Palijativna skrb kao javnozdravstveni prioritet Bjelovarsko-bilogorske županije

Među brojnim zdravstvenim prioritetima u Hrvatskoj palijativna skrb, odnosno briga za oboljele u završnom stadiju neizlječive bolesti, relativno je kasno prepoznata te još uvijek nisu uspostavljeni odgovarajući institucionalni oblici takve skrbi unutar sustava javnog zdravstva. Upravo stoga Županijski tim za zdravlje BBŽ odlučio je među zdravstvene prioritete županije uvrstiti i prioritet poboljšanja skrbi za one koji boluju od neizlječivih bolesti u svom završnom stadiju. Najčešće se radi o oboljelima od zloćudnih bolesti koje, nažalost, pogađaju sve uzraste pa i djecu, ali isto tako postoje i nemaligne kronične bolesti progresivnog i fatalnog tijeka za koje nema drugih metoda liječenja osim metoda palijativne medicine (npr. amiotrofična lateralna skleroza)

Inervacijsko područje glosofaringealnog živca kao ishodište orofacijalne boli - dijagnostički i terapijski izazov

Chronic neuropathic orofacial pain along with physical suffering can cause emotional, psychological and social difficulties, which significantly affects the quality of life of patients. Pain in the area of glossopharyngeal nerve innervation, especially chronic neuropathic, is relatively rare, but is significant because of the great suffering it causes to sufferers. It can be life threatening, due to the cardiac arrhythmia, syncope or convulsions it can cause. Drug treatment is often of limited effectiveness and can be fraught with side effects. It is necessary to look for the etiology of the underlying disease, and if possible, to take adequate causal treatment. This review article discusses the etiology, clinical features, differential diagnosis, and treatment modalities of neuropathic pain in the area of glossopharyngeal nerve innervation.Kronična neuropatska orofacijalna bol uz fizičku patnju može uzrokovati emocionalne, psihičke i socijalne poteškoće, što značajno utječe na kvalitetu života bolesnika. Bol u inervacionom području glosofaringealnog živca, osobito kronična neuropatska, relativno je rijetka, ali je značajna zbog velike patnje koju može uzrokovati oboljelima. Istodobno, može biti životno ugrožavajuća, zbog srčane aritmije, sinkope ili konvulzija koje može uzrokovati. Medikamentno liječenje je često ograničene učinkovitosti i može biti opterećeno nuspojavama. Neophodno je tragati za etiologijom poremećaja, te po mogućnosti poduzeti adekvatno kauzalno liječenje. Ovaj pregledni članak govori o etiologiji, kliničkim značajkama, diferencijalnoj dijagnostici i modalitetima liječenja kronične neuropatske boli koja potječe iz inervacionog područja glosofaringealnog živca

Mogućnosti upravljanja materijalnim troškovima anestezije analizom različitih anestezioloških tehnika

The must of material cost rationalization in medical practice has stimulated the authors to analyze the structure of material expenses of spinal and general anesthesia on a model of arthroscopic knee surgery. The aim was to determine whether the cost of spinal anesthesia was still lower than that of general anesthesia after the introduction of expensive atraumatic needles. In addition, we were interested in the extent to which our daily practice correlated with that in industrialized countries and what were the possibilities of cost rationalization. Using retrograde analysis of two comparable groups of 40 patients each, submitted to arthroscopic knee surgery in general or spinal anesthesia, the anesthesia material expenses were divided into variable and constant expenses that are partially common to both types and partially specific for each type of anesthesia. The sums of variable and specific expenses were compared between the two types of anesthesia, amounting to 78,26 HRK for spinal anesthesia and 115,19 HRK for general anesthesia. There were no major operative or postoperative complications in either patient group. As only 40% of the procedures were performed in spinal anesthesia, whereas the respective figure in industrialized countries exceeds 70%, there is obviously much room for savings. If the percent of the procedures performed in spinal anesthesia were increased to the feasible 60%, a saving of 1470 HRK would be achieved exclusively in knee arthroscopy surgery, considering that some 200 procedures have been performed per year.Imperativ racionalizacije materijalne potrošnje u medicinskoj praksi potaknuo je autore da na modelu artroskopske operacije koljena analiziraju strukturu materijalnih troškova spinalne i opće anestezije. Cilj je bio utvrditi je li spinalna anestezija i nakon uvođenja skupih atraumatskih igala i dalje jeftinija od opće anestezije. Zanimalo nas je kako naša dnevna praksa korelira s onom u razvijenim zemljama i koje su mogućnosti racionalizacije. Retrogradnom analizom dviju usporedivih skupina od po 40 bolesnika artroskopiranih u općoj, odnosno spinalnoj anesteziji materijalni troškovi anestezije podijeljeni su na varijabilne i stalne, od kojih je dio univerzalan za obje anestezije, a dio specifičan za svaki tip anestezije. Uspoređivane su sume varijabilnih i specifičnih troškova dvaju tipova anestezije koje za spinalnu anesteziju iznose 78,26 kn, a za opću 115,19 kn. Ni u jednoj skupini nisu zabilježene značajne operacijske ili poslijeoperacijske komplikacije. Kako je od spomenutih operacija samo 40% operirano u spinalnoj anesteziji, dok je prosjek razvijenih zemalja iznad 70%, postoji dosta prostora za uštedu. Samo na artroskopijama koljena kojih se godišnje radi oko 200 uštedjelo bi se 1470 kn kad bismo postotak operiranih u spinalnoj anesteziji podigli na realno ostvarivih 60%

Demographic Features of Respondents with Chronic Orofacial Pain and Healthy Respondents from the Bjelovar-Bilogora County

Medicinska znanost bitno je napredovala u pitanjima kontrole boli, ali taj napredak ne prati i napredak u objektivnim metodama mjerenja boli, prema principima medicine temeljene na dokazima. Bol je kompleksno iskustvo koje, osim senzornih, uključuje i emocionalne faktore. Preduvjet zadovoljavajućeg lij ečenja boli dobra je procjena karaktera i intenziteta boli. Orofacij alna neuropatska bol izaziva veliku patnju oboljelih, a mogućnosti lij ečenja ograničene su iz više razloga. Provedenim istraživanjem željelo se utvrditi stupanj prepoznavanja neuropatske boli kao specifi čnoga kliničkog entiteta. Kvalitativna svojstva boli vrednovana su Leedskim upitnikom neuropatskih simptoma i znakova (LANSS), a kvantitativna svojstva pomoću vizualno analogne ljestvice (VAS). Rezultati su pokazali da se neuropatska orofacij alna bol kvalitativno jasno razlikuje od ostalih tipova boli. Upotrebom standardiziranih upitnika bol se može kvantifi cirati i uspoređivati. Želja nam je da rezultati istraživanja utječu na svjesnost stručne i znanstvene javnosti o kroničnoj neuropatskoj boli kao devastirajućoj bolesti koja uzrokuje veliku patnju oboljelih te da posluže kao poticaj za daljnja istraživanja, ali i kao pomoć radi usklađivanja algoritama lij ečenja koje donose stručna društva i smjernica za propisivanje lijekova Hrvatskog zavoda za zdravstveno osiguranje.Medical science has signifi cantly improved regarding pain control issues, yet this improvement has not been accompanied by improvement regarding objective methods of pain measurement according to the principles of evidence-based medicine. Pain is a complex experience, which, except for sensor factors, includes the emotional ones as well. A prerequisite for adequate pain treatment is proper assessment of pain character and intensity. Orofacial neuropathic pain causes serious suff ering in patients, while due to a number of reasons, treatment options are limited. The objective of the conducted research was to determine the level of recognition of neuropathic pain as a specifi c clinical entity. The qualitative features of pain are evaluated based on the Leeds Pain Scale (LANSS), and the quantitative features thereof on the basis of the Visual Analogue Scale (VAS). Results have shown that in the qualitative respect, neuropathic orofacial pain clearly diff ers from other types of pain. By using standardised questionnaires, pain may be quantifi ed and compared. It is wished for the research results to raise the awareness of the professional and academic public regarding chronic neuropathic pain as a devastating disease causing serious suff ering in patients, and to serve as an impetus for further research. They should furthermore serve as help in harmonising treatment algorithms issued by expert societies, as well as guidelines for prescribing medications by the Croatian Health Insurance Fund

PAINFUL NEUROPATHY OF THE LINGUAL NERVE – A CASE REPORT

Prikazan je slučaj šezdesetdvogodišnje bolesnice s karakterističnom kliničkom slikom kronične neuropatske orofacijalne boli u inervacijskom području lingvalnog živca. Medicinska dokumentacija pokazuje da je bolesnica tijekom šestogodišnjeg liječenja učinila brojne kliničke preglede kao i laboratorijske, ultrazvučne, radiološke, neuroradiološke i endoskopske pretrage u cilju pronalaženja mogućeg patološkog procesa u podlozi neuropatske boli. Upotrebom različitih analgetika i koanalgetika postignuta je tek djelomična analgezija. Razlozi za to mogu se pripisati nedostatku dobre komunikacije s bolesnicom, nedostatku defi niranih lako primjenjivih dijagnostičkih kriterija i metoda, nedostatnoj edukaciji o boli u dodiplomskoj nastavi, te nedostatku analgetika i koanalgetika koji bi bili učinkovitiji, sigurniji i s manje nuspojava. Još jednu od značajnih prepreka donosi i neusklađenost terapijskih algoritama i smjernica za propisivanje lijekova stručnih društava i propisa nacionalnog zavoda za zdravstveno osiguranje.In this paper, we present a case of a female 62-year-old patient with a characteristic clinical picture of chronic neuropathic orofacial pain in the lingual nerve innervation area. During six years of treatment, the patient had undergone numerous diagnostic tests, which were normal. By using different analgesics and co-analgesics, partial analgesia was achieved. The reasons for this could be the lack of appropriate communication with the patient, absence of validated and diagnostic criteria and methods easily applicable in clinical practice, insuffi cient education in pain management through undergraduate medical studies, as well as shortage in analgesics and co-analgesics that would be more effi cient, safer and with fewer side effects. Another major obstacle originates from the mismatch in therapeutic algorithms and prescribing guidelines favored by professional societies and those regulated by the National Institute of Health

COMPASSION AS THE ADDED VALUE OF HEALTH CARE

Tijekom posljednjih godina objavljen je veliki broj radova koji proučavaju učinke različitih emocionalnih interakcija između zdravstvenih djelatnika i bolesnika na ishode liječenja, cijenu ukupne skrbi te učinke na same zaposlenike u zdravstvu. Interes za ovo područje dijeli i šira javnost zbog raširenog mišljenja kako se suvremena medicina suviše depersonalizirala i distancirala od emocionalne uključenosti i suosjećajnosti. Tako nastaje nova znanstvena disciplina „kompasionomika“ (engl. Compassionomic) koja proučava mehanizme djelovanja i učinke na ishod liječenja suosjećajnog pristupa u zdravstvenoj skrbi. Istraživanja ukazuju da se pozitivni učinci na ishod bolesnika liječenih u okruženju koje njeguje kulturu suosjećajnosti i brižnosti postižu većim stupnjem povjerenja, time snažnijom mobilizacijom neuro-endokrinih i imunoloških mehanizama obrane te boljim pridržavanjem terapijskih preporuka. Time se poboljšava kvaliteta te istovremeno smanjuje cijena liječenja. Pritom je važno defi nirati pojam suosjećajnosti (engl. Compassion) koji u ovom kontekstu znači ne samo suosjećanje s patnjom (empatiju) već i spremnost aktivnog činjenja da se pacijentu pomogne. Preliminarna istraživanja pokazuju da bolji ishod liječenja kao rezultat većeg emocionalnog i stručnog angažmana zdravstvenim djelatnicima dolazi kao nagrada koja im pruža ispunjenje i time ukupno manji stres izgaranja. Ovakav koncept u mnogome je još hipotetičan. Međutim, ako su pretpostavke o „multiplicirajućem“ pozitivnom učinku suosjećajnosti na sve zainteresirane strane zdravstvenog sustava točne, tada se nameće potreba kreiranja i provedbe odgovarajućih edukacijskih programa, kako bi se osnažio terapijski pristup koji uključuje aktivnu suosjećajnost. Učinkovitost takvih programa može se mjeriti pomoću odgovarajućih alata koji mjere indikatore zadovoljstva pacijenata, zdravstvenih djelatnika i trećeg sektora kao i indikatore ishoda liječenja čime ulazimo u područje medicine utemeljene na dokazima. Suosjećajni pristup u liječenju svoje mjesto ima u svakoj medicinskoj djelatnosti, kako kurativnoj tako i palijativnoj, jer u svojoj biti njeguje holistički pristup s bolesnikom u središtu, s punom društvenom odgovornošću i visokim moralnim i etičkim standardima struke.In the past few years, there were many papers in the biomedical literature studying the effects of various emotional interactions between healthcare professionals and patients regarding treatment outcomes, total cost of care and effects on healthcare workers themselves. The interest in this area is also shared by the wider public because of the widespread belief that modern medicine has become depersonalized and distant from emotional involvement and compassion. Today, there is considerable evidence from relevant research suggesting that compassionate care brings additional value to therapeutic procedures. The study of these benefi ts, their mechanisms of action and effects on treatment outcome, as well as on healthcare providers is called ‘compassionomics’. Compassion in this context means not only emotional response to the other’s suffering, but also the willingness to help the patient. By contrast, the term empathy, often used as a synonym of the concept of compassion, refers only to understanding and being affected with the other’s suffering. Positive effects on the outcome of patients treated in an environment that fosters a culture of compassionate care are likely to be achieved through a greater degree of trust between physicians and other healthcare professionals and patients, resulting in stronger mobilization of neuroendocrine and immune defense mechanisms that can contribute to healing or alleviating the symptoms of the disease. Better compliance to therapeutic recommendations has also been noted. These favorable effects are also refl ected in reducing the length of hospital stay and frequency of readmission, thus reducing the cost of treatment. Although it may seem that relationship to patients involving more emotion and compassion would lead healthcare workers faster to burnout syndrome, preliminary research suggests the opposite. It is interpreted by the fact that better outcome of treatment as a result of the more emotional and professional involvement of healthcare professionals comes as a reward that provides fulfi llment of their human and professional mission and thus ultimately causes less pronounced burnout syndrome. All of this is the backbone of the theory of ‘multiplying’ the positive effect of compassion on all stakeholders in healthcare. If this theory is correct, then there is the need for creation and implementation of appropriate educational programs through which a therapeutic approach based on the culture of active and effective compassion will be designed. The effectiveness of such programs can be measured by appropriate tools that measure patient satisfaction, satisfaction of healthcare professionals and other interested parties. More objective indicators can be obtained by measuring the outcome of treatment, thus entering the sphere of the evidence-based medicine. In many aspects, this concept is still hypothetical and based in particular on observational studies. Compassionomics strives to make this area a subject of serious scientific expertise in which it is increasingly successful. Active compassion has its place in every medical activity, both curative and palliative, because it cares for the holistic approach with the patient in the center, with full social responsibility and high moral and ethical standards of profession. Since all healthcare systems, including ours, are constantly in the midst of increased needs and limited resources, the understanding of the multiple positive effects of compassion offers new hope for rationalization and sustainability of the healthcare system and its further development in the direction of increasing humanity

QUALITY OF LIFE IN PATIENTS WITH CHRONIC NEUROPATHIC NONODONTOGENIC OROFACIAL PAIN

Kronična neuropatska neodontogena orofacijalna bol (OFP) vodeći je simptom širokoga spektra bolesti, a može egzistirati i samostalno, bez drugih kliničkih znakova ili simptoma, uz uredne radiološke ili laboratorijske nalaze. OFP može uzrokovati emocionalne, psihološke i socijalne poremećaje i tako značajno utjecati na kvalitetu života oboljele osobe. Cilj je istraživanja usporedba procijenjene, sa zdravljem povezane kvalitete života, i stupnja depresije ispitanika s OFP, s rezultatima zdravih ispitanika kontrolne skupine. Ispitanici i metode: u studiju je uključeno 100 ispitanika prosječne dobi 56,95(±13,58), s kliničkom dijagnozom OFP, u trajanju od najmanje šest mjeseci, i 119 zdravih ispitanika prosječne dobi 57,21(±13,87), koji su bili kontrolna skupina. Primjenjen je standardni dijagnostički protokol: 1) demografski podaci; 2) procjena nazočnosti neuropatske boli Leedskim upitnikom neuropatskih znakova i simptoma (LANSS); 3) određivanje intenziteta boli vizualno analognom ljestvicom (VAS) u trenutku ispitivanja te tijekom protekloga mjeseca; 4) procjena emocionalnoga statusa Beckovim inventarom depresije II (BDI-II); 5) procjena o zdravlju ovisne kvalitete života SF-36 upitnikom. Rezultati: prosječan LANSS rezultat za skupinu oboljelih iznosi 17,18, a za kontrolnu skupinu 0. Prosječan rezultat BDI-II u skupini oboljelih je 18,31, prema 5,87 u kontrolnoj skupini. Mann-Whitneyjevim U testom svaka od devet kategorija koje mjeri SF-36 statistički se signifikantno razlikuje između bolesnih i zdravih ispitanika. U svim kategorijama, osim jedne (vitalnost), kontrolna skupina ima viši indeks u odnosu na skupinu s OFP. Rezultat kontrolne skupine veći je od 60% u šest od devet kategorija, dok skupina oboljelih ne prelazi granicu od 60% niti u jednoj kategoriji. Zaključak: kronična neuropatska neodontogena orofacijalna bol uzrokuje depresiju i utječe na gotovo sve odrednice kvalitete života, mjerene SF-36 upitnikom. Postoji jaka povezanost između depresije i niske kvalitete života oboljelih od OFP.Background: Chronic neuropathic nonodontogenic orofacial pain (OFP) is the leading symptom of a wide range of diseases, which can exist independently, without other clinical signs or symptoms and without abormalities in radiological or laboratory findings. OFP is a disease which should be treated adequately. Its successful treatment depends on the early diagnostics and understanding of the mechanisms of its occurrence. The most frequent clinical entity in our sample was nonodontogenic trigeminal neuralgia, the fifth cranial nerve disorder characterized by bouts of intense, sharp pain which usually affects one or two branches of the nerve on one side of the face. In most cases, the exact cause of trigeminal neuralgia has not been completely clarified. OFP causes emotional, psychological and social disorders, which can significantly affect the quality of life of the affected person. Aim of study: The aim of the research is to compare the estimated health-related quality of life and the degree of depression of patients with OFP with healthy control subjects, using a validated Croatian version of the SF-36 Health Survey Questionnaire and the Beck Depression Inventory II. Patients and Methods: The controlled cross-sectional study included 100 patients aged between 18 and 75, with the clinical diagnosis of OFP in duration of at least six months (72 females and 28 males), and 119 healthy subjects (73 females and 46 males) as a control group. A standardized diagnostic protocol was applied to both the patients and the control group: 1) demographic data and quantitative estimate of pain on the visual analog scale (VAS); 2) evaluation of presence of neuropathic pain measured by the Leeds Assessment of Neuropathic Signs and Symptoms (LANSS); 3) evaluation of emotional status using the Beck Depression Inventory II, and 4) assessment of health-related quality of life using the SF-36 Questionnaire. The Kolmogorov–Smirnov Test analyzed the normality of data distribution, and, in keeping with the results, suitable nonparametric tests were used in further data processing. Quantitative data were shown through medians and interquartile range, while the nominal and categorical data were presented through absolute frequencies and the corresponding relative frequencies. The difference in the continued values between the groups were analyzed using Mann-Whitney U Test, while the differences between the nominal and categorical values were analyzed using Chi-Square Test. Spearman's rank correlation coefficient between individual clinical parameters was calculated. All P values smaller than 0.05 were considered statistically significant. Results: The average LANSS score for the patients was 17.18, and for the control group 0. The average BDI-II score for the patients was 18.31, as opposed to 5.87 for the control group. The Mann-Whitney U Test for each of the nine categories that measure SF-36, shows statistically significant difference between the affected and healthy subjects. In all the categories except one (Vitality), the control group has a higher index than the group with OFP. The result of the control group was equal or greater than 60% of the possible overall result in seven out of nine categories, while the treatment group did not exceed the limit of 60% in any of the categories. A statistically significant correlation was noted between the degree of depression and the SF-36 domains of Physical Functioning (PF), Body Pain (BP), General Health Perception (GH), Vitality (VT), Social Functioning (SF), Role Emotional (RE) and Mental Health (MH). No statistically significant correlation was proven between the degree of depression and the domains of Role Physical (RP) and Health Transition (HT). Conclusion: Chronic neuropathic nonodontogenic orofacial pain causes depression and affects almost all the determinants of quality of life measured by SF-36 Questionnaire. There is a strong correlation between depression and low quality of life in patients with OFP

QUALITY OF LIFE IN PATIENTS WITH CHRONIC NEUROPATHIC NONODONTOGENIC OROFACIAL PAIN

Kronična neuropatska neodontogena orofacijalna bol (OFP) vodeći je simptom širokoga spektra bolesti, a može egzistirati i samostalno, bez drugih kliničkih znakova ili simptoma, uz uredne radiološke ili laboratorijske nalaze. OFP može uzrokovati emocionalne, psihološke i socijalne poremećaje i tako značajno utjecati na kvalitetu života oboljele osobe. Cilj je istraživanja usporedba procijenjene, sa zdravljem povezane kvalitete života, i stupnja depresije ispitanika s OFP, s rezultatima zdravih ispitanika kontrolne skupine. Ispitanici i metode: u studiju je uključeno 100 ispitanika prosječne dobi 56,95(±13,58), s kliničkom dijagnozom OFP, u trajanju od najmanje šest mjeseci, i 119 zdravih ispitanika prosječne dobi 57,21(±13,87), koji su bili kontrolna skupina. Primjenjen je standardni dijagnostički protokol: 1) demografski podaci; 2) procjena nazočnosti neuropatske boli Leedskim upitnikom neuropatskih znakova i simptoma (LANSS); 3) određivanje intenziteta boli vizualno analognom ljestvicom (VAS) u trenutku ispitivanja te tijekom protekloga mjeseca; 4) procjena emocionalnoga statusa Beckovim inventarom depresije II (BDI-II); 5) procjena o zdravlju ovisne kvalitete života SF-36 upitnikom. Rezultati: prosječan LANSS rezultat za skupinu oboljelih iznosi 17,18, a za kontrolnu skupinu 0. Prosječan rezultat BDI-II u skupini oboljelih je 18,31, prema 5,87 u kontrolnoj skupini. Mann-Whitneyjevim U testom svaka od devet kategorija koje mjeri SF-36 statistički se signifikantno razlikuje između bolesnih i zdravih ispitanika. U svim kategorijama, osim jedne (vitalnost), kontrolna skupina ima viši indeks u odnosu na skupinu s OFP. Rezultat kontrolne skupine veći je od 60% u šest od devet kategorija, dok skupina oboljelih ne prelazi granicu od 60% niti u jednoj kategoriji. Zaključak: kronična neuropatska neodontogena orofacijalna bol uzrokuje depresiju i utječe na gotovo sve odrednice kvalitete života, mjerene SF-36 upitnikom. Postoji jaka povezanost između depresije i niske kvalitete života oboljelih od OFP.Background: Chronic neuropathic nonodontogenic orofacial pain (OFP) is the leading symptom of a wide range of diseases, which can exist independently, without other clinical signs or symptoms and without abormalities in radiological or laboratory findings. OFP is a disease which should be treated adequately. Its successful treatment depends on the early diagnostics and understanding of the mechanisms of its occurrence. The most frequent clinical entity in our sample was nonodontogenic trigeminal neuralgia, the fifth cranial nerve disorder characterized by bouts of intense, sharp pain which usually affects one or two branches of the nerve on one side of the face. In most cases, the exact cause of trigeminal neuralgia has not been completely clarified. OFP causes emotional, psychological and social disorders, which can significantly affect the quality of life of the affected person. Aim of study: The aim of the research is to compare the estimated health-related quality of life and the degree of depression of patients with OFP with healthy control subjects, using a validated Croatian version of the SF-36 Health Survey Questionnaire and the Beck Depression Inventory II. Patients and Methods: The controlled cross-sectional study included 100 patients aged between 18 and 75, with the clinical diagnosis of OFP in duration of at least six months (72 females and 28 males), and 119 healthy subjects (73 females and 46 males) as a control group. A standardized diagnostic protocol was applied to both the patients and the control group: 1) demographic data and quantitative estimate of pain on the visual analog scale (VAS); 2) evaluation of presence of neuropathic pain measured by the Leeds Assessment of Neuropathic Signs and Symptoms (LANSS); 3) evaluation of emotional status using the Beck Depression Inventory II, and 4) assessment of health-related quality of life using the SF-36 Questionnaire. The Kolmogorov–Smirnov Test analyzed the normality of data distribution, and, in keeping with the results, suitable nonparametric tests were used in further data processing. Quantitative data were shown through medians and interquartile range, while the nominal and categorical data were presented through absolute frequencies and the corresponding relative frequencies. The difference in the continued values between the groups were analyzed using Mann-Whitney U Test, while the differences between the nominal and categorical values were analyzed using Chi-Square Test. Spearman's rank correlation coefficient between individual clinical parameters was calculated. All P values smaller than 0.05 were considered statistically significant. Results: The average LANSS score for the patients was 17.18, and for the control group 0. The average BDI-II score for the patients was 18.31, as opposed to 5.87 for the control group. The Mann-Whitney U Test for each of the nine categories that measure SF-36, shows statistically significant difference between the affected and healthy subjects. In all the categories except one (Vitality), the control group has a higher index than the group with OFP. The result of the control group was equal or greater than 60% of the possible overall result in seven out of nine categories, while the treatment group did not exceed the limit of 60% in any of the categories. A statistically significant correlation was noted between the degree of depression and the SF-36 domains of Physical Functioning (PF), Body Pain (BP), General Health Perception (GH), Vitality (VT), Social Functioning (SF), Role Emotional (RE) and Mental Health (MH). No statistically significant correlation was proven between the degree of depression and the domains of Role Physical (RP) and Health Transition (HT). Conclusion: Chronic neuropathic nonodontogenic orofacial pain causes depression and affects almost all the determinants of quality of life measured by SF-36 Questionnaire. There is a strong correlation between depression and low quality of life in patients with OFP