A new paper (on-line only at the moment) (1) reports a prospective epidemiological study that examines the association between Adverse Childhood Experiences (ACEs) and the subsequent occurrence of painful medical conditions. The role that mood and anxiety disorders play in this association is also carefully assessed.
Archive for the ‘Stress Research’ Category
ACEs and the Epidemiology of Psychophysiologic Disorders
Thursday, June 8th, 2017Major Change in Financial Incentives for Care of Psychophysiologic Disorders (PPD)
Monday, February 13th, 2017A major change in the financial incentives for care of Psychophysiologic Disorders (PPD) has just occurred in the United States (1). The case for integrating both medical and mental health care into primary care has always been compelling. Now, in 2017, the U.S. Medicare/Medicaid system has decided it will pay for a form of care that is strongly aligned with this concept (more on that below).
The Dawn of Integrated Care for Psychophysiologic Disorders (PPD)
Thursday, September 1st, 2016A paper published in 2014 (1) is getting a lot of attention now because of the following conclusions (italics mine): (more…)
What Will Replace Opiates?
Sunday, March 27th, 2016Prescription opiate medication for chronic pain is a treatment whose time is ending. To quote Dr. Tom Frieden, director of the Center for Disease Control (CDC), for most pain patients the benefits of opiate painkillers are “unproven and transient” and they can be “just as addictive as heroin.” In addition, annually since 1999, ten thousand people have died from overdoses of prescription painkillers. The pain management community has concluded that, apart from people with cancer pain or those at the end of life, opiate painkillers have become a public health crisis. The CDC now recommends against using them for most non-cancer patients.
Psychophysiologic Disorders and Controlled Research
Saturday, November 14th, 2015Acceptance by the health care profession that Psychophysiologic Disorders (PPD) can be successfully diagnosed and treated will depend on completion of at least two randomized controlled trials (RCT). The RCT is the gold standard method for documenting that a new form of treatment is superior to a placebo. Only when a treatment passes this test and that passing is then confirmed by at least one additional RCT will clinicians consider making the effort to apply it to their patients.
Patients Who Have “Nothing the Matter with Them”
Tuesday, June 9th, 2015Among physicians with a humanistic soul, perhaps no quotation is more fondly remembered than one from Dr Francis Peabody. He was born in 1881 to a prominent New England family, trained at Harvard and Massachusetts General Hospital and was the first director of the Thorndike Laboratory at Boston City Hospital. Tragically, he died of sarcoma at age 46.
A Physiologic Basis for Fibromyalgia
Tuesday, March 24th, 2015A study of the brain (published on-line Jan 2015) has uncovered an important difference in the processing of pain signals between people with fibromyalgia (FM) and those without FM.(1) Participants with FM had brain imaging with functional magnetic resonance (fMRI) while a blood pressure cuff on their leg created pain at a level (determined by each person) of 40 out of 100.
Stress, Illness and Points of View (2)
Saturday, November 8th, 2014The last post briefly described a few psychotherapy concepts employed by students of Carl Jung. I wrote this to suggest the diversity of the scores of theoretical models currently used to treat clients. Why are there so many? The answer seems to be that they are all about equally effective when compared in trials so none has become dominant. Why are they so similar in their outcomes? The best explanation is that the theory behind a particular psychotherapeutic approach is one of the least important of several factors that determine how much a client benefits from treatment. What are these other components? In order of importance they are factors connected to: (more…)
How Many Adults Have a Psychophysiologic Disorder?
Tuesday, September 2nd, 2014The question of the prevalence of Psychophysiologic Disorders (PPD) is an important one so I looked into it a little more. The original study of this issue was by Kroenke & Mangelsdorf in 1989 and found that 70% of primary care patients had no explanation for their symptoms 12 months after they first went to their primary care physician. However, this study was done on a military base and though it included non-military family may not have been representative of the general public.
New DVD on Adverse Childhood Experience
Monday, August 27th, 2012There is a new compilation of the latest research on the long-term impact of childhood adversity. I have written about this key subject in earlier blogs (here and again here). Now there is a new DVD where the latest research and its implications for policy are presented by those who conducted the studies.
