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F508 PSYCHIATRIC COMORBIDITIES OF PERIPHERAL NEUROPATHIC PAIN: A FRENCH CROSS-SECTIONAL STUDY
POSTER SESSIONS / European Journal of Pain Supplements 5 (2011) 15–295
(20.3%) of category C responses. There was no relationship between the response times across four pain categories (p = 0.120).
161
peripheral neuropathic pain and are predicted by pain intensity but also by the catastrophising and the number of pain sites. Disclosure: None declared
F509 PREVALENCE OF NEUROPATHIC PAIN IN DIABETIC PATIENTS: A FRENCH CROSS-SECTIONAL STUDY D. Bouhassira1 *, A. Hartemann2 , M. Letanoux3 . 1 CETD/Hopital Ambroise Par´e, Boulogne, 2 Service de diab´etologie/Hopital Piti´e-Salpˆetri`ere, 3 Cabinet d’endocrinologie, Paris, France
Figure: Relationship between acute pain in patients requesting an emergency ambulance and subsequent ambulance response times.
Conclusions: Triage algorithms used to prioritise ambulance response do not consider pain severity. Humane care requires that appropriate analgesia is administered in a timely manner. Ambulance triage needs to be revised to ensure appropriate responses to severe pain. Disclosure: None declared
F508 PSYCHIATRIC COMORBIDITIES OF PERIPHERAL NEUROPATHIC PAIN: A FRENCH CROSS-SECTIONAL STUDY F. Radat1 *, N. Attal2 , A. Margot-Duclot3 . 1 CHU de Bordeaux, Bordeaux, 2 Inserm U987/Hopital Ambroise Par´e, Boulogne, 3 CETD/Fondation A. de Rothschild, Paris, France Background: Neuropathic pain is particularly difficult to treat. One reason may be the presence of comorbidities such as sleep disorders, depression and anxiety. There is a lack of studies assessing the prevalence of comorbid psychiatric entities using structured validated interviews in neuropathic pain. The aim of this study was to estimate the lifetime and present prevalence of psychiatric comorbidities in patients with peripheral neuropathic pain and identify predictive factors for such comorbidities. Methods: Consecutive patients with peripheral neuropathic pain for at least three months as confirmed by the DN4 questionnaire were recuited by pain specialists or neurologists. Lifetime and current psychiatric comorbidites were looked for using a structured interview assessing the presence of DSM IV diagnosis criteria for major depression, bipolar disorders, generalized anxiety, panic disorder, agoraphobia, dysthymia, suicidal ideation and social phobia (Mini International Neuropsychiatric Interview). Sleep, quality of life and catastrophizing were also assessed. Results: A total of 212 patients (52% women, age 59.3±14.2 years) were included. Current major depression and generalized anxiety were the most prevalent psychiatric disorders (respectively 17% and 12% of cases). Multivariate analyses showed that catatrophizing, multiple pain sites and the intensity of minimal pain made an independent contribution to the presence of mood disorders whereas only catastrophizing was a predictor of current anxiety disorder. Conclusions: Psychiatric comorbidities particularly anxiety and depression disorders are highly prevalent in patients with
Background: We estimated the prevalence of distal neuropathic pain in type 1 and type 2 diabetic patients and its impact on quality of life. Methods: A total of 766 diabetic patients (44.8% women, 39% type 1) seen by diabetologists participated in this study. All the patients had to fill out a series of questionnaire for identification of chronic pain (i.e. daily pain for more than 3 months) in the lower limbs and assessment of health related quality of life (SF-12), sleep disturbances (MOS-Sleep), depression and anxiety (HAD). In addition, the 7-item DN4-interview questionnaire and the Michigan Neuropathy Screening Instrument (MNSI) were systematically admistered in the patients with chronic pain. Results: Chronic pain was reported by 32.8% of the patients and 64.5% had neuropathic characteristics (i.e. DN4-interview score ≥3). The MNSI was positive in 92.9% of these patients. Thus, our estimated prevalence of distal neuropathic pain was 20.8% [IC 95%: 14.7–26.9] and in the vast majority of the patients it was related to a polyneuropathy. The SF-12, MOS-sleep and HAD scores were all more significantly altered in patients with chronic pain. Conclusion: This study confirms the high prevalence of chronic neuropathic pain in diabetic type 1 and 2 patients and its significant impact on quality of life. The close correlation between the results of the 7-item DN4-interview and MNSI indicates that the DN4 could be used in daily practice as a simple and rapid screening test for the identification of painful diabetic polyneuropathy. Disclosure: None declared
F510 PERSISTENT POST-SURGICAL PAIN FOLLOWING THORACIC SURGERY: A CROSS-SECTIONAL STUDY K. Grosen1 *, G.L. Petersen2 , M.P. Jensen3 , H.K. Pilegaard1 . 1 Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Skejby, 2 Danish Pain Research Center, 3 Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark Background and Aims: The prevalence of persistent pain following thoracic surgical procedures is poorly characterized, and the influence of this pain on patients’ lives remains unclear. The objectives of this study were to investigate the prevalence and characteristics of persistent post-surgical pain following videoassisted thoracic surgery and anterior thoracotomy in patients with pulmonary malignancies. Methods: Patients with pulmonary malignancies who had undergone thoracic surgery by means of video-assisted thoracic surgery or anterior thoracotomy between 2000 and 2009 (N = 702) were invited to fill in a specifically developed 18-item questionnaire regarding present post-surgical pain. Results: Seventy-nine percent of the participants (n = 64) stated that the pain had emerged immediately after surgery, and more than half of the participants (n = 44) had experienced the pain for 1 to 5 years prior to study. The overall prevalence of persistent postsurgical pain was 18.6% (95% CI: 15.0 to 22.7%) and 13.8 (95% CI: 3.9 to 31.7%) following anterior thoracotomy and video-assisted thoracic surgery, respectively. Overall mean pain intensity was estimated to 3.2 (95% CI: 2.8 to 3.6) on an 11-point Numerical Rating Scale (NRS). The prevalence of moderate to severe pain was 7.2% (95% CI: 5.0 to 10.0%). Pain was predominately located along the
(20.3%) of category C responses. There was no relationship between the response times across four pain categories (p = 0.120).
161
peripheral neuropathic pain and are predicted by pain intensity but also by the catastrophising and the number of pain sites. Disclosure: None declared
F509 PREVALENCE OF NEUROPATHIC PAIN IN DIABETIC PATIENTS: A FRENCH CROSS-SECTIONAL STUDY D. Bouhassira1 *, A. Hartemann2 , M. Letanoux3 . 1 CETD/Hopital Ambroise Par´e, Boulogne, 2 Service de diab´etologie/Hopital Piti´e-Salpˆetri`ere, 3 Cabinet d’endocrinologie, Paris, France
Figure: Relationship between acute pain in patients requesting an emergency ambulance and subsequent ambulance response times.
Conclusions: Triage algorithms used to prioritise ambulance response do not consider pain severity. Humane care requires that appropriate analgesia is administered in a timely manner. Ambulance triage needs to be revised to ensure appropriate responses to severe pain. Disclosure: None declared
F508 PSYCHIATRIC COMORBIDITIES OF PERIPHERAL NEUROPATHIC PAIN: A FRENCH CROSS-SECTIONAL STUDY F. Radat1 *, N. Attal2 , A. Margot-Duclot3 . 1 CHU de Bordeaux, Bordeaux, 2 Inserm U987/Hopital Ambroise Par´e, Boulogne, 3 CETD/Fondation A. de Rothschild, Paris, France Background: Neuropathic pain is particularly difficult to treat. One reason may be the presence of comorbidities such as sleep disorders, depression and anxiety. There is a lack of studies assessing the prevalence of comorbid psychiatric entities using structured validated interviews in neuropathic pain. The aim of this study was to estimate the lifetime and present prevalence of psychiatric comorbidities in patients with peripheral neuropathic pain and identify predictive factors for such comorbidities. Methods: Consecutive patients with peripheral neuropathic pain for at least three months as confirmed by the DN4 questionnaire were recuited by pain specialists or neurologists. Lifetime and current psychiatric comorbidites were looked for using a structured interview assessing the presence of DSM IV diagnosis criteria for major depression, bipolar disorders, generalized anxiety, panic disorder, agoraphobia, dysthymia, suicidal ideation and social phobia (Mini International Neuropsychiatric Interview). Sleep, quality of life and catastrophizing were also assessed. Results: A total of 212 patients (52% women, age 59.3±14.2 years) were included. Current major depression and generalized anxiety were the most prevalent psychiatric disorders (respectively 17% and 12% of cases). Multivariate analyses showed that catatrophizing, multiple pain sites and the intensity of minimal pain made an independent contribution to the presence of mood disorders whereas only catastrophizing was a predictor of current anxiety disorder. Conclusions: Psychiatric comorbidities particularly anxiety and depression disorders are highly prevalent in patients with
Background: We estimated the prevalence of distal neuropathic pain in type 1 and type 2 diabetic patients and its impact on quality of life. Methods: A total of 766 diabetic patients (44.8% women, 39% type 1) seen by diabetologists participated in this study. All the patients had to fill out a series of questionnaire for identification of chronic pain (i.e. daily pain for more than 3 months) in the lower limbs and assessment of health related quality of life (SF-12), sleep disturbances (MOS-Sleep), depression and anxiety (HAD). In addition, the 7-item DN4-interview questionnaire and the Michigan Neuropathy Screening Instrument (MNSI) were systematically admistered in the patients with chronic pain. Results: Chronic pain was reported by 32.8% of the patients and 64.5% had neuropathic characteristics (i.e. DN4-interview score ≥3). The MNSI was positive in 92.9% of these patients. Thus, our estimated prevalence of distal neuropathic pain was 20.8% [IC 95%: 14.7–26.9] and in the vast majority of the patients it was related to a polyneuropathy. The SF-12, MOS-sleep and HAD scores were all more significantly altered in patients with chronic pain. Conclusion: This study confirms the high prevalence of chronic neuropathic pain in diabetic type 1 and 2 patients and its significant impact on quality of life. The close correlation between the results of the 7-item DN4-interview and MNSI indicates that the DN4 could be used in daily practice as a simple and rapid screening test for the identification of painful diabetic polyneuropathy. Disclosure: None declared
F510 PERSISTENT POST-SURGICAL PAIN FOLLOWING THORACIC SURGERY: A CROSS-SECTIONAL STUDY K. Grosen1 *, G.L. Petersen2 , M.P. Jensen3 , H.K. Pilegaard1 . 1 Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Skejby, 2 Danish Pain Research Center, 3 Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark Background and Aims: The prevalence of persistent pain following thoracic surgical procedures is poorly characterized, and the influence of this pain on patients’ lives remains unclear. The objectives of this study were to investigate the prevalence and characteristics of persistent post-surgical pain following videoassisted thoracic surgery and anterior thoracotomy in patients with pulmonary malignancies. Methods: Patients with pulmonary malignancies who had undergone thoracic surgery by means of video-assisted thoracic surgery or anterior thoracotomy between 2000 and 2009 (N = 702) were invited to fill in a specifically developed 18-item questionnaire regarding present post-surgical pain. Results: Seventy-nine percent of the participants (n = 64) stated that the pain had emerged immediately after surgery, and more than half of the participants (n = 44) had experienced the pain for 1 to 5 years prior to study. The overall prevalence of persistent postsurgical pain was 18.6% (95% CI: 15.0 to 22.7%) and 13.8 (95% CI: 3.9 to 31.7%) following anterior thoracotomy and video-assisted thoracic surgery, respectively. Overall mean pain intensity was estimated to 3.2 (95% CI: 2.8 to 3.6) on an 11-point Numerical Rating Scale (NRS). The prevalence of moderate to severe pain was 7.2% (95% CI: 5.0 to 10.0%). Pain was predominately located along the