Cognitive behavioral therapy for chronic pain is effective, but for whom?

This study was designed to examine differential response to treatment for patient subgroups to guide clinical decision-making for treatment. Based on existing literature, demographic (age, sex, race/ethnicity, and education) and clinical variables (disease severity, body mass index, patient treatment expectations, depression, and patient pain coping style) were specified a priori as potential moderators. Trial outcome variables (N = 15) included pain, fatigue, self-efficacy, quality of life, catastrophizing, and use of pain medication. Results yielded 5 significant moderators for outcomes at posttreatment: pain coping style, patient expectation for treatment response, radiographically assessed disease severity, age, and education. Thus, sex, race/ethnicity, body mass index, and depression at baseline were not associated with level of treatment response. In contrast, patients with interpersonal problems associated with pain coping did not benefit much from the treatment. Although most patients projected positive expectations for the treatment prior to randomization, only those with moderate to high expectations benefited. Patients with moderate to high osteoarthritis disease severity showed stronger treatment effects. Finally, the oldest and most educated patients showed strong treatment effects, while younger and less educated did not.
Source: Pain - Category: Anesthesiology Tags: Research Paper Source Type: research

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Authors: Hawker GA Abstract Osteoarthritis (OA) is the most common form of arthritis, affecting 1 in 3 people over age 65 and women more so than men. The prevalence of OA is rising due, in part, to the increasing prevalence of OA risk factors, including obesity, physical inactivity, and joint injury. OA-related joint pain causes functional limitations, poor sleep, fatigue, depressed mood and loss of independence. Compared to age and sex-matched peers, OA patients incur higher out of pocket health-related expenditures and substantial costs due to lost productivity. Most people with OA (59-87%) have at least one othe...
Source: Clinical and Experimental Rheumatology - Category: Rheumatology Tags: Clin Exp Rheumatol Source Type: research
The OsteoArthritis and Therapy for Sleep (OATS) study is a population-based randomized controlled trial of cognitive behavioral therapy for insomnia (CBTI) with four innovative methodological aims. These are to: (1) Enroll representative participants across Washington state, including those from medically underserved communities; (2) Enroll persons with persistent insomnia and chronic osteoarthritis (OA) pain; (3) Test a scalable CBT-I intervention; and (4) Evaluate patient-reported outcomes (insomnia, pain severity, fatigue, depression) and cost-effectiveness over one year.
Source: Contemporary Clinical Trials - Category: Radiology Authors: Source Type: research
Publication date: Available online 14 September 2019Source: Reumatología Clínica (English Edition)Author(s): Manuel Jiménez Ortiz, Alfonso Espinosa Ruiz, Cristóbal Martínez Delgado, Pablo Barrena Sánchez, José A. Salido ValleAbstractBackgroundThe association of depression and chronic pain in knee osteoarthritis is a complex and difficult phenomenon to understand. In fact, establishing the order of appearance of these entities might result in an arduous task.ObjectiveIn addition to analysing the relationship between preoperative anxiety and depression according to the results...
Source: Reumatologia Clinica - Category: Rheumatology Source Type: research
This study sought to investigate what could be learned from how these men have fared. The men were born in 1925-1928 and similar health-related data from questionnaires, physical examination, and blood samples are available for all surveys. Survival curves over various variable strata were applied to evaluate the impact of individual risk factors and combinations of risk factors on all-cause deaths. At the end of 2018, 118 (16.0%) of the men had reached 90 years of age. Smoking in 1974 was the strongest single risk factor associated with survival, with observed percentages of men reaching 90 years being 26.3, 25.7, ...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
I was looking back over the last 8 years since the first Wheat Belly book was released. It’s been 8 years of astounding, truly breathtaking stories of success over weight issues, health, and physical transformations that skeptics even today claim are impossible. It’s been a virtual avalanche of wonderful stories. Although I’ve seen all of them, often more than once, I could not help but be overcome with satisfaction and pride for the many, many spectacular photos and stories people have shared. So I thought it would be fun to re-post a small sample of some of these stories dating back from the start of th...
Source: Wheat Belly Blog - Category: Cardiology Authors: Tags: Wheat Belly Success Stories grain-free Inflammation Source Type: blogs
Conclusions: Study results suggest multiple mechanisms contributing to pain experiences in IBD, to include central mechanisms. Features related to demographics, extraintestinal manifestations, IBD subtype, and clinical IBD features were not predictors of subgroup membership. However, total comorbidity demonstrated association with pain subgroups in this population.
Source: The Clinical Journal of Pain - Category: Anesthesiology Tags: Original Articles Source Type: research
This study supports the hypothesis that BDNF and S100B neuromodulators present different serum levels according to the background disease associated to the chronic pain. These have the potential to be studied as markers of active disease or treatment evolution.
Source: Neuroscience Letters - Category: Neuroscience Source Type: research
In this study, we evaluated the involvement of sigma-1 receptor (σ1R) on the nociceptive, cognitive and emotional alterations associated with chronic osteoarthritis pain. Monosodium iodoacetate (MIA) was injected into the knee of Swiss-albino CD1 mice to induce osteoarthritis pain, which then received a repeated treatment with the σ1R antagonist E-52862 or its vehicle. Nociceptive responses and motor performance were assessed with the von Frey and the Catwalk gait tests. Cognitive alterations were evaluated using the novel object recognition task, anxiety-like behaviour with the elevated plus maze and the zero-...
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
Conclusion: These findings support the hypothesis that in FM a deteriorated function of cortical inhibition, indexed by a higher SICI parameter, a lower function of the DPMS, together with a higher level of BDNF indicate that FM has different pathological substrates from depression. They suggest that an up-regulation phenomenon of intracortical inhibitory networks associated with a disruption of the DPMS function occurs in FM. Introduction Major depressive disorder (MDD) and fibromyalgia (FM) present overlapped symptoms. Although the connection between these two disorders has not been elucidated yet, the disruption...
Source: Frontiers in Human Neuroscience - Category: Neuroscience Source Type: research
Publication date: Available online 18 April 2019Source: Journal of Sport and Health ScienceAuthor(s): Xin Luan, Xiangyang Tian, Haixin Zhang, Rui Huang, Na Li, Peijie Chen, Ru WangAbstractA growing understanding of the benefits of exercise over the past few decades has prompted researchers to take an interest in the possibilities of exercise therapy. Because each sport has its own set of characteristics and physiological complications that tend to appear during exercise training, the effects and underlying mechanisms of exercise remain unclear. Thus, the first step in probing exercise effects on different diseases is the s...
Source: Journal of Sport and Health Science - Category: Sports Medicine Source Type: research
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