Complications of Uncontrolled, Persistent Pain – By Forest Tennant, MD, DrPH – Jan 2018
To the unfortunate patient who is afflicted and the practitioner who treats it, incurable, persistent pain is truly its own disease regardless of its underlying cause.
Persistent pain, which is also often characterized as chronic or intractable, has all the ramifications of a disease in that it may have pre-clinical and overt phases.
I like that he calls it “persistent pain” instead of “chronic pain”, a term which has become synonymous in the public’s eye as a whining, complaining, catastrophizing, gonna-be addict. Continue reading
Depression treatment needs overhaul – by Tess Redgrave, University of Auckland
This is an interesting article that proposes 12 categories of depression, with different symptoms and requiring different treatment.
The way depression is diagnosed and treated needs a major overhaul, say authors of a new review article in the scientific journal Brain, Behavior, and Immunity.
This is because current treatment of depression is ineffective and lacks a plausible, coherent theoretical basis, they claim.
A new theory for depression and its treatment is proposed in the article “Depression subtyping based on evolutionary psychiatry: Proximate mechanisms and ultimate functions,” Continue reading
Managing Chronic Pain, Depression & Antidepressants: Issues & Relationships – Johns Hopkins Arthritis Center – by Michael Clark, M.D., M.P.H. – 1995, updated August 15, 2017
Signs, Symptoms, and Prevalence
In several studies of patients presenting to clinics specializing in the evaluation of pain, the prevalence of psychiatric conditions was systematically assessed.
Affective and anxiety disorders were the most commonly found (Reich et al. 1983). For example, the prevalence of major depression in patients with chronic low back pain is 3-4 times greater than in the general population (Sullivan et al. 1992). However, the causal relationship between these syndromes remains controversial. Continue reading
Emotional Impact of Pain | Pain Management & Understanding | Arthritis.org
Although it may feel like it’s coming from your joints, pain – particularly the chronic pain common to arthritis – is also an expression of your state of mind.
If you’re depressed or anxious, you’ll very likely hurt more than when your mood is lighter or more balanced.
The crucial distinction is that depression or anxiety will only worsen *pre-existing* pain, not create new pain.
The fact that pain itself is depressing and worrying only makes the problem worse. Continue reading
This article made a big splash arguing that opioids, and not the pain we take them for, cause our depression.
Depression in chronic pain: might opioids be responsible? : PAIN – M.D. Sullivan and D.N. Juurlink – Nov 2018
Of course, the answer is “NO”, but this low-quality study with specious claims of “causal inference” tries to show a causal relationship that cannot be proven.
As usual, they are looking only at opioids with little concern for chronic pain, but if we substitute the words “chronic pain” everywhere they say “opioids” these studies make a lot more sense. Continue reading
Urine Test Could Diagnose Depression, Anxiety | American Council on Science and Health – By Alex Berezow — September 29, 2018
This seems like a hugely significant discovery that could save the healthcare system a lot of money treating people for suspected mental disorders when there is not psychological problem at all.
Depression and anxiety are not always easy to detect. The obvious symptoms, such as persistent sadness or worry, may not be present.
Instead, a person may exhibit insidious symptoms, like chronic indecision or excessive sleepiness. Diagnosis usually requires a psychologist. Besides being time consuming and inconvenient, diagnostic criteria are rather subjective. Continue reading
Can genetic tests gauge how well antidepressants will work? – By Rebecca Robbins @rebeccadrobbins – September 28, 2018
It can be notoriously difficult for psychiatrists and patients to determine which antidepressant might be most effective, or which might cause side effects.
And so Color Genomics, a company that already sells genetic tests to determine someone’s risk of developing certain cancers, said this week that it will also begin to offer a DNA test to determine how well widely used antidepressants are likely to work for patients.
With the new test2 (part of a $249 product), Color joins several dozen companies probing patients’ DNA in search of insights to help inform decisions about which psychiatry medications patients should take. Continue reading
Commentary: We must understand the causes of anxiety and suicide – By Perry G. Fine – September 16, 2018
Although the U.S. Centers for Disease Control and Prevention asserts that there is no single cause that can be attributed to this national trend, we know that serious, life-impacting anxiety, depression and chronic pain are at an all-time high and strongly correlated with suicide attempts.
The 25 percent increase in the suicide rate has mirrored similar upswings in other harmful behaviors and chronic illnesses.
These include parallel increases in diabetes and obesity-related mortality, gun violence deaths and drug overdose fatalities. Continue reading
Chronic Pain Among Suicide Decedents, 2003 to 2014 | Annals of Internal Medicine | American College of Physicians – Sept 2018
The CDC finally looks at suicide and chronic pain:
“increases in opioid availability are not associated with greater suicide risk from opioid overdose among patients with chronic pain.”
During 2003 to 2014, the NVDRS identified 123,181 suicide decedents aged 10 years or older, 10,789 (8.8%) of whom had evidence of chronic pain. The percentage of decedents with chronic pain increased from 7.4% in 2003 to 10.2% in 2014, but the percentage who died by opioid overdose remained low overall (<2.0%). Continue reading
Ketamine’s antidepressive effects tied to opioid system in brain – By Kimber Price – Aug 2018
Scientists at the Stanford University School of Medicine have discovered that ketamine works as an antidepressant at least in part by activating the brain’s opioid system.
The finding overturns previously held beliefs that the drug’s antidepressant effects stemmed solely from its impact on the glutamate system.
These beliefs led to the widespread use of ketamine to treat depression and spurred the development of glutamate-blocking drugs for use as antidepressants. Continue reading