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At least 973 records · Page 54Linked to original sources
PubMed1995

Fear of movement/(re)injury in chronic low back pain and its relation to behavioral performance.

Two studies are presented that investigated 'fear of movement/(re)injury' in chronic musculoskeletal pain and its relation to behavioral performance. The 1st study examines the relation among fear of movement/(re)injury (as measured with the Dutch version of the Tampa Scale for Kinesiophobia (TSK-DV)) (Kori et al. 1990), biographical variables (age, pain duration, gender, use of supportive equipment, compensation status), pain-related variables (pain intensity, pain cognitions, pain coping) and affective distress (fear and depression) in a group of 103 chronic low back pain (CLBP) patients. In the 2nd study, motoric, psychophysiologic and self-report measures of fear are taken from 33 CLBP patients who are exposed to a single and relatively simple movement. Generally, findings demonstrated that the fear of movement/(re)injury is related to gender and compensation status, and more closely to measures of catastrophizing and depression, but in a much lesser degree to pain coping and pain intensity. Furthermore, subjects who report a high degree of fear of movement/(re)injury show more fear and escape/avoidance when exposed to a simple movement. The discussion focuses on the clinical relevance of the construct of fear of movement/(re)injury and research questions that remain to be answered.

Adaptation, Psychological↗
PubMed2006

The detection of malingered post-traumatic stress disorder.

The detection of malingered PTSD is made particularly challenging by the subjective nature of PTSD criteria and requires a thorough, systematic approach. The psychiatrist must gather and analyze evidence from the evaluation, clinical records, psychologic testing, third parties, and other sources. Although some individuals may malinger PTSD to avoid criminal sanctions, the most common motivation for malingering PTSD is financial gain. Clinical nuances may help distinguish genuine from malingered PTSD. The psychiatrist should be aware of the differences observed between civilian and combat-related PTSD. Although special effort is required, the psychiatrist bears considerable responsibility to assist society in differentiating true PTSD from malingering.Undetected malingering is not limited simply to fraudulent monetary awards, but can involve misuse of limited mental health resources, leading to negative consequences for the mental health system. As Burkett aptly notes, malingered combat PTSD cases "take time, energy, and financial resources away from treating true combat veterans with PTSD. And real combat vets who truly need help end up in group therapy with phonies, get disgusted, and quit treatment".

Combat Disorders↗
PubMed2000

[Effectiveness and usefulness of neuropsychological rehabilitation methods].

Every year, more than half a million people in Germany experience a stroke or a traumatic brain injury. A high percentage of them leave the hospital with neuropsychological deficiencies of attention, memory, speech or perception preventing them from returning to work. The German rehabilitation system is primarily funded by the statutory pension insurance system and is hospital-based, but only very few brain-damaged patients have the opportunity to be treated there. Hospital rehabilitation programmes often integrate neuropsychological trainings whereas neuropsychologically based outpatient programmes do not exist. Therefore two questions are crucial. First, are those separate neuropsychological trainings effective? Second, are positive effects generalized? Studies concerning these questions are reviewed. Not many of them, however, meet the usual requirements for valid intervention research, and their findings are equivocal. Nevertheless, they suggest that neuropsychological rehabilitation should be undertaken more frequently, which would offer a framework for future efficacy research.

Attention↗
PubMed2005

[Simulation of deafness in expertise affairs].

The simulation of deafness rarely occurs in the course of medical expertise. However, it is a problem that needs to be recognized and demonstrated by proving methods of investigation. For this purpose, a number of subjective and objective hearing tests exist which can provide evidence for the simulation of uni- or bilateral hearing loss. These methods include the measurement of oto-acoustic emissions, brainstem-evoked response audiometry and the determination of the stapedius reflex threshold as well as subjective methods such as Stenger- and Lee-test. Among the expertise carried out in our department during the past few years, we found 5 cases of simulation of deafness. In these cases -- as opposed to simulated traffic accidents -- there was no criminal prosecution regarding insurance fraud.

Adolescent↗
PubMed2006

[Treatment results from inpatient psychosomatic rehabilitation of Turkish migrants: a prospective study].

Psychosomatic rehabilitation and the concluding social-medical assessment constitute a particular challenge. The aim of this study was to examine whether inpatient psychosomatic rehabilitation in the context of an integrated treatment concept, conducted in Turkish and German, is effective in the rehabilitation of Turkish migrant laborers, and what concluding socio-medical assessment results from this treatment. 195 Turkish patients--44 male and 151 female--received inpatient psychosomatic treatment for approximately 40 days. Sociodemographic, psychiatric and social-medical data were recorded, as well as Symptom Checklist (SCL-90-R) testing upon admission and discharge. A predominant number of patients were laborers, with a low level of primary education, who were afflicted with psychosocial problems and dissatisfaction with their workplace and who first came into psychosomatic treatment many years following the onset of their illness. Many of them had a clearly defined desire to retire. At the end of their admission, a significant improvement in almost all the scales of the SCL-R-90 was ascertained on the one hand, but on the other, adequate socio-medical results were hardly observed. The symptoms' improvement would confirm that the combination of service offerings in Turkish and German proved themselves. A portion of the patients (approx. 40 %) were classified subsequent to treatment as capable of working for 6 hours or more. Nevertheless, approximately approx. 75 % still sought to retire. Timely psychosomatic treatment could counteract chronification of the illness and the establishment of a steadfast desire to enter retirement, and consequently represent an improvement in the prognosis. Likewise, consistent psychosomatic training of physicians, as well as systematic prophylactic measures with the migrant laborers, should be considered.

Adult↗
PubMed2003

Presence of post-concussion syndrome symptoms in patients with chronic pain vs mild traumatic brain injury.

PRIMARY OBJECTIVE: Post-concussion syndrome (PCS) is a controversial diagnosis, in part because many symptoms may be present in other conditions, such as chronic pain (CP). However, direct comparisons between people with CP and mild traumatic brain injury (MTBI) are limited. The purpose of this study was to compare people with CP and MTBI on a measure of PCS symptoms. DESIGN: Group comparison between patients with CP and MTBI on the Rivermead Post-Concussion Questionnaire (RPCQ). METHODS: Sixty-three patients with CP and 32 with MTBI were evaluated at the authors' institutions. Patients completed the RPCQ as part of their initial evaluation. RESULTS: No group differences were found for total RPCQ scores. There were some differences in the proportion of patients endorsing specific symptoms. However, most people with CP endorsed symptoms consistent with PCS. CONCLUSIONS: PCS symptoms are not unique to MTBI, and may be seen in conditions such as CP.

Adult↗
PubMed2004

Swedish Council on Technology Assessment in Health Care (SBU). Chapter 12. Future need for research.

Despite the extensive consequences of sickness absence, scientific research is both surprisingly scarce and theoretically and conceptually underdeveloped. There are few longitudinal studies, and even fewer intervention studies. The medical aspects in sickness insurance are seldom addressed, effects of factors at different structural levels are not considered,and the consequences of sick leave have barely been studied. Furthermore, little is known about the employer's role and the layperson's perspectives. Gender and ethnicity factors should be considered further. The concept of work ability needs to be defined, problematized, and operationalized. However, it is not only more, but mainly it is studies of better quality that are needed, e.g. longitudinal studies, international comparative studies, and randomised controlled trials. This would require multidisciplinary research groups, long-term research environments, international commitment, opportunities for good professional development within the field, and reliable basic data, including sick-listing diagnoses.

Absenteeism↗
PubMed2000

Multidisciplinary vocational rehabilitation focusing on work training and case management for unemployed sick-listed people.

Twenty-four unemployed sick-listed people were referred during 1996 and 1997 to a multidisciplinary vocational rehabilitation programme with additional work training and case management. Twelve months after the programme, 54.2% in the study group had lowered their benefit levels compared with those at the start while 26.1% in the control group - who underwent a conventional rehabilitation programme - had lowered their benefit levels (p = 0.050, Chi-squared test). There were no significant differences regarding fewer sick days three and 12 months after the programme between the study group and the control group. Regarding self-assessed quality of life, there were no significant differences within or between the groups. We conclude that this multidisciplinary vocational rehabilitation programme with work training and case-management affected the outcome positively regarding lowered level of benefits 12 months after termination of programme compared with level at start. Studies of the long-term effect of the programme should, however, be performed with more subjects in both study group and control group.

Adult↗
PubMed2006

Cognitive functioning in patients with suspected chronic toxic encephalopathy: evidence for neuropsychological disturbances after controlling for insufficient effort.

OBJECTIVES: Chronic toxic encephalopathy (CTE) caused by long term occupational exposure to organic solvents is still a controversial disorder. Neuropsychological testing is the cornerstone for diagnosing the syndrome, but can be negatively influenced by motivational problems. In this nationwide study, we investigated the neuropsychological functioning and psychological symptoms of a large group of patients with suspected CTE, and ruled out alternative explanations for their complaints, including suboptimal performance due to insufficient effort. METHODS: We studied participants with suspected CTE (n = 386) who were referred for further diagnosis to the Netherlands Centre of Occupational Diseases in the period 1998-2003 and who had completed the entire diagnostic protocol. Patients were excluded if there was the slightest suspicion that test performance had been negatively influenced by insufficient effort (n = 221), or if comprehensive assessment identified an alternative diagnosis (n = 80). Insufficient effort was defined by a combination of three indices. The neuropsychological test scores of the patient group (n = 85) were compared with those of a control group of building trade workers matched for sex, age, and educational level (n = 35). RESULTS: The patient group had significantly more psychological complaints and performed significantly worse than the control group on tests of speed of information processing and memory and learning. However, only a small percentage of the patients had clearly abnormal scores for cognitive speed (9%) or memory (8%). Attention, verbal abilities, and constructional functions were not disturbed. Exposure duration and cognitive complaints were significantly correlated, whereas the correlation between exposure duration and neuropsychological domain scores was not significant. CONCLUSIONS: Insufficient effort was present in a substantial part of the patient group. After minimising the likelihood that insufficient effort negatively influenced neuropsychological scores, we still found neuropsychological deficits in speed of cognitive processing and memory; however, these scores were clearly abnormal only in a minority of patients with suspected CTE. Screening instruments should focus on these domains.

Adult↗