Tuesday, June 9, 2009

In Pain and Of Mental

I have a dream... one day, I am going to find a world of literature showing chronic pain could lead to the worsening of psychotic symptoms with the underlying model in human all figured out...

Yet, to date, the only thing I could find is a case study reporting how a lady who initially reported tick bites eventually had a full-blown psychotic episode... Good luck to her and wish her a full recovery and no more relapses...

When scanning through the Chapter Assessment of Psychiatric Disorder in the Handbook for Pain Assessment, the authors did a, presumably, comprehensive review of pain-related psychiatric disorders including Depressive Disorder, Anxiety Disorders, Somatiform Disorders as well as Substance Abuse and Dependence. Yet, there is not much mentioning about psychosis.

In line with the structure of the above chapter, when searching for literature concerning pain and psychosis, it appears to me that the consensus the experts has achieved so far is that people with psychosis are insensitive to pain and have high pain threshold..... 8-O

I do have to mention that there do exist literature looking into the the pain perceptions of pain as part of the delusions and hallucinations.

Granted, much has been written about how depression often follows the onset of chronic pain and how patients with depression have the propensity to report worse pain level in various dimensions (as long as you don't ask me how they come up with the baseline since I have not had the chance yet to go much into the original research papers).

Of course, despite of my idiopathic pain, one thing I am trying to accomplish is to understand how my psychiatric condition, namely, although Schizo (psychotic) also affective (neurotic), might have had an impact on the unfolding of my recovery process from my spinal injuries and chronic pain, and, how pain might have had an impact on my psychiatric condition, be it Schizo (psychotic) or affective (neurotic).

As you could tell through them purple texts, it appears that more studies have done and theories have been formed concerning the association between depressive symptoms and pain.

Maybe it has something to do with the garbage-can nature of da Schizo syndrome, there seems to be far less research done in examining psychotics in excruciating pain.

This leads me to wonder...

How does my being both psychotic and neurotic, or, both the propensity for insensitivity and sensitivity to pain, have an impact on my pain experiences? Is there an additive effect when they simply cancel each other out or might there be an interaction effect although I am not quite sure how they might interact? Unless, it is simply choosing the more miserable outcome effect I am pondering about and speaking of.... Or, what it be like if the pain I was supposed to perceive should have actully be more.... 8-O lol sigh

And, perhaps, the specific topic I have in mind concerning pain assessment would be around the alley of the assessment of pain for people with some kind of mental health condition(s).... with the pain, perhaps, neuropathic?

(This writing is cross-posted in my Ratology in Disability Blog)

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