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2 results

  • A clinical survey of pain in Parkinson's disease in Eastern China

  • Xing-Jian Lin, Nian Yu, Xiao-Guang Lin, Yan-Fang Zhang, Yan Chen, Kang Zhang, Xiao-Shan Wang, Wei-Guo Liu
  • Journal:
    International Psychogeriatrics / Volume 28 / Issue 2 / February 2016
    Published online by Cambridge University Press:
    07 October 2015, pp. 283-289
  • Background:

    This is a case-control study to investigate the prevalence, characteristics, and risk factors of pain in patients with Parkinson's disease (PD).

    Methods:

    A total of 200 PD patients from eastern China were enrolled in our study. Accordingly, 200 healthy elderly adults were recruited as controls. The characteristics of pain were collected by using the Visual Analog Scale, Brief Pain Inventory (BPI), SF-36 Bodily Pain Scale, Unified Parkinson's Disease Rating Scale, Hoehn–Yahr Scale (H-Y), Hamilton Depression Scale, and Leeds Assessment of Neuropathic Symptoms and Signs.

    Results:

    Of the 200 PD patients, pain was complained by 106 patients (53%). According to the SF-36 Bodily Pain Scale, pain morbidity in PD patients was significantly higher than in the control group. The average pain during last 24 h measured by the BPI was 2.67. About 76% of PD patients were found to have one pain type, 21.7% were having two pain types, and 1.9% had three pain types. Further, 69.8% of these patients were presented with musculoskeletal pain, 4.7% with dystonic pain, 22.6% with radicular-neuropathic pain, 20.8% with central neuropathic pain, and 9.4% with akathisia pain. The onset age and depression were the most significant predictors of pain in PD patients (p < 0.05). However, there was no significant association between pain and gender, age, disease duration, or severity of the disease. Only 5.7% of PD patients with pain received treatment in this study.

    Conclusions:

    Pain is frequent and disabling, independent of demographic and clinical variables, and is significantly more common in PD patients.

  • Chapter 17 - The patient with excited delirium in the emergency department

  • from Section 3. - Psychiatric illnesses
  • Edited by Leslie S. Zun
  • Edited in association with Lara G. Chepenik, Mary Nan S. Mallory
  • Book:
    Behavioral Emergencies for the Emergency Physician
    Published online:
    05 April 2013
    Print publication:
    21 March 2013, pp 125-131

  • Summary

    Somatoform disorders (SDs) consist of a group of psychiatric conditions that cause unintentional physical symptoms suggestive of a general medical condition. SDs specifically addressed in this chapter include somatization disorder, undifferentiated somatoform disorder, conversion disorder, pain disorder, hypochondriasis, body dysmorphic disorder, and somatoform disorder not otherwise specified. There are general similarities among the different somatoform disorders that may help guide a healthcare provider's evaluation. There are inherent difficulties to evaluating SD patients in the emergency department (ED) which may contribute to both patient and physician discontent. Stronger treatment alliances with healthcare providers form if patients do not feel blamed for producing their unintentional symptoms. A treatment alliance can start in the ED, but ideally continues with inpatient or outpatient mental healthcare professionals or other specialists. Cognitive behavioral therapy (CBT) and antidepressant medication have each demonstrated success in treating patients with SDs.