Life satisfaction in patients with long-term non-malignant pain - relating LiSat-11 to the Multidimensional Pain Inventory (MPI).

BACKGROUND: The West-Haven Multidimensional Pain Inventory (MPI) can be used to describe behavioural and psychosocial consequences of long-term pain but little is known about how MPI items and MPI subgroups relate to goals that patients find important in rehabilitation. Life satisfaction measured by the LiSat-11 checklist can be defined as an individual's perception of the difference between his reality and his needs or wants. This difference can be considered a "goal achievement gap". This study investigates the relation of MPI to LiSat-11 with the aim to explore the possibility that LiSat-11 can be used to measure pain rehabilitation outcomes that are important from the patients' view. METHODS: Participators were patients (n = 294) referred to the Pain and Rehabilitation Clinic in Uppsala, Sweden. Measures used were LiSat-11, MPI and its Swedish version MPI-S. LiSat-11 domains were correlated to MPI scales. Cluster analysis was used to demonstrate MPI-S subgroups. Analysis of variance followed by post-hoc analysis was used to investigate life satisfaction in the three MPI-S subgroups. RESULTS: The strongest positive correlation were found for the LiSat-11 domains/MPI scales: psychological health/life control and contacts/social activities, and the strongest negative correlation for: psychological health/affective distress, partner relationship/punishing responses, somatic health/interference and leisure/interference. None or only little correlation was found between MPI scale pain severity and most LiSat-11 domains and satisfaction with life as a whole. Among the MPI-S subgroups, adaptive copers generally had better life satisfaction than the dysfunctional and the interpersonally distressed. CONCLUSION: Pain severity alone is a rather poor predictor of low life satisfaction. MPI and LiSat-11 partly supplement each other as tools to describe how functional impairments relate to life satisfaction domains, which may be relevant for identifying domains which the patients find important to improve. Furthermore, differences in life satisfaction between the MPI-S subgroups may help to identify functional domains that may be of particular importance in specialised rehabilitation programs.

Life satisfaction in patients with long-term non-malignant pain-relation to demographic factors and pain intensity.

PURPOSE: Life satisfaction can be defined as a measure of a patient's perception of the difference between his reality and his needs or wants. Here we compare life satisfaction in patients with long-term pain to a reference group sampled from the normal population, and relate the results to pain intensity and to demographic factors. METHOD: Questionnaires containing the Life satisfaction (LiSat-11) checklist, a visual analogue scale (VAS) for pain, and questions on demographic background. RESULTS: The prevalence of responders with low level of life satisfaction was larger among the patients than in the reference group. In particular, patients born outside Northern Europe scored significantly lower than patients born in Northern Europe in many of the LiSat-11 domains. Pain intensity did not correlate well to the level of life satisfaction, except for weak negative correlations to satisfaction with physical health and with financial situation. CONCLUSION: Long-term pain is strongly associated with low life satisfaction. In order to increase life satisfaction, interventions related to social factors seem to be important.

Psychopathology and personality traits in patients with treated Wilson disease grouped according to gene mutations.

Wilson disease (WD) is a recessively inherited copper storage disorder mainly affecting liver and brain. Genotype/phenotype correlations have been report ed but as yet not regarding psychic symptoms. Our aim was to investigate if a correlation might exist between genotype and phenotype concerning psychopathology and/or personality traits in patients with treated WD. Nine homozygous and three compound heterozygous Swedish patients were retrospectively investigated, representing four different mutation settings. Psychopathological symptoms were studied using the Comprehensive Psychopathological Rating Scale (CPRS), personality traits using the Karolinska Scales of Personality (KSP) and mutations were analyzed by manifold sequencing. Psychopathological symptoms: Patients with the Trp779Stop mutation had the lowest scores on the total CPRS, due to less pronounced reported CPRS items, as compared to the other three groups of patients. Compound heterozygotes for the His1069Gln/Arg1319Stop mutation showed the highest total CPRS scores. Personality traits: Patients homozygous for the Trp779Stop and the Thr977Met mutations had high scores on Psychopathy related scales whereas patients with His1069Gln/Arg1319Stop mutations had the lowest scores on these scales. Serum ceruloplasmin levels were undetectable in all patients with the Trp779Stop and Thr977Met mutations. The results show a trend towards a genotype/phenotype correlation regarding psychopathological symptoms and personality traits in treated patients with WD. If replicable, these results might contribute to the elucidation of the possible clinical importance of functionally deleterious gene mutations in WD psychopathology and personality traits.

Sleep in patients with treated Wilson's disease. A questionnaire study.

OBJECTIVE: To examine general sleep habits and sleep disturbances among patients with treated Wilson's disease (WD), and in comparison with an age- and sex-matched reference group (RG). METHODS: Twenty-four patients with WD with a mean (+/-s) age of 35.1 +/- 8.7 years and a disease duration of 17.7 +/- 5.1 years were investigated using a standardized sleep questionnaire comprising 87 questions concerning sleep habits, sleeping difficulties, demographic and lifestyle variables. The results were compared with those from a random sample of 72 individuals. RESULTS: There was no significant difference in sleep time during the night, but WD patients had a significantly greater number of nocturnal awakenings compared with the RG. Fifty-nine per cent of the WD patients reported frequently being awake for more than 30 min during the night. Number of nocturnal awakenings was correlated to nightmares and palpitations only in the WD group. WD patients complained significantly more often than the RG over not feeling rested after sleep, taking frequent naps and fatigue during the daytime. Moreover, sleep paralysis and cataplexy occurred more often in the WD patients than in the RG. CONCLUSION: The sleep pattern of patients with treated WD differed from that of the reference group. The spectrum of reported symptoms by patients with treated WD suggests an altered REM sleep function. Future studies with objective methods are required to elucidate the mechanisms involved.