9 research outputs found
Sensitivity and specificity of the Major Depression Inventory in outpatients
.001). Subjects with major depressive disorder (MDD) had a significantly higher MDI score than subjects with anxiety disorders (but no MDD), dysthymias, bipolar, psychotic, other neurotic disorders, and subjects with relational problems. In ROC analysis we found that the area under the curve was 0.68 for the MDI. A good cut-off point for the MDI seems to be 26, with a sensitivity of 0.66, and a specificity of 0.63. The indication of the presence of MDD based on the MDI had a moderate agreement with the diagnosis made by a psychiatrist (kappa: 0.26). Conclusion The MDI is an attractive, brief depression inventory, which seems to be a reliable tool for assessing depression in psychiatric outpatients
Randomised controlled trial of cervical radiofrequency lesions as a treatment for cervicogenic headache [ISRCTN07444684]
BACKGROUND: Cervicogenic headache (CEH) is a unilateral headache localised in the neck or occipital region, projecting to the frontal and temporal regions. Since the pathogenesis of this syndrome appears to have an anatomical basis in the cervical region, several surgical procedures aimed at reducing the nociceptive input on the cervical level, have been tested. We developed a sequence of various cervical radiofrequency neurotomies (facet joint denervations eventually followed by upper dorsal root ganglion neurotomies) that proved successful in a prospective pilot trial with 15 CEH patients. To further evaluate this sequential treatment program we conducted a randomised controlled trial METHODS: 30 patients with cervicogenic headache according to the Sjaastad diagnostic criteria, were randomised. 15 patients received a sequence of radiofrequency treatments (cervical facet joint denervation, followed by cervical dorsal root ganglion lesions when necessary), and the other 15 patients underwent local injections with steroid and anaesthetic at the greater occipital nerve, followed by transcutaneous electrical nerve stimulation (TENS) when necessary. Visual analogue scores for pain, global perceived effects scores, quality of life scores were assessed at 8, 16, 24 and 48 weeks. Patients also kept a headache diary. RESULTS: There were no statistically significant differences between the two treatment groups at any time point in the trial. CONCLUSION: We did not find evidence that radiofrequency treatment of cervical facet joints and upper dorsal root ganglions is a better treatment than the infiltration of the greater occipital nerve, followed by TENS for patients fulfilling the clinical criteria of cervicogenic headache
What is important in transdisciplinary pain neuroscience education? : A qualitative study
Purpose: The main focus of Pain Neuroscience Education is around changing patientsâ pain perceptions and minimizing further medical care. Even though Pain Neuroscience Education has been studied extensively, the experiences of patients regarding the Pain Neuroscience Education process remain to be explored. Therefore, the aim of this study was to explore the experiences in patients with non-specific chronic pain. Materials and methods: Fifteen patients with non-specific chronic pain from a transdisciplinary treatment centre were in-depth interviewed. Data collection and analysis were performed according to Grounded Theory. Results: Five interacting topics emerged: (1) âthe pre-Pain Neuroscience Education phaseâ, involving the primary needs to provide Pain Neuroscience Education, with subthemes containing (a) âa broad intakeâ and (b) âthe healthcare professionalsâ; (2) âa comprehensible Pain Neuroscience Educationâ containing (a) âunderstandable explanationâ and (b) âinteraction between the physiotherapist and psychologistâ; (3) âoutcomes of Pain Neuroscience Educationâ including (a) âawarenessâ, b) âfinding peace of mindâ, and (c) âfewer symptomsâ; 4) â"scepticismâ containing (a) âdoubt towards the diagnosis and Pain Neuroscience Educationâ, (b) âdisagreement with the diagnosis and Pain Neuroscience Educationâ, and (c) âPain Neuroscience Education can be confrontingâ. Conclusion: This is the first study providing insight into the constructs contributing to the Pain Neuroscience Education experience of patients with non-specific chronic pain. The results reveal the importance of the therapeutic alliance between the patient and caregiver, taking time, listening, providing a clear explanation, and the possible outcomes when doing so. The findings from this study can be used to facilitate healthcare professionals in providing Pain Neuroscience Education to patients with non-specific chronic pain. Implications for RehabilitationAn extensive biopsychosocial patient centred intake is crucial prior to providing Pain Neuroscience Education.Repetitions of Pain Neuroscience Education, in different forms (verbal and written information, examples, drawings, etc.) help patients to understand the theory of neurophysiology.Pain Neuroscience Education induces insight into the patientâs complaints, improved coping with complaints, improved self-control, and induces in some cases peace of mind.Healthcare professionals providing Pain Neuroscience Education should be aware of the possible confronting nature of the contributing factors