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Biomedical subjects

Harold Merskey

Publications and source records attributed to Harold Merskey.

27 records · Page 2Linked to original sources
PubMed1993

Chronic musculoskeletal pain and depressive symptoms in the National Health and Nutrition Examination. I. Epidemiologic follow-up study.

We report here follow-up data on subjects who were examined in two surveys conducted by the United States Center for Health Statistics at an interval of 8 years. The first survey was the 1st National Health and Nutrition Examination Survey (NHANES-1), and the second conducted 8 years later was the National Health and Nutrition Epidemiologic Follow-up Study (NHEFS). From an original sample of 3023 subjects, 153 were known to be deceased, leaving a potential sample of 2870 cases, of whom 2341 were ultimately examined in the NHEFS. The definition of pain used in the NHANES-1 survey identified 15% of the subjects as suffering from persistent pain. Using a different pain definition, in the NHEFS, the frequency of subjects with chronic pain was 32.8%. Applying this second definition, the percentage of subjects with chronic pain in the NHANES-1 had risen from 15 to 20.2. Some subjects (32.5%) who originally had chronic pain were free from pain at the time of follow-up; 59% of the subjects with chronic pain on follow-up did not have it initially. As found originally in the NHANES-1, the group with chronic pain at the NHEFS comprised significantly more females, older people, and people with lower income. On logistic regression analysis the strongest relationship found at the NHEFS between the variables examined was between chronic pain and depression.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Chronic musculoskeletal pain and depressive symptoms in the general population. An analysis of the 1st National Health and Nutrition Examination Survey data.

Chronic pain and depression frequently occur together. A selection bias afflicts all hospital clinic and family practice populations in which this relationship has been examined. We report here some of the results from civilian populations outside institutions, examined in the United States in national surveys. The findings are based upon the recollection of individuals with respect to the period of 12 months prior to interview and upon the occurrence of depression in the previous week as indicated by the answers to the Depression Scale of the Centre for Epidemiologic Studies (CES-D). They indicate that 14.4% of the United States population between the ages of 25-74 suffer from definite chronic pain related to the joints and musculoskeletal system. Another 7.4% have some pain of uncertain duration. Eighty-three percent of the definite pain group received treatment. Chronic pain subjects scored significantly higher than normals on the CES-D (10.68 +/- S.E.M. 0.76 vs. 8.05 +/- 0.23, P less than 0.01) with subjects with pain of uncertain duration scoring similar to the definite chronic pain population (11.13 +/- 0.76). Using a high cut-off score for depression. 18% of the population with chronic pain were found to have depression. This is in contrast to 8% of the population who did not have chronic pain.

Adult↗
PubMed1990

Psychological defence mechanisms in patients with pain.

There is a long standing position that pain, and especially chronic pain, may arise from psychological mechanisms of defence. We have compared a group of chronic pain patients with a sample of psychiatric patients attending for reasons other than pain. The pain group had less evidence of poor care in childhood (measured by the Parental Bonding Instrument) and tended to use more mature psychological defence mechanisms (assessed with the Defense Mechanisms Inventory), compared with the other group. The pain group also had fewer current psychiatric diagnoses but more evidence of anxiety and depression on the Hospital Anxiety and Depression Scale. We conclude that in general the patients with chronic pain had more normal childhoods and more mature defences than the psychiatric control group. They showed an increase in the diagnosis of depression, attributable to reactive factors. In the sample of patients with pain the majority of the psychological change cannot be attributed to the operation of primitive psychological defences.

Adult↗
PubMed1987

A simple examination of the relationships between pain, organic lesions and psychiatric illness.

It is often assumed that pain can be caused by psychological illness and also that severely painful organic lesions may cause emotional change. If these assumptions are correct, pain in the absence of lesions should be associated with a very high rate of psychiatric diagnosis; pain with lesions should occur with psychological illness more often than by chance but less often than in the group without lesions. To test these hypotheses two groups have been compared, one with pain and no evidence of organic lesions, the other with pain proportionate to organic lesions. Ninety-seven per cent of the first group and 39% of the second group were found to have psychiatric conditions (P less than 0.001).

Adult↗
PubMed1979

Biofeedback therapy for headache and other pain: an evaluative review.

A survey of the literature is presented in two areas of biofeedback treatment for headache--muscle contraction and migraine--and a variety of miscellaneous pain syndromes. The studies done to date are characterized largely by lack of proper no-treatment or placebo control groups, by confounding biofeedback with a variety of other strategies, or by sample sizes too small to afford any reasonable conclusions about efficacy. There is some evidence that biofeedback works better for muscle contraction headache than false feedback, but it also appears that biofeedback is no more effective than relaxation training. The application of biofeedback to migraine or other pain syndromes remains of unproven value. Investigators seldom attempt to relate empirically their interventions to hypothetical models of pain mechanisms. The potential influence of extraneous factors linked to the therapeutic situation is pervasive in these studies, but examination of their specific roles in symptom reduction is largely missing. Some variables are listed which need to be examined and which may contribute to the alleviation of pain with much less expenditure of clinical resources than that demanded by biofeedback. Perhaps the main contribution of biofeedback has been to highlight such extraneous variables in the pain treatment setting.

Adolescent↗
PubMed1978

Abdominal pain and the emotions.

Sites in the gut that are related to pain are reviewed with respect to the special psychophysiological factors that operate locally. Topics considered are the irritable bowel, appendicitis and appendicectomy, duodenal ulceration and biliary disorders. Psychological states that promote the complaint or experience of abdominal pain are discussed. Possible psychological mechanisms are considered for abdominal pain with the reservation that we still do not know even the main physical mechanisms of pain related to gut disturbance.

Abdomen↗