Biomedical subjects

R Lousberg

Publications and source records attributed to R Lousberg.

13 recordsLinked to original sources

PubMed1999

Psychometric properties of the Multidimensional Pain Inventory, Dutch language version (MPI-DLV).

The purpose of this study was to investigate the psychometric properties of a Dutch translation of the Multidimensional Pain Inventory, MPI-DLV. Data was available on 733 chronic pain patients. There were three issues of special interest. The first one related to the comparability between the MPI-DLV and the American and German MPI versions with regard to the psychometric aspects. The second dealt with the construct validity of the MPI-DLV scale 'general activity'. It was predicted that patients with high scores on this scale would be in better physical condition, as measured on a working-to-tolerance bicycle ergometer test. In relation to the third issue, attention was given to the factor-invariance between fibromyalgia patients and back pain patients. From the results obtained it was concluded that (1) the factorial structure of the three MPI parts is replicated and the reliability estimates and validity indicators are similar to those from the American and German versions; (2) patients with high scores on the 'general activity' scale are in better physical condition and (3) MPI-DLVs of fibromyalgia and back pain patients do have similar factorial structures. Evidence was also obtained that the MPI-DLV is sensitive to treatment changes. Applications of the MPI-DLV are discussed.

Adult↗

PubMed1999

Distribution of psychological aspects in subgroups of chronic low back pain patients divided on the score of physical performance.

This study investigates whether different subgroups of chronic low back pain patients (CLBPs) differ in psychological aspects assessed with the Symptom Checklist (SCL-90) and the Multidimensional Pain Questionnaire (MPI-DLV). Four subgroups of CLBPs are discerned using the results of lumbar dynamometry: 1. Patients with performances lower than healthy subjects (expected performance; n = 45). 2. Patients with performances comparable to healthy subjects (normal performance; n = 18). 3. Patients with inconsistent test behaviour (submaximal performance; n = 6). 4. Patients with performances that could be either maximal or submaximal (gray-zone performance; n = 10). Significant differences in psychological aspects were found between patients with submaximal and patients with expected performances but not between patients with normal and patients with expected performances. All patients with submaximal performance report a high degree of psychological distress, in contrast to 30% of those with normal performance and 20% of those with expected performance. Because of the differences found in psychological aspects between the CLBP subgroups, it is thought that a physical screening together with a psychological screening provides better insight in the two aspects of the deconditioning syndrome and thus can give better treatment indications than a physical screening alone.

Adult↗

PubMed1998

Cardiac side-effects of two selective serotonin reuptake inhibitors in middle-aged and elderly depressed patients.

Selective serotonin reuptake inhibitors (SSRIs) are the 'new' drugs of first choice for the treatment of depression in the older patient. Systematic studies on the effects of SSRIs on cardiac function are scarce, despite the high prevalence of cardiac disorders in the older depressed patient. This is a study which systematically assessed cardiac function by echocardiography in middle-aged and elderly depressed patients treated with SSRI. In a double-blind randomized trial, 20 patients were assigned to receive fluvoxamine 100 mg/day [DOSAGE ERROR CORRECTED] or fluoxetine 20 mg/day [DOSAGE ERROR CORRECTED] for 6 weeks. Cardiac function was assessed by left ventricle ejection fraction, aortic flow integral and early or passive/late or active mitral inflow, and electrocardiography. Neither SSRI significantly affected cardiac function. Compared with patients without a history of myocardial infarction and/or hypertension, patients with such a history showed a significant improvement in left ventricular ejection fraction. Despite our small study sample, these data indicate that both fluoxetine and fluvoxamine do not affect cardiac function adversely.

Aged↗

PubMed1997

[Depression following a first heart infarct; similarities with and differences from 'ordinary' depression].

OBJECTIVE: To determine frequency and clinical features of major depressive disorder according to DSM IV criteria in patients following a first myocardial infarction. DESIGN: Questionnaire. SETTING: Departments of Cardiology and Psychiatry, University Hospital Maastricht, the Netherlands. METHOD: Depression was assessed using the Zung 'Self-rating depression scale' (Zung-SDS) and the 'Symptom checklist' (SCL)-90 in 228 patients who filled the questionnaires out themselves (response: 60-70%), 1, 3, 6 en 12 months after their first heart attack. When the score on one or both lists was above threshold, the patient was invited for a clinical interview with a psychiatrist. RESULTS: One month post infarction 10% were diagnosed with a major depressive episode, a percentage which increased to 34% one year post infarction. The clinical features of the depression in these patients were the same as in a matched sample of depressed psychiatric inpatients without a cardiac history, except that hostility was significantly increased in the post-infarction patients. There was no mortality. CONCLUSION: Depressive disorder is a frequent comorbid disease after a first myocardial infarction.

Depression↗

PubMed1997

Within-person relationships among pain intensity, mood and physical activity in chronic pain: a naturalistic approach.

Fifty-seven chronic pain patients rated their pain intensity, mood and activity level, at a random time schedule, eight times a day during 6 consecutive days, according to the Experience Sampling Method (ESM). Within-person correlations among pain intensity, mood and activity level were calculated. We found pain intensity to be significantly associated with mood. However, the associations between pain intensity and activity level, and activity level and mood could not be supported. Further, we examined whether the relationship between pain intensity and mood was the result of a pattern across the day. Results showed that pain intensity and mood were worst in the morning and improved during the afternoon among participants whose pain intensity and mood were correlated significantly. We suggest that attentional as well as behavioural processes might explain the established day pattern of pain intensity and mood.

Adult↗

PubMed1997

Validating the MPI-DLV using experience sampling data.

The present study investigates the relationship between scale scores on the Dutch version of the Multidimensional Pain Inventory (MPI-DLV) and data derived from comparable items from an experience sampling procedure. Fifty-seven chronic pain patients participated in the study, which lasted 6 consecutive days. Special attention was given to the relationship between the MPI-DLV pain intensity score and the mean experience sampling pain intensity score. Significant correlations were found between the MPI-DLV scales Pain Severity, Interference, Solicitous, Punishing and Distracting Responses, and Household Chores and their experience sampling analogues. A marginally significant correlation was found with regard to the MPI-DLV Life Control scale. The General Activity and Affective Distress scales had no relationship with the analogous experience sampling items. The significant correlations were regarded as further validation of the MPI-DLV. A regression analysis revealed that 58% of the variance of the experience sampling pain intensity score could be explained by the MPI-DLV present pain intensity item score.

Adult↗

PubMed1996

Profile characteristics of the MPI-DLV clusters of pain patients.

This article describes an investigation into whether there are differences among the four pain patient clusters from the Multidimensional Pain Inventory-Dutch Language Version (MPI-DLV) in terms of prescribed analgesic medication, level of intelligence, and other personality characteristics (MMPI). Dysfunctional patients were distinguished by a higher level of analgesic medication intake. Patients classified as Average were marked by a marginally significant higher level of intelligence. The personality profile of Interpersonally Distressed patients indicated an elevated neurotic triad and a tendency to a passive-aggressive personality structure. Patients classified as Dysfunctional and Average were marked by the so-called conversion-V. There were no elevated scales in the Adaptive Coper profile. Clinical implications are discussed.

Adaptation, Psychological↗

PubMed1996

Radiofrequency lesion adjacent to the dorsal root ganglion for cervicobrachial pain: a prospective double blind randomized study.

Each of 20 consecutive patients with a history of at least 1 year of intractable chronic cervicobrachial pain was randomly assigned to one of two treatment groups. The pretreatment investigation included at least three diagnostic segmental nerve blocks in each patient. Each patient in Group 1 received a 67 degrees C radiofrequency lesion adjacent to the dorsal root ganglion. The patients in Group II were treated in an identical manner as those in Group I, except that no actual radiofrequency lesion was made. Neither the therapist nor the patients were aware of the treatment group assignment. All patients were questioned about their pain experience 1 week before and 8 weeks after the procedure. The following tests were used in evaluating patient response: Visual Analogue Scale (VAS); McGill Pain Questionnaire, Dutch Language Version (MPQ-DLV); and Multidimensional Pain Inventory, Dutch Language Version (MPI-DLV). These tests showed that 8 weeks after the procedure, there was a significant number of "successful" patients in Group I compared to Group II (P = 0.0027); there was a significant reduction in VAS score (P < 0.01) and also in parameters measured with MPQ-DLV and MPI-DLV in Group I. This study indicates that a 67 degrees C radiofrequency lesion adjacent to the dorsal root ganglion can result in a significant alleviation of pain in chronic cervicobrachial pain.

Adult↗

PubMed1996

Operant conditioning of the pain experience.

Two experiments were carried out to study operant conditioning of pain report. Further, it was investigated whether pain-related psychophysiological and psychological measures (skin conductance response and magnitude matching) could also be conditioned operantly. In both experiments subjects received 12 painful electric shocks of equal intensity. In Exp. 1 healthy subjects were assigned to either a control group or an up-conditioning group. Up-conditioning occurred by verbally rewarding increases in pain report and punishing decreases. Analyses indicated that up-conditioning of both pain report and the pain-related psychophysiological measures succeeded. To rule out alternative explanations of the results (attention shift towards pain and conditioning of anxiety) the verbal punishments were adjusted in Exp. 2. A down-conditioning group was also added. The attempt to replicate the results of Exp. 1 failed and down-conditioning of the pain report could not be established. These inconsistent results are most probably due to modified punishment of responses. The consequences for the results of Exp. 1 are discussed. Based on the results of post hoc analyses, some suggestions are made for operant conditioning studies of pain.

Adolescent↗

PubMed1995

Effects of producing a radiofrequency lesion adjacent to the dorsal root ganglion in patients with thoracic segmental pain.

OBJECTIVE: To evaluate the effectiveness of a radiofrequency lesion adjacent to the dorsal root ganglion (RF-DRG) on a consecutive group of patients presenting with chronic thoracic pain. DESIGN: Retrospective study by a disinterested third party. SETTING: Clinical outcome study. PATIENTS: Forty-three patients with a minimum of 6 months history of unilateral thoracic segmental pain, unresponsive to conservative therapy were involved. INTERVENTIONS: Patients were selected for a radiofrequency lesion adjacent to the dorsal root ganglion after two or more prognostic nerve blocks had been performed under fluoroscopic control. The level which provided the best analgesic response was selected. At this level, a radiofrequency lesion was made at 67 degrees for 60 s immediately adjacent to the dorsal root ganglion. OUTCOME MEASURES: Rating of pain was done on a four-step verbal rating scale. RESULTS: A radiofrequency lesion adjacent to the dorsal root ganglion provided short-term (8 weeks) relief of pain in 67% and long-term relief (> 36 weeks) of pain in 52% of patients with a limited segmental distribution of pain. If more than two segmental levels were involved, the procedure was found to be less effective. CONCLUSIONS: There was a significantly (p < 0.05) better short-term and long-term pain relief in patients with a clearly localized pain that was confined to one or two thoracic segmental levels, compared to patients with more than two segmental levels involved in the pain syndrome.

Adolescent↗

PubMed1993

Hypochondriasis in ENT practice.

In this study the incidence of hypochondriasis among new ENT out-patients was investigated. A validated questionnaire, which was administered twice with an interval of 3 months, was used to make the diagnosis. Medical information also played a part in the assessment. The diagnosis hypochondriasis applied to 13% of the patients who completed the entire diagnostic procedure. This group made very frequent use of a range of medical services and took a large amount of medicine. Compared with the non-hypochondriacal ENT group, the hypochondriacal group had a more negative opinion about their own health, although those in the latter group were less ill, measured by objective criteria. In order to be able to diagnose hypochondriasis in ENT practice, psychological or psychiatrical consultation is necessary.

Adolescent↗

PubMed1990

Is the match/mismatch model based on a statistical artefact?

In the match/mismatch model, recently formulated by Rachman and coworkers, it is stated that incorrectly predicted aversive experiences are generally followed by an immediate adjustment of the predictions concerning aversiveness of the next experience. This model can be considered to reflect a psychological process of the formation of expectations. In the present article it is argued that a simple H0 model, assuming that predictions are completely randomly generated by the subject, may account for the same effects. This H0 model is used in a stringent test of empirical data to determine if there are any effects of the discrepancy between prediction and experience on next prediction that exceed the effects explained by the H0 model. Although the H0 model produces effects very similar to the empirically observed effects, there is clear support for the hypothesized influence of the discrepancy between prediction and experience. Therefore, the model appears to reflect 'real' psychological processes and not chance findings.

Agoraphobia↗

PubMed1990

The effects of underestimated pain and their relationship to habituation.

The intensity of a painful stimulus was experimentally manipulated in order to induce underpredictions of pain. The experiment aimed at (1) replicating previous findings on the effects of underpredicted pain and (2) investigating the relationship between underpredicted pain and habituation. Most previous findings were replicated: underpredictions of pain were followed by raised expectations of pain and increased fear of pain. In addition, the underprediction had long-term effects on fear of pain, uncertainty about predictions, and expected aversiveness of the painful stimulus. In contrast to previous findings and to Rachman's match/mismatch model, it was found that underpredicted pain can have dishabituating effects. It is theorized that inaccurately predicted pain can cause dishabituation, depending on the extent of the underprediction and on the subjective certainty of the prediction. Theoretical and clinical implications are discussed.

Adolescent↗