Pain Sensitivity and Psychiatric Comorbidities in Chronic Pancreatitis Patients With and Without Pain: Past Experience Matters
Background and Aims: Pain is the primary symptom of chronic pancreatitis (CP) and has been associated with abnormal pain processing and psychologic distress. Little is known about these phenomena in patients with painless disease. The aim of this study was to characterize patterns of pain processing...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2022-01-01
|
| Series: | Gastro Hep Advances |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772572322000668 |
| _version_ | 1811274035196067840 |
|---|---|
| author | Anna E. Phillips Benjamin L. Bick Mahya Faghih Dhiraj Yadav Asbjørn M. Drewes Vikesh K. Singh Søren S. Olesen |
| author_facet | Anna E. Phillips Benjamin L. Bick Mahya Faghih Dhiraj Yadav Asbjørn M. Drewes Vikesh K. Singh Søren S. Olesen |
| author_sort | Anna E. Phillips |
| collection | DOAJ |
| description | Background and Aims: Pain is the primary symptom of chronic pancreatitis (CP) and has been associated with abnormal pain processing and psychologic distress. Little is known about these phenomena in patients with painless disease. The aim of this study was to characterize patterns of pain processing and psychologic distress in patients with primary painless vs painful CP. Methods: This was a cross-sectional multicenter study of 235 patients with definitive CP. Patients were categorized based on current and past pain history; current pain (79%), no current (but prior) pain (11%), and painless CP (10%). Demographic information and clinical data including symptoms of anxiety and depression using the Hospital Anxiety and Depression Scale were collected. All patients underwent quantitative sensory testing to assess patterns of pain processing. Results: A total of 235 patients (57% males, mean age 53.9 ± 14.0 years, 41% alcohol etiology) were included. Compared to patients with painless CP, enhanced pain sensitivity was observed in both patients with current pain (odds ratio [OR] 3.29; 95% confidence interval [CI] [1.11–9.77], P = .032) and no current pain (OR 4.07; 95% CI [1.10–15.03], P = .035). Patients with current pain also had increased depression prevalence compared to patients with painless CP (OR 6.15; 95% CI [1.28–29.41], P = .023), while no difference was seen for patients with no current pain (OR 1.24; 95% CI [0.19–8.26], P = .824). Conclusion: Total absence of pain in CP is associated with normal pain processing and low prevalence of psychologic distress, whereas patients with prior pain experience appear to have persistent and enhanced pain sensitivity even in the absence of clinical pain and psychologic distress. |
| first_indexed | 2024-04-12T23:10:32Z |
| format | Article |
| id | doaj.art-6af5b56a38bb42d7bf2f94b08d92157d |
| institution | Directory Open Access Journal |
| issn | 2772-5723 |
| language | English |
| last_indexed | 2024-04-12T23:10:32Z |
| publishDate | 2022-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Gastro Hep Advances |
| spelling | doaj.art-6af5b56a38bb42d7bf2f94b08d92157d2022-12-22T03:12:48ZengElsevierGastro Hep Advances2772-57232022-01-0115796802Pain Sensitivity and Psychiatric Comorbidities in Chronic Pancreatitis Patients With and Without Pain: Past Experience MattersAnna E. Phillips0Benjamin L. Bick1Mahya Faghih2Dhiraj Yadav3Asbjørn M. Drewes4Vikesh K. Singh5Søren S. Olesen6Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PennsylvaniaDivision of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, IndianaDivision of Gastroenterology and Hepatology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MarylandDivision of Gastroenterology, Hepatology, and Nutrition, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PennsylvaniaDepartment of Gastroenterology and Hepatology, Centre for Pancreatic Diseases and Mech-Sense, Aalborg University Hospital, Aalborg, DenmarkDivision of Gastroenterology and Hepatology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MarylandDepartment of Gastroenterology and Hepatology, Centre for Pancreatic Diseases and Mech-Sense, Aalborg University Hospital, Aalborg, Denmark; Correspondence: Address correspondence to: Søren S. Olesen, MD, PhD, Department of Gastroenterology and Hepatology, Centre for Pancreatic Diseases, Aalborg University Hospital, Mølleparkvej 4, Aalborg 9000, Denmark.Background and Aims: Pain is the primary symptom of chronic pancreatitis (CP) and has been associated with abnormal pain processing and psychologic distress. Little is known about these phenomena in patients with painless disease. The aim of this study was to characterize patterns of pain processing and psychologic distress in patients with primary painless vs painful CP. Methods: This was a cross-sectional multicenter study of 235 patients with definitive CP. Patients were categorized based on current and past pain history; current pain (79%), no current (but prior) pain (11%), and painless CP (10%). Demographic information and clinical data including symptoms of anxiety and depression using the Hospital Anxiety and Depression Scale were collected. All patients underwent quantitative sensory testing to assess patterns of pain processing. Results: A total of 235 patients (57% males, mean age 53.9 ± 14.0 years, 41% alcohol etiology) were included. Compared to patients with painless CP, enhanced pain sensitivity was observed in both patients with current pain (odds ratio [OR] 3.29; 95% confidence interval [CI] [1.11–9.77], P = .032) and no current pain (OR 4.07; 95% CI [1.10–15.03], P = .035). Patients with current pain also had increased depression prevalence compared to patients with painless CP (OR 6.15; 95% CI [1.28–29.41], P = .023), while no difference was seen for patients with no current pain (OR 1.24; 95% CI [0.19–8.26], P = .824). Conclusion: Total absence of pain in CP is associated with normal pain processing and low prevalence of psychologic distress, whereas patients with prior pain experience appear to have persistent and enhanced pain sensitivity even in the absence of clinical pain and psychologic distress.http://www.sciencedirect.com/science/article/pii/S2772572322000668Chronic PancreatitisPainPsychiatric ComorbiditiesHyperalgesia |
| spellingShingle | Anna E. Phillips Benjamin L. Bick Mahya Faghih Dhiraj Yadav Asbjørn M. Drewes Vikesh K. Singh Søren S. Olesen Pain Sensitivity and Psychiatric Comorbidities in Chronic Pancreatitis Patients With and Without Pain: Past Experience Matters Gastro Hep Advances Chronic Pancreatitis Pain Psychiatric Comorbidities Hyperalgesia |
| title | Pain Sensitivity and Psychiatric Comorbidities in Chronic Pancreatitis Patients With and Without Pain: Past Experience Matters |
| title_full | Pain Sensitivity and Psychiatric Comorbidities in Chronic Pancreatitis Patients With and Without Pain: Past Experience Matters |
| title_fullStr | Pain Sensitivity and Psychiatric Comorbidities in Chronic Pancreatitis Patients With and Without Pain: Past Experience Matters |
| title_full_unstemmed | Pain Sensitivity and Psychiatric Comorbidities in Chronic Pancreatitis Patients With and Without Pain: Past Experience Matters |
| title_short | Pain Sensitivity and Psychiatric Comorbidities in Chronic Pancreatitis Patients With and Without Pain: Past Experience Matters |
| title_sort | pain sensitivity and psychiatric comorbidities in chronic pancreatitis patients with and without pain past experience matters |
| topic | Chronic Pancreatitis Pain Psychiatric Comorbidities Hyperalgesia |
| url | http://www.sciencedirect.com/science/article/pii/S2772572322000668 |
| work_keys_str_mv | AT annaephillips painsensitivityandpsychiatriccomorbiditiesinchronicpancreatitispatientswithandwithoutpainpastexperiencematters AT benjaminlbick painsensitivityandpsychiatriccomorbiditiesinchronicpancreatitispatientswithandwithoutpainpastexperiencematters AT mahyafaghih painsensitivityandpsychiatriccomorbiditiesinchronicpancreatitispatientswithandwithoutpainpastexperiencematters AT dhirajyadav painsensitivityandpsychiatriccomorbiditiesinchronicpancreatitispatientswithandwithoutpainpastexperiencematters AT asbjørnmdrewes painsensitivityandpsychiatriccomorbiditiesinchronicpancreatitispatientswithandwithoutpainpastexperiencematters AT vikeshksingh painsensitivityandpsychiatriccomorbiditiesinchronicpancreatitispatientswithandwithoutpainpastexperiencematters AT sørensolesen painsensitivityandpsychiatriccomorbiditiesinchronicpancreatitispatientswithandwithoutpainpastexperiencematters |