ABSTRACT
Chronic pain and especially back pain rank among the most meaningful medical conditions worldwide. This leads to extensive costs in medical care systems. In about 80-85% of cases there is no morphologic evidence for a possible pain etiology, hence such forms are called "non-specific back pain". Therapies with a pure focus on symptomatic aspects are not effective to treat non-specific pain. The origin of chronic back pain can be best explained via a multi causal mechanism with a combination of bio-psycho-social, biographical, neurobiological, genetic, and cognitive factors. Since various aspects of the pain genesis have to be considered, multidisciplinary treatment shows much better results.
Subject(s)
Back Pain/psychology , Back Pain/therapy , Somatoform Disorders/psychology , Somatoform Disorders/therapy , Back Pain/rehabilitation , Combined Modality Therapy , Female , Guideline Adherence , Humans , Interdisciplinary Communication , Intersectoral Collaboration , Male , Patient Care Team , Psychology , Somatoform Disorders/rehabilitationABSTRACT
OBJECTIVE: Various childhood adversities have been found to be associated with chronic pain in adulthood. However, associations were moderate in most studies, i.e. odds ratios (OR) were between one and two. METHOD: An internet survey was performed in 508 Polish and 500 German subjects. A total of 19 childhood adversities were selected and their associations with headaches explored. Age, gender and country were included as potential confounders, as well as their two-way interaction with the risk factors. RESULTS: Two strong risk factors were identified. (1) A combined score for physical and emotional neglect showed an odds ratio (OR) of 2.78 (p < .002) to the frequency of headache in adulthood as a main effect. (2) Father having had chronic pain showed an OR of 4.36 (p < .001) with headache in adulthood for women, but not for men (OR = 0.86, p < .556). The majority of the examined childhood adversities were not associated with adult headache, neither when tested individually nor as a sum score. CONCLUSION: This study confirms results from previous ones that childhood adversities may play a role in the development of adult headache, but it is a rather minor one. Contrary to other studies, neglect turned out to be one of the strongest predictors.
Subject(s)
Adult Survivors of Child Adverse Events/statistics & numerical data , Headache/epidemiology , Adult , Child , Child, Preschool , Female , Germany/epidemiology , Headache/etiology , Headache/psychology , Health Surveys , Humans , Infant , Infant, Newborn , Male , Odds Ratio , Poland/epidemiology , Risk FactorsABSTRACT
BACKGROUND: Back pain is the most common form of pain and leads to high costs in all medical care systems. OBJECTIVE: The present study examines the prevalence of back pain and its associations with some basic demographics. METHODS: Two samples from Poland and Germany (about n = 500 each) were examined via Internet regarding back pain, gender, age, and body mass index (BMI). RESULTS: Back pain is more common in women than in men (risk ratio about 1.7), and a high BMI constitutes an additional risk factor. Age was not related to back pain prevalence. CONCLUSION: Congruent results in two countries based on the same measure of back pain lead to the assumption that much of the variety found in estimates of back pain are due to inconsistent assessment. For future research, a definition of common criteria on how to assess back pain would be an asset.
Subject(s)
Back Pain/epidemiology , Body Mass Index , Adult , Back Pain/pathology , Female , Germany/epidemiology , Humans , Logistic Models , Male , Middle Aged , Poland/epidemiology , Risk Factors , Sex CharacteristicsABSTRACT
The symptom checklist-27-plus has demonstrated good psychometric properties in various samples, but clinical data have not yet been published. Data from 690 mostly young female patients with eating disorders show reliabilities ranging from acceptable to very good (Cronbachs α between 0.76 und 0.89). Data from intake and discharge show a good ability to measure change (Cohen's d between 0.27 und 1.31). At intake, patients display a very high symptom load, which has decreased significantly at discharge.
