'Medical or physical management of facial muscle and joint pain'.
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Biomedical subjects
Publications and source records attributed to C Feinmann.
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Ninety three patients took part in a two centre double blind controlled clinical trial designed to assess the efficacy of dothiepin (Prothiaden) as compared with placebo and a soft biteguard in the treatment of psychogenic facial pain. The results showed the superiority of dothiepin over placebo in achieving pain relief; 71% of patients were pain free in the dothiepin group at nine weeks compared with 47% in the placebo group. The biteguard conferred no benefit and compliance in its use was poor. Out of 84 patients followed up for 12 months, 68 (81%) became pain free. An adverse life event before development of pain, minimal previous surgical treatment, and freedom from pain at nine weeks were strong prognostic indicators for successful treatment. These results are clear evidence of the efficacy of dothiepin in psychogenic facial pain, though the drug may be needed for up to a year.
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An account is given of a two-centre controlled clinical trial to assess the efficacy of dothiepin (Prothiaden) against placebo and a soft bite-guard in the treatment of psychogenic facial pain. The results confirm the superiority of the dothiepin to placebo in achieving pain relief, but show no benefit from the use of mechanical treatment. Short-term relapse of pain which occurred in the follow-up period was not associated with recurrence of psychiatric symptoms but appeared to be directly related to withdrawal of dothiepin.
A new technique designed to measure a patient's anxiety during a psychotherapeutic interview is described. Videotaped recordings were made of interviews between 2 psychotherapists and 6 patients. The anxiety levels experienced by the patients during the interview were measured in three ways. One therapist signalled his recognition of a patient's changing anxiety levels and his interventions to manipulate the patient's anxiety during the interview. Subsequently, the 2 therapists and 6 patients made independent retrospective ratings while viewing a recording of the interview. Significant agreement was found between three sets of ratings and the results suggest that the technique may be of value in psychotherapy process research.
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