THE EFFECT OF CHRONIC PAIN UPON THE RESPONSE TO NOXIOUS STIMULI BY PSYCHIATRIC-PATIENTS
THE EFFECT OF CHRONIC PAIN UPON THE RESPONSE TO NOXIOUS STIMULI BY PSYCHIATRIC-PATIENTS
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DOI：
10.1016/0022-3999(65)90083-8
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发表时间：
1965-01-01
影响因子：
4.7
通讯作者：
MERSKEY, H
中科院分区：
文献类型：
--
作者：
MERSKEY, H
对慢性疼痛患者对伤害性刺激的实验反应的文献进行了综述，结果表明，在这一领域，无论是“心因性”还是“器质性”疼痛的研究都很少。然后报告的结果调查的反应针刺，阈值获得的压力algometer和响应电击测量的电子记录的手指运动。压力algometer是最敏感的测试仪器。结果表明，女性的反应比男性多，而正常人的反应比患者少。一组特殊的极低血糖患者反应最早，也最强烈。没有疼痛的焦虑患者比没有疼痛的抑郁患者有更多的反应，事实上没有疼痛的抑郁患者反应相对较晚。另一方面，焦虑的疼痛患者对测痛计的反应较晚，而抑郁的疼痛患者对测痛计的反应相对较早。癔症和疼痛的患者处于其他诊断组之间的中间位置。对电击的手指运动反应的测试清楚地证明，部分反应与测试环境中的焦虑有关，部分与刺激的不愉快性质有关。它没有很好地区分两组，但确实表明，正常受试者的反应比焦虑或疼痛患者少。虽然痛觉计是最有效的指标组之间的差异，在对伤害性刺激的反应有几个显着的相互关系与其他测试措施。因此，P.P.T.和S.P.T.都与针刺反应显著相关。此外，手指运动测试显示出与P.P.T.显著相关，最后，当考虑与特定部位相关的反应时，结果表明，没有头痛的精神病患者的反应倾向于略低于头痛患者。然而，他们和其他有疼痛的精神病患者之间没有显著差异，即使是用包括前额疼痛的痛觉计测试。因此，至少在这种情况下，局部心因性疼痛对同一部位的创伤反应没有显着影响。
The literature on the experimental response to noxious stimuli in patients with chronic pain has been reviewed and it has been shown that there are very few studies in this field either of “psychogenic” or “organic” pain. The results are then reported of investigations of the response to pin-prick, of thresholds obtained with the pressure algometer and of the response to electric shock measured by electronic recording of finger-movement.The pressure algometer was the most sensitive test-instrument employed. It showed a tendency for females to react more than males and for normal subjects to react less than patients. A special group of very hypochondriacal patients reacted earliest and most. There was a tendency for anxious patients without pain to react more than depressed patients without pain, and in fact depressed patients without pain reacted relatively late. On the other hand anxious patients with pain responded late to the algometer and depressed patients with pain responded to it relatively early. Patients with hysteria and pain occupied an intermediate position between other diagnostic groups.A test of finger-movement in response to electric shock gave clear evidence that part of the response was related to anxiety in the test situation and part to the unpleasant nature of the stimulus. It did not distinguish well between groups but did indicate that normal subjects reacted less than patients with anxiety or with pain. Whilst the algometer was the most effective indicator of differences between groups in the response to noxious stimuli there were several significant intercorrelations with other test measures. Thus the two algometer measures of P.P.T. and S.P.T. were both significantly correlated with the response to pin prick. Further, the finger-movement test showed a significant correlation with the P.P.T., so that it seems as if these tests measured a common parameter of response.Lastly, when the responses associated with a particular site were considered it was shown that psychiatric patients without headache were inclined to react slightly less than those with headache. However, there was no significant difference between them and other psychiatric patients with pain—even with the algometer tests which involved pain on the forehead. Thus, in at least this instance, there was no significant effect of local psychogenic pain upon the response to trauma at the same site.