PubMed · 10304115
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P J Maraldo. 1989. The nursing solution.. https://pubmed.ncbi.nlm.nih.gov/10304115/
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The natural history of schizophrenia is often chronic and debilitating, an enduring fact that draws attention to the first episode and early course of the disorder when neurobiological deficits apparently form. Many recent studies have focused on the duration of untreated psychosis (DUP) in first-episode patients for reasons that are reviewed here. DUP is often months or years in length, making it a major public mental health problem. Reducing DUP through early detection may be possible from a service systems perspective. This may be very important because earlier treatment not only reduces acute psychotic symptoms, but may also improve long-term prognosis by attenuating the deficit processes active at this time; processes that are either signaled by or a product of DUP. Finally, DUP appears to influence sampling in first-episode research in that longer DUP is associated with higher recruitment refusal rates to studies. For all of these reasons, DUP should be added to the battery of descriptive variables routinely collected on all patients with schizophrenia, whether for treatment or research.
STUDY DESIGN: A cross-sectional study of baseline correlates of clinical pain and functional status in consecutive patients being treated for chronic low back pain. OBJECTIVES: To determine if an individual's global pain sensitivity, measured by experimental pain threshold to pressure at various regions of the body, is associated with baseline measures of clinical pain and physical functioning. SUMMARY OF BACKGROUND DATA: Previous studies have demonstrated that in individuals with chronic low back pain, clinical pain and functional status are significantly associated with demographic, structural, and psychosocial factors. However, a large portion of variance remains unexplained. Because pain sensitivity (tenderness) has been shown to occur as a continuum in the population, the authors sought to determine if such sensitivity might be associated with clinical status in chronic low back pain, beyond what is known regarding demographic, structural, and psychosocial factors. METHODS: Forty-five patients with chronic low back pain were assessed for a variety of demographic, structural, and psychosocial factors, which previously have been shown to contribute to clinical status. In addition, all patients underwent testing for pain tolerance and threshold at various areas of the body. RESULTS: Age, degree of structural abnormality observed on magnetic resonance imaging, and depressive symptoms were all significantly correlated with either clinical pain or functional status. Pain sensitivity, the target of this investigation, accounted for significant proportions of variance in functional status and pain, even after controlling for demographic, structural, and psychosocial variables. CONCLUSIONS: These pilot data suggest that an individual's experimental pain threshold (a measure of tenderness) is associated with baseline functional status and pain in cases of chronic low back pain and may represent an important domain warranting further investigation.