Prevalence of suicide attempt and associations with deliberate self-harm, mental health problems, drug misuse and traumatic experiences - a cross sectional survey of the Norwegian population.

BACKGROUND: Monitoring self-reported suicide attempts (SA) with nationally representative surveys is important to initiate suicide prevention strategies. The aim of the study was to assess the prevalence of SA and compare deliberate self-harm, (DSH), mental health, drug misuse and traumas between SA and non-suicide attempters (NSA). METHODS: In this cross-sectional survey of a representative sample (N=1757) of the Norwegian population, we compared people with self-reported SA (n=54) to NSA (n=1703) regarding sociodemographic data, mental health problems, drug misuse and exposure to trauma. RESULTS: The prevalence of SA was 3.1 %. There was a higher proportion of welfare recipients and more deliberate self-harm, mental health problems, drug misuse and traumas in the SA group compared to NSA. CONCLUSION: This national study confirms the association between suicide attempt and deliberate self-harm, mental health problems, drug misuse and traumas.

Prevalence and predictors of persistent post-surgical pain 12 months after thoracotomy.

BACKGROUND: Persistent post-surgical pain is recognised as a major problem. Prevalence after different surgical procedures has been reported to range from 5% up to 85%. Limb amputation and thoracotomy have the highest reported prevalence. Prediction of persistent post-surgical pain has over the last decade caught attention. Several factors have been investigated, but in-depth knowledge is still scarce. The purpose of this study was to investigate the prevalence of persistent post-surgical pain, and predictive factors for persistent post-surgical pain 12 months after thoracotomy. METHODS: A prospective longitudinal study was conducted. One-hundred and seventy patients were recruited before scheduled thoracotomy, and asked to answer a questionnaire. One-hundred and six patients completed the same questionnaire at 12-month follow-up. Regression analysis was performed to explore variables assumed predictive of persistent post-surgical pain. RESULTS: One-hundred and six patients (62%) filled out the questionnaire at both time points. Preoperative, 34% reported muscle-skeletal related chronic pain. At 12-month follow-up, 50% of the patients reported persistent post-surgical pain. Of the variables explored in the logistic regression model, only preoperative pain (P < 0.001) and dispositional optimism (P = 0.04) were statistically significant. In this study, preoperative pain was a predominant predictor for persistent postoperative pain (OR 6.97, CI 2.40-20.21), while dispositional optimism (OR 0.36, CI 0.14-0.96) seem to have protective properties. CONCLUSION: Our results show that preoperative pain is a predominant predictor of future pain. This implies that patients presenting with a chronic pain condition prior to surgery should be assessed thoroughly preoperatively and have an individually tailored analgesic regimen.

Does chronic pre-operative pain predict severe post-operative pain after thoracotomy? A prospective longitudinal study.

BACKGROUND: Despite advances in pain research, many patients still experience moderate to severe post-operative pain that needs to be alleviated. The primary aim of this study was to identify predictive factors for severe post-operative pain after thoracotomy. Secondary, we investigated the levels of post-operative pain in this group of patients. METHODS: A prospective longitudinal study with 144 patients scheduled for thoracotomy was conducted between December 2007 and August 2010. All patients were given a questionnaire consisting of three sections (Brief Pain Inventory, Life Orientation Test-revised and Hospital Anxiety and Depression Scale) the day before surgery. Only those patients with pre-existing chronic pain were asked to complete all three sections. Post-operative pain scores were recorded three times a day for 6 days using the Numeric Rating Scale, and all analgesic consumption was recorded daily. RESULTS: Fifty-four patients reported pre-existing pain before surgery, most commonly from the neck, shoulders, lower back, hips or knees. For the first 3 days after surgery, the pain scores for those who had pre-existing chronic pain and those who did not, where almost similar with no statistically significant difference. The total amount of the epidural analgesia-mixture used where also almost similar for both groups with no statistically significant difference. CONCLUSION: In contrast to previous studies, which have reported pre-operative chronic pain to be a strong predictor of moderate to severe post-operative pain, we have in our study not been able to replicate these findings.