The effects of analgesics on mood in patients with pain of different etiologies Book Section

  


Authors: Wallenstein, S. L.; Heidrich, G. 3rd; Kaiko, R. F.; Houde, R. W.
Editors: Bromm, B.; Desmedt, J. E.
Article/Chapter Title: The effects of analgesics on mood in patients with pain of different etiologies
Title Series: Advances in Pain Research and Therapy
Abstract: A self-administered questionnaire consisting of 15 pairs of descriptors representing mood opposites (i.e., shaky-serene, blue-cheerful, etc.) was developed to evaluate various aspects of mood in patients with pain. In cancer-pain patients who completed the questionnaire before and after receiving a narcotic for pain, factor analysis of the items in the questionnaire developed four main factors: I, agitation-serenity; II, euphoria-dysphoria; III, optimism-pessimism; and IV, apathy-enthusiasm. Factor I accounted for 70% of the variation and factor II for 15%, The factors correlated highly with mood measurements on a visual analogue scale (VAS), and the patients showed significant improvement in mood measurements for factors I and IV after receiving narcotics. Factor II, consisting of items related to euphoria-dysphoria commonly associated with the effects of narcotics in addicts, was only minimally affected in these patients, The questionnaire has been employed in volunteer subjects without pain and in a variety of patient populations (chronic cancer pain, postoperative cancer pain, and postoperative orthopedic pain) in studies involving narcotics (morphine and heroin), a nonsteroidal antiinflammatory drug (NSAID) (zomepirac), and a partial narcotic agonist/antagonist (buprenorphine). Patients with chronic cancer pain had measurably poorer mood than patients with postoperative pain. Improvements in mood correlated well with analgesia after the use of all analgesics in the postoperative-pain patients. However, in patients with chronic cancer pain, significantly greater mood changes occurred after the narcotics than after the non-narcotics, even when degrees of analgesia were similar. While mood in postoperative-pain patients would appear to directly reflect the degree of pain, the relationship is more complex in chronic-pain patients. The interactions of mood, pain severity, and pain etiology merit further study.
Keywords: morphine; cancer-patients
Book Title: Pain and the Brain: From Nociception to Cognition
Volume: 22
ISBN: 0146-0722
Publisher: Lippincott-Raven  
Publication Place: Philadelphia, PA
Date Published: 1995-01-01
Start Page: 559
End Page: 569
Language: English
ACCESSION: WOS:A1995BE25E00036
PROVIDER: wos
Notes: Article; Proceedings Paper; Chapter 36 -- From Nociception to Pain Symposium -- AUG 27-29, 1993 -- BEAUNE, FRANCE -- Bayer, Boehringer Ingelheim, Byk Gulden, Cascan, Glaxo, Godecke, Hoechst, Knoll AG, Krewel, Lichtwer, Merck Darmstadt, Merck Sharp & Dohme, Mundipharma, Nordmark, Philips, Sandoz, Schwarz Pharma -- E WASHINGTON SQ, PHILADELPHIA, PA 19105 -- Source: Wos