European Journal of Pain最新文献

{"title":"Pain intensity and comorbid depressive symptoms in the general population: An analysis of the German Health Update Study (GEDA 2019/2020-EHIS).","authors":"Jan Niklas Ahrend, Kathrin Jobski, Carsten Bantel, Falk Hoffmann","doi":"10.1002/ejp.4745","DOIUrl":"https://doi.org/10.1002/ejp.4745","url":null,"abstract":"<p><strong>Background: </strong>Pain and depressive symptoms often co-occur, but the influence of pain intensity remains unclear. This study analyses the association between pain intensity and depressive symptoms in the general adult German population.</p><p><strong>Methods: </strong>Data was obtained from the cross-sectional German Health Update Study (GEDA 2019/2020-EHIS). Pain intensity in the last 4 weeks was categorized into no pain, mild, moderate, and severe. Depressive symptoms were assessed using the 8-item Patient Health Questionnaire (PHQ-8). The prevalence of depressive symptoms was analysed including a 95% confidence interval (95% CI). A multivariable logistic regression analysed associated factors with depressive symptoms by odds ratio (OR).</p><p><strong>Results: </strong>Of 22,708 participants (51.0% women, 35.1% aged 45-64 years), 41.2% reported no pain, 32.1% mild, 15.3% moderate, and 11.5% severe pain. Depressive symptoms were present in 8.3% overall (women 9.1%, men 7.5%). Participants with no pain, mild, moderate, and severe pain reported depressive symptoms in 2.5%, 6.5%, 14.4%, and 27.1%, respectively. In the multivariable analysis, higher pain intensity was associated with a higher risk of depressive symptoms (mild pain OR 1.8, 95% CI 1.3-2.4; moderate pain OR 2.8, 95% CI 2.0-4.0; severe pain OR 4.0, 95% CI 2.8-5.6). Depressive symptoms were further associated with a Body Mass Index (BMI) under 18.5 kg m^-2 (OR 2.4; 95% CI 1.4-4.1), but not with sex (OR 1.1; 95% CI 0.9-1.3).</p><p><strong>Conclusions: </strong>Higher pain intensity increases the risk of depressive symptoms. We suggest regular assessment of pain and further assessment of depressive symptoms in patients with moderate or severe pain.</p><p><strong>Significance statement: </strong>Our study found a clear association between higher pain intensity and depressive symptoms in the general population across all types of pain. Further, being underweight was linked to depressive symptoms overall and the highest prevalence of depressive symptoms was found in underweight persons with severe pain. These findings highlight the importance of assessing depressive symptoms in patients with higher pain intensity, especially in underweight patients.</p>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142497532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A randomized clinical trial of emotional freedom techniques for chronic pain: Live versus self-paced delivery with 6-month follow-up.","authors":"Peta Stapleton, Clara Wilson, Nicola Uechtritz, Michele Stewart, Michelle McCosker, Tom O'Keefe, Matthew Blanchard","doi":"10.1002/ejp.4740","DOIUrl":"https://doi.org/10.1002/ejp.4740","url":null,"abstract":"<p><strong>Background: </strong>Chronic pain represents a major global healthcare crisis, and current treatments are limited in effectiveness and safety. Emotional freedom techniques (EFTs) show promise as a potential psychological treatment.</p><p><strong>Methods: </strong>The current study investigated the effect of a randomized clinical trial of EFT for chronic pain in a sample of 147 adult chronic pain sufferers (89.9% female; mean 54.63 years). Participants engaged in a 6-week EFT programme (either online self-paced or in-person).</p><p><strong>Results: </strong>The per-protocol analysis indicated pain severity and interference scores were significantly lower at the end of treatment for the EFT group compared to waitlist, and these were sustained at follow-up. There were no differences between the in-person or self-paced programmes at follow-up for pain severity and interference. Somatic symptoms were significantly lower after EFT, although no further differences at follow-up. Quality of life scores were significantly higher after EFT, which were sustained at follow-up, and no differences between two styles of programme. No significant effects were found for anxiety, depression, happiness or satisfaction with life across the 6-week programmes for either style of delivery or at follow-up. These are discussed in terms of clinical score meanings. Intent-to-treat analysis was consistent with the per-protocol analyses. Limitations of the study are identified and future directions are discussed.</p><p><strong>Conclusions: </strong>Findings offer early promise for EFT as a potentially effective pain management strategy, as well as support for online intervention without compromising treatment outcomes.</p><p><strong>Significance statement: </strong>An emerging body-based intervention for chronic pain may be a possible solution for remote clients who cannot attend in-person sessions. In this clinical trial Emotional Freedom Techniques (EFT) significantly reduced chronic pain severity and interference, and there were no differences between and online self-paced program toan online in-person EFT intervention. Both were equally effective, also enhancing quality of life without compromising outcomes. The results were significant at 6-month follow-up/. These findings highlight a body-based approach as a promising, accessible pain management strategy, and highlights that online programs may be part of the solution for chronic pain patients.</p>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142461135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Signs of hyperpathia in chronic peripheral neuropathic pain.","authors":"Malin Erika Carmland, Melissa Dall Kreutzfeldt, Peter Kolind Brask-Thomsen, Troels Staehelin Jensen, Flemming Winther Bach, Søren Hein Sindrup, Nanna Brix Finnerup","doi":"10.1002/ejp.4739","DOIUrl":"https://doi.org/10.1002/ejp.4739","url":null,"abstract":"<p><strong>Background: </strong>Neuropathic pain is pain due to a disease or lesion of the somatosensory system, and can be either spontaneous, evoked or both. Hyperpathia is a type of evoked pain defined by IASP as 'a painful syndrome characterized by an abnormally painful reaction to a stimulus, especially a repetitive stimulus, as well as an increased threshold'. The literature is sparse, and definitions are unclear and inconsistent.</p><p><strong>Methods: </strong>The aim of this study was to examine for the presence of mechanical hyperpathia in a heterogeneous group of patients with peripheral neuropathic pain and correlate signs of hyperpathia with other sensory signs. Patients were examined with graded pinprick stimuli to obtain a stimulus-response curve and repetitive pinprick stimuli to assess increase in pain over time and aftersensations. Then, patients were grouped based on the likelihood of having mechanical hyperpathia with either a steep stimulus-response curve or a steep curve on the repetitive pinprick test and results were correlated to mechanical detection and pain thresholds and other outcomes from a full quantitative sensory testing.</p><p><strong>Results: </strong>We included 124 patients with documented peripheral neuropathic pain. Patients with a steep stimulus-response curve did not overlap with patients with a steep curve on the repetitive pinprick test and both groups more often had decreased rather than increased detection and pain thresholds.</p><p><strong>Conclusions: </strong>Our study questions the concept of hyperpathia and suggests that more studies are needed to identify which symptoms and signs group together and might form a syndrome.</p><p><strong>Significance statement: </strong>Hyperpathia is a syndrome of evoked pain. It is poorly defined and little is known about its clinical presentation. Since it is part of pain symptomatology it is important to have a clear definition and understand the pathophysiology behind. This study explored signs of hyperpathia in a heterogeneous group of patients with peripheral neuropathic pain. We used stimulus-response function and repetitive pinprick stimulation to group patients based on the IASP definition. More studies are needed to understand how symptoms and signs coincide.</p>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142461137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lower thresholds and stronger adaptation to pain in musicians reflect occupational-specific adaptations to contact heat stimulation.","authors":"Rebecca Divarco, Fabian Sternkopf, André Lee, Matthias Karst, Perianen Ramasawmy, Andrea Antal, Eckart Altenmüller","doi":"10.1002/ejp.4738","DOIUrl":"https://doi.org/10.1002/ejp.4738","url":null,"abstract":"<p><strong>Background: </strong>Extensive audio-motor training and psychological stress can cause professional musicians acute overstrain-injury and chronic pain, resulting in damaged careers and diminished quality of life. It has also been previously shown that musicians might perceive pain differently than non-musicians. Therefore, the aim of our study was to quantify differences between musicians and non-musicians regarding their subjective responses to painful contact heat stimuli and assess how emotional traits might influence these responses.</p><p><strong>Methods: </strong>Upon completing the StateTrait-Anxiety-Depression Inventory, 15 healthy musicians and 15 healthy non-musicians from German universities received 15 noxious contact heat stimuli at the dorsal side of each hand and foot. After each stimulation, participants were asked to provide a pain rating from 0 to 10.</p><p><strong>Results: </strong>Musicians not only reported significantly higher pain ratings after the first stimulation but also showed a significantly higher degree of habituation compared to non-musicians. Additionally, musicians showed a significantly less pronounced difference regarding the pain rating of the hands compared to the feet than non-musicians. Trait anxiety and trait depression scores had no effect on the pain rating or the habituation.</p><p><strong>Conclusion: </strong>The more pronounced habituation of musicians might hint at a neuroplastic nociceptive alteration in musicians. The lack of significance between the psychological traits and their effect on the pain ratings is surprising but could be a result of both participant groups having stressful careers.</p><p><strong>Significance: </strong>The findings of this report justify musicians' repetitive sensorimotor training as an important model for plasticity and contribute to a better understanding of pain perception in musicians.</p>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142461136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pain profiles and variability in temporal summation of pain and conditioned pain modulation in pain-free individuals and patients with low back pain, osteoarthritis, and fibromyalgia.","authors":"Kristian Kjær-Staal Petersen, Søren O'Neill, Morten Rune Blichfeldt-Eckhardt, Casper Nim, Lars Arendt-Nielsen, Henrik Bjarke Vægter","doi":"10.1002/ejp.4741","DOIUrl":"https://doi.org/10.1002/ejp.4741","url":null,"abstract":"<p><strong>Background: </strong>Pain profiles (e.g. pro- and anti-nociceptive) can be developed using quantitative sensory testing (QST) but substantial variability exists. This study describes the variability in temporal summation of pain (TSP) and conditioned pain modulation (CPM) in chronic musculoskeletal pain patients, proposes cut-off values, and explores the association with clinical pain intensity.</p><p><strong>Methods: </strong>This is a secondary analysis in which TSP and CPM were assessed using cuff algometry in pain-free subjects (n = 69), and patients with chronic low back pain (cLBP, n = 267), osteoarthritis (n = 134), and fibromyalgia (n = 101). Using TSP and CPM from the pain-free subjects as a reference, four distinct pain profiles TSP (low/high) and CPM (low/high) were created, and differences in clinical pain between pain profiles were explored.</p><p><strong>Results: </strong>Individual data revealed large inter-person variability. High TSP and low CPM were found in fibromyalgia (p < 0.01) and osteoarthritis (p < 0.01) but not cLBP when compared to pain-free subjects. The proportion of patients classified into the distinct pain profiles was significantly different (p < 0.001) with the largest proportion in the high TSP and low CPM group in fibromyalgia (52.5%) and osteoarthritis (41.4%). Clinical pain was not significantly different comparing the pain profiles, and no significant correlations were observed between clinical pain and TSP or CPM.</p><p><strong>Conclusion: </strong>These results demonstrated substantial inter-person variability in TSP and CPM in patients with different chronic pain conditions and pain-free subjects. The proportion of patients with a pro-nociceptive profile appears larger in fibromyalgia and osteoarthritis, but we found no association to clinical pain.</p><p><strong>Significant statement: </strong>This analysis shows that there is variability when assessing TSP and CPM in both pain-free subjects and patients with chronic pain. A cut-off for determining when a person is pain-sensitive is proposed, and data based on this cut-off approach suggest that significantly more patients with osteoarthritis and fibromyalgia are pain-sensitive (i.e. higher TSP and lower CPM) compared to pain-free subjects. This analysis does not find an association between pain sensitivity and clinical pain.</p>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142389110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peak alpha frequency differs between chronic back pain and chronic widespread pain.","authors":"Natalie McLain, Rocco Cavaleri, Jason Kutch","doi":"10.1002/ejp.4737","DOIUrl":"https://doi.org/10.1002/ejp.4737","url":null,"abstract":"<p><strong>Background: </strong>Low peak alpha frequency (PAF) is an electroencephalography (EEG) outcome associated reliably with high acute pain sensitivity. However, existing research suggests that the relationship between PAF and chronic pain is more variable. This variability could be attributable to chronic pain groups typically being examined as homogenous populations, without consideration being given to potential diagnosis-specific differences. Indeed, while emerging work has compared individuals with chronic pain to healthy controls, no previous studies have examined differences in PAF between diagnoses or across chronic pain subtypes.</p><p><strong>Methods: </strong>To address this gap, we reanalysed a dataset of resting state EEG previously used to demonstrate a lack of difference in PAF between individuals with chronic pain and healthy controls. In this new analysis, we separated patients by diagnosis before comparing PAF across three subgroups: chronic widespread pain (n = 30), chronic back pain (n = 38), and healthy controls (n = 87).</p><p><strong>Results: </strong>We replicate the original finding of no significant difference between chronic pain groups and controls, but also find that individuals with widespread pain had significantly higher global average PAF values than those of people with chronic back pain [p = 0.028, β = 0.25 Hz] after controlling for age, sex, and depression.</p><p><strong>Conclusions: </strong>These novel findings reveal PAF values in individuals with chronic pain may be diagnosis-specific and not uniformly shifted from the values of healthy controls. Future studies should account for diagnosis and be cautious with exploring homogenous 'chronic pain' classifications during investigations of PAF.</p><p><strong>Significance: </strong>Our work suggests that, contrary to previous hypotheses, inter-individual differences in PAF reflect diagnosis-specific mechanisms rather than the general presence of chronic pain, and therefore may have important implications for future work regarding individually-tailored pain management strategies.</p>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigating the light and shadow of scientific publishing faced with machine learning and generative AI.","authors":"Federico Palmisani, Daniel Segelcke, Jan Vollert","doi":"10.1002/ejp.4736","DOIUrl":"https://doi.org/10.1002/ejp.4736","url":null,"abstract":"<p><strong>Background: </strong>The public release of ChatGPT in November 2022 sparked a boom and public interest in generative artificial intelligence (AI) that has led to journals and journal families hastily releasing generative AI policies, ranging from asking authors for acknowledgement or declaration to the outright banning of use.</p><p><strong>Results: </strong>Here, we briefly discuss the basics of machine learning, generative AI, and how it will affect scientific publishing. We focus especially on potential risks and benefits to the scientific community as a whole and journals specifically.</p><p><strong>Conclusion: </strong>While the concerns of editors, for example about manufactured studies, are valid, some recently implemented or suggested policies will not be sustainable in the long run. The quality of generated text and code is quickly becoming so high that it will not only be impossible to detect the use of generative AI but would also mean taking a powerful tool away from researchers that can make their life easier every day.</p><p><strong>Significance: </strong>We discuss the history and current state of AI and highlight its relevance for medical publishing and pain research. We provide guidance on how to act now to increase good scientific practice in the world of ChatGPT and call for a task force focusing on improving publishing pain research with use of generative AI.</p>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neural correlates of pain acceptance and the role of the cerebellum: Functional connectivity and anatomical differences in individuals with headaches versus matched controls.","authors":"Vasilis S Vasiliou, Nikos Konstantinou, Yiolanda Christou, Savvas Papacostas, Fofi Constantinidou, Eleni Heracleous, Ioannis Seimenis, Maria Karekla","doi":"10.1002/ejp.4734","DOIUrl":"10.1002/ejp.4734","url":null,"abstract":"<p><strong>Background: </strong>Despite functional connectivity network dysfunction among individuals with headaches, no studies have examined functional connectivity neural correlates and anatomical differences in coping with headaches.</p><p><strong>Methods: </strong>This study investigated inter-individual variability in whole-brain functional connectivity and anatomical differences among 37 individuals with primary headaches and 24 age- and gender-matched controls, and neural correlates of psychological flexibility (PF) that was previously found to contribute to headache adjustment. Participants (84% women; M headache severity = 4/10; M age = 43 years) underwent functional magnetic resonance imaging scans and completed questionnaires to examine global and subnetwork brain areas, and their relations with PF components, controlling for age, gender, education, and head-motion.</p><p><strong>Results: </strong>Seed and voxel-based contrast analyses between groups showed atypical functional connectivity of regions involved in pain matrix and core resting-state networks. Pain acceptance was the sole PF component that correlated with the cerebellum (x, y, z: 28, -72, -34, p-false discovery rate <0.001), where individuals with headaches showed higher grey matter density compared to controls.</p><p><strong>Conclusions: </strong>The cerebellum, recently implicated in modulating emotional and cognitive processes, was indicated to process information resembling what individuals do when practicing pain acceptance. Our findings establish for the first time this connection of the cerebellum and its role in pain acceptance. We propose that pain acceptance might be a behavioural biomarker target that could modulate problematic headache perceptions and brain networks abnormalities.</p><p><strong>Significance: </strong>This study highlights the potential use of emerging behavioural biomarkers in headache management, such as pain acceptance, and their role in modifying the headache experience. Notably, grey matter reorganization in the cerebellum and other known brain pain networks, could indicate brain networks that can be modified from targeted behavioural interventions to help decode the nociplastic mechanisms that predominates in headaches.</p>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142344196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Persistence, not avoidance, is associated with low back pain-An observational cohort study.","authors":"Sabina Hotz-Boendermaker, Ursula Surbeck, Rita Morf, Fabian Pfeiffer","doi":"10.1002/ejp.4728","DOIUrl":"https://doi.org/10.1002/ejp.4728","url":null,"abstract":"<p><strong>Background: </strong>Low back pain (LBP) is increasingly understood as a long-lasting condition with a variable course. Avoidance and persistence behaviour have been described to mediate pain persistence by potentially linking psychosocial factors and biomechanics. The resulting maladaptive changes in musculoskeletal structures can result in movement control impairment (MCI). This investigation aimed to observe avoidance and persistence behaviour and MCI in participants with acute LBP over 1 year and explore their association with pain persistence.</p><p><strong>Methods: </strong>In this observational cohort study, 165 participants were assessed at five time points: ≤ 1 month (baseline), 2, 3, 6, and 12 months after the onset of acute LBP. Simultaneously collected clinical data such as self-reported outcomes at baseline for avoidance and persistence and assessments of MCI were filled in linear mixed-effects regression models.</p><p><strong>Results: </strong>The mixed-effects analysis revealed for the adjusted model that a one-point increase in persistence scores resulted in a 3.31-point increase in pain intensity while interacting with state anxiety over time (p = 0.05, 95% confidence interval 0.07-6.07). This effect was not found for avoidance behaviour at baseline (p = 0.21) and MCI.</p><p><strong>Conclusions: </strong>The relationship between persistence and pain intensity throughout measurement suggests that continuing usual activities beyond pain, coupled with feelings of distress, may lead to persistent LBP. These results underscore the need for a therapeutic shift toward a multidimensional approach that considers the physical and psychological characteristics of persons with LBP. Screening for activity patterns in acute LBP is critical for providing tailored treatment and counselling.</p><p><strong>Significance statement: </strong>In acute low back pain (LBP), maintaining usual activities despite pain and distress can contribute to the continuation of LBP. Alongside a multidimensional approach that considers physical and psychological factors, attitudes toward daily activities are also important. Screening for both maladaptive and adaptive activity patterns in individuals with acute LBP is essential for effective LBP management, improving patient outcomes, and preventing persistent pain.</p>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142344197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Geographical disparities in fibromyalgia severity: An Italian study.","authors":"Marco Di Carlo, Sonia Farah, Fabiola Atzeni, Alessandra Alciati, Manuela Di Franco, Cristina Iannuccelli, Laura Bazzichi, Gerolamo Bianchi, Massimo Giovale, Rosella Tirri, Serena Guiducci, Giuliana Guggino, Franco Franceschini, Rosario Foti, Alberto Lo Gullo, Giovanni Biasi, Elisa Gremese, Lorenzo Dagna, Enrico Tirri, Roberto Giacomelli, Alberto Batticiotto, Maurizio Cutolo, Piercarlo Sarzi-Puttini, Fausto Salaffi","doi":"10.1002/ejp.4735","DOIUrl":"https://doi.org/10.1002/ejp.4735","url":null,"abstract":"<p><strong>Background: </strong>Geographic origin may represent a variable capable of influencing health status. This study aims to investigate the presence of differences of disease severity in Italian patients with fibromyalgia from different macro-regions.</p><p><strong>Methods: </strong>This retrospective, cross-sectional study involved patients included in the Italian Fibromyalgia Registry. Three geographical macro-regions were identified, comprising patients from Northern Italy, Central Italy and Southern Italy. Clinical differences (evaluated through PolySymptomatic Distress Scale [PSD], revised Fibromyalgia Impact Questionnaire [FIQR] and modified Fibromyalgia Assessment Status [FASmod]) among the geographical macro-regions were studied using one-way analysis of variance (ANOVA) and the Scheffé's test.</p><p><strong>Results: </strong>A total of 6095 patients (5719 females and 376 males) were included, with 1957 from Northern Italy, 2979 from Central Italy and 1159 from Southern Italy. All studied clinical indices showed a trend indicative of greater disease severity in Southern Italy, followed by Northern Italy and then Central Italy (mean values for PSD: 19.97 ± 6.20 in Northern Italy, 18.61 ± 7.12 in Central Italy, 23.01 ± 5.66 in Souther Italy). These differences were statistically significant for the overall scores of all studied indices, evaluated with ANOVA (all p < 0.001) and in the head to head comparisons, evaluted with Scheffé's test.</p><p><strong>Conclusions: </strong>Geographic background is significantly associated with variations in the severity of fibromyalgia in Italian patients.</p><p><strong>Significance statement: </strong>This is the first study to demonstrate geographical origin-dependent intra-national differences in the severity of fibromyalgia. The results confirm the necessity of considering fibromyalgia within the context of the biopsychosocial model and of implementing healthcare policies targeted towards the most underserved regions.</p>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142344195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}