Cognitive Impairment and Associated Factors in Patients with Chronic Pain. Preliminary results.

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Publicación: Abstract online. Accesible: http://www.abstracts2view.com/iasp/index.php

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  • 1. 0 1 2 3 4 5 6 7 8 9 10 Average intensity from VAS scale: 6.46 (SD: 2.118) COGNITIVE IMPAIRMENT AND ASSOCIATED FACTORS IN PATIENTS WITH CHRONIC PAIN. PRELIMINARY RESULTS Ojeda B1,2, Dueñas M1,2, Salazar A1,2, Torres LM2,4, Sánchez-Magro I3, Failde I1,2 1 Department of Preventive Medicine and Public Health, University of Cádiz, Spain, 2External Chair of Pain Grünenthal Fundation-University of Cádiz, 3Medical Department-Grünenthal Fundation, 4University Hospital “Puerta del Mar”, Cádiz, Spain. Methods Abstract Objectives Results Conclusions References 1. Povedano, M., J. Gascón, R. Gálvez, M. Ruiz & J. Rejas (2007) Cognitive Function Impairment in Patients with Neuropathic Pain Under Standard Conditions of Care. Journal of Pain and Symptom Management, 33, 78-89. 2. Rodríguez-Andreu, J., R. Ibáñez-Bosch, A. Portero-Vázquez, X. Masramón, J. Rejas & R. Gálvez (2009) Cognitive impairment in patients with Fibromyalgia syndrome as assessed by the mini-mental state examination. BMC Musculoskeletal Disorders, 10: 162. To compare cognitive function in patients with chronic pain and patients suffering from non painful processes. To identify those variables linked to cognitive impairment in patients with chronic pain. In addition to a sensory phenomenon, chronic pain presents other dimensions such as the affective-emotional or cognitive. In patients with chronic pain, the normal functioning of these dimensions is disturbed, leading to depression and cognitive impairment in many cases. The evaluation and management of these problems, which often occur in parallel, must be taken into account in order to achieve a comprehensive approach to patients with chronic pain. MMSE results were lower in those patients with chronic pain included in the research than those in controls. These marks are more related to some factors such as depression and education studies than to pain peculiarities. Identification and right treatment of depression in patients with pain is a factor to take into account in order to control their cognitive function. Cross-sectional study in 213 patients with different chronic pain characteristics, treated at the pain unit of a University Hospital (cases); and 29 patients treated in a medical centre due to non painful conditions (controls). The Spanish version of MiniMentalState (MMS) was used for cognitive evaluation. Depression and anxiety were assessed by the Hospital Anxiety and Depression scale (HADs). The MOS Sleep scale and the Visual Analogue Scale (VAS) were undertaken to valuate sleep characteristics and pain intensity, respectively. Sociodemographic and clinic information was collected through a structured questionnaire. Two-dimensional analyses were carried out with the objective of finding out differences between cases and controls. A linear regression model was used to identify variables associated with the MMS score in patients with pain. Printed by Cases (n=213) Controls (n=29) p Male Female 38.0 62.0 37.9 62.1 0.581a Age (mean (SD)) 47.31 (8.71) 42.10 (10.27) 0.008b No studies Primary studies Secondary studies Professional training University studies 11.3 39.0 15.5 27.2 7.0 13.8 41.4 24.1 20.7 0 0.266c a Chi square, b U-Mann Whitney, c H Kruskal Wallis Time duration (months) (mean (SD)) 106.6 (98.001) 59.6%, ≥ 8 years under pain 44,6 40,8 14,6 Neuropathic pain Musculoskeletal pain Fibromyalgia Fig 2. Pain intensity and duration Neuropathic pain (n=95) Musculoskeletal pain (n=87) Fibromyalgia (n=31) pa Anxiety (n=171) 49.3 47.1 71.4 0.078 Depression (n=178) 33.8 31.5 56.0 0.076 aChi square 38,5 19,7 41,8 86,2 3,4 10,3 0 20 40 60 80 100 120 No axiety (≤7) Uncertain (8-10) Anxiety (≥11) 53,5 16,4 30 93,1 6,9 0 0 20 40 60 80 100 120 No depression (≤7) Uncertain (8-10) Depression (≥11) Cases Controls HAD Anxiety HAD Depression Fig 1. Pain types (N=213). Variables B (SE) t p-value 95% CI Constant 25.636 (0.47) 54.54 <0.001 (24.71; 26.53) Studies No studies* Primary education Secondary education Professional training University studies 1.654 (0.48) 1.879 (0.57) 2.177 (0.50) 2.309 (0.69) 3.42 3.31 4.31 3.32 0.001 0.001 <0.001 0.001 (0.70; 2.61) (0.76; 2.99) (1.18; 3.17) (0.94; 3.68) Depression No depression* Uncertain Depression -0.580 (0.40) -1.304 (0.33) -1.45 -3.92 0.150 <0.001 (-1.37; 0.211) (-1.96; -0.65) Adjusted R2 = 0.178; df = 206 *Reference Category Dependent variable: score on the MMSE Table 1. Descriptive data. Table 3. Variables associated to the cognitive status on chronic pain patients (N=213). Fig 3. Frequency of depression and anxiety: Cases/Controls. Table 2. Frequency of depression and anxiety: Pain Types. Fig 4. Mean score of MMSE 3. Söderfjell, S., B. O. Molander, H. Johansson, M. Barnekow-Bergkvist & L. G. Nilsson (2006) Musculoskeletal pain complaints and performance on cognitive tasks over the adult life span. Scandinavian Journal of Psychology, 47, 349-359. 26,84 29,69 24 25 26 27 28 29 30 Cases (n=213) Controls (n=29) 26,84 27 26,39 24 25 26 27 28 29 30 Neuropatic Pain (n=95) Musculoskeletal Pain (n=87) Fibromyalgia (n=31)