS: A significant improvement in the quality of life score was observed at 3 (score 38 [interquartile range 30-40] vs 75 [60-80], p<0.05) and 6 months (38 [30-40] vs 70 [60-80], p<0.05). Overall, patients' psychological state investigated by the test showed a clear and positive trend. All patients need to empower through complete information about the device, related risks and life expectancy. Interdisciplinary approach improved compliance with therapy. CONCLUSIONS: Successful treatment and efficient psychological care are closely related to assessment and continuous clinical support. This approach ensures a better selection of patients and improves their compliance. Further data are needed to support our preliminary observations and to explore long-term quality of life.