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      Cognitive, emotional, and behavioral profile in children and adolescents with chronic pain associated with rheumatic diseases: A case-control study

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          Abstract

          Background:

          The prevalence of chronic pain is about 30% in children and adolescents which suffer from severe emotional distress. The aim of this observational study is to investigate cognitive, emotional and behavioral consequences of benign chronic pain in children and adolescents suffering of reumathologic diseases.

          Materials and Methods:

          A total of 49 participants, chronic pain participants (CPPs) and controls (CGPs), affected by rheumatic diseases, were enrolled. Assessment included collection of sociodemographic data, pain characteristics, and administration of Visual Analog Scale (VAS), Depression Inventory for Children and Adolescents (CDI), Conners’ Parent Rating Scales–Revised (CPRS-R), Child Behavior Checklist (CBCL), and Screen for Child Anxiety–Related Disorders (SCARED). For the statistical analysis, Student’s t-test for independent samples and Pearson’s correlation were used. The significance value was set at p less than .05.

          Results:

          A significant difference of mean scores of CBCL items and of CPRS items between the two groups was found. In CPPs, a significant correlation between VAS and mean scores of several CBCL items and between VAS and mean scores of several CPRS items was found.

          Conclusion:

          Chronic pain is a real syndrome in which an interdisciplinary treatment should be applied, considering the psychopathological risk, especially in developmental age.

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          Most cited references42

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          Understanding the co-occurrence of anxiety disorders and chronic pain: state-of-the-art.

          The purpose of this article is to describe the current state-of-the-art regarding the co-occurrence of the anxiety disorders and chronic pain. First, we describe the core characteristics of chronic pain and its co-occurrence with the anxiety disorders. Second, we review data on the prevalence of co-occurrence. Third, we describe the mutual maintenance and shared vulnerability models, both of which have been offered to explain the co-occurrence of posttraumatic stress disorder (PTSD) and chronic pain and may have applicability to various other anxiety disorders. Fourth, we provide an integrative review of available research addressing the postulates of these models specific to the mechanisms of anxiety sensitivity, selective attention to threat, and reduced threshold for alarm. We conclude with general recommendations for improving assessment and treatment of patients who present with an anxiety disorder accompanied by clinically significant pain. Given that most of the available evidence has come from studies of PTSD and chronic pain, we provide a detailed agenda for future investigation of the co-occurrence of chronic pain and other anxiety disorders.
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            The costs and consequences of adequately managed chronic non-cancer pain and chronic neuropathic pain.

            Chronic pain is distressing for patients and a burden on healthcare systems and society. Recent research demonstrates different aspects of the negative impact of chronic pain and the positive impact of successful treatment, making an overview of the costs and consequences of chronic pain appropriate.
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              Is Open Access

              Depression and chronic pain in the elderly: links and management challenges

              Aging is an inevitable process and represents the accumulation of bodily alterations over time. Depression and chronic pain are highly prevalent in elderly populations. It is estimated that 13% of the elderly population will suffer simultaneously from the two conditions. Accumulating evidence suggests than neuroinflammation plays a critical role in the pathogenesis of both depression and chronic pain. Apart from the common pathophysiological mechanisms, however, the two entities have several clinical links. Their management is challenging for the pain physician; however, both pharmacologic and nonpharmacologic approaches are available and can be used when the two conditions are comorbid in the elderly patients.
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                Author and article information

                Journal
                Clin Child Psychol Psychiatry
                Clin Child Psychol Psychiatry
                CCP
                spccp
                Clinical Child Psychology and Psychiatry
                SAGE Publications (Sage UK: London, England )
                1359-1045
                1461-7021
                22 October 2018
                July 2019
                : 24
                : 3
                : 433-445
                Affiliations
                [1 ]Pediatric Unit, Department of Biomedical Sciences and Human Oncology, Hospital Polyclinic of Bari, University of “Aldo Moro” Bari, Italy
                [2 ]Unit for Severe Disabilities in Developmental Aging and Young Adults, IRCCS Eugenio Medea, “La Nostra Famiglia”, Brindisi, Italy
                [3 ]Pediatric Unit, “A. Perrino” Hospital Brindisi, Italy
                [4 ]Psychiatry Unit, Department of Neuroscience and Sense Organs, Hospital Polyclinic of Bari, University of “Aldo Moro” Bari, Italy
                [5 ]Child Neuropsychiatry Unit, Department of Neuroscience and Sense Organs, Hospital Polyclinic of Bari, University of “Aldo Moro” Bari, Italy
                Author notes
                [*]Lucia Margari, Department of Neuroscience and Sense Organs, Hospital Polyclinic of Bari, University of “Aldo Moro” Bari, Piazza Giulio Cesare 1, 70100 Bari, Italy. Email: lucia.margari@ 123456uniba.it
                Article
                10.1177_1359104518805800
                10.1177/1359104518805800
                6620765
                30343596
                13957f1f-9f79-4e40-a3cd-111a1b1720ba
                © The Author(s) 2018

                This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

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                pain,children,behavior,depression,anxiety
                pain, children, behavior, depression, anxiety

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