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Discrimination of idiopathic pain syndromes from neurogenic pain syndromes and healthy volunteers by means of clinical rating, personality traits, monoamine metabolites in CSF, serum cortisol, platelet MAO and urinary melatonin

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Summary

The aim of the present study was to investigate the discriminative power of a series of variables (including determination of depressive symptomatology by means of a visual analogue scale, determination of personality traits by means of the Karolinska Scales of Personality, determination of monoamine metabolites in CSF, platelet MAO activities, serum cortisol before and after dexamethasone suppression and urinary melatonin) in differentiating (a) chronic pain patients from healthy subjects, and (b) patients with idiopathic pain syndromes from patients with neurogenic pain syndromes. Separately each of the measures gave a significant but often low contribution to the discrimination, while a combination of several measures gave a complete discrimination both between healthy subjects and patients with chronic pain syndromes and between patients with idiopathic and neurogenic pain syndromes, respectively.

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References

  • Ågren H (1981) Biological markers in the major depressive disorders. Academic Dissertation, Uppsala University, Uppsala

    Google Scholar 

  • Almay BGL, Johansson F, von Knorring L, Terenius L, Wahlström A (1978) Endorphins in chronic pain. I. Differences in CSF endorphin levels between organic and psychogenic pain syndromes. Pain 5:153–162

    Google Scholar 

  • Almay BGL (1986) Clinical characteristics of patients with idiopathic pain syndromes. Pain (in press)

  • Almay BGL, von Knorring L, Oreland L (1986a) Platelet MAO activities in patients with idiopathic pain disorders. J Neural Transm Pain (in press)

  • Almay BGL, Häggendal J, von Knorring L, Oreland L (1986b) 5-HIAA and HVA in CSF in patients with idiopathic pain disorders. Biol Psychiatry (in press)

  • Almay BGL, von Knorring L, Johansson F (1986c) Serum cortisol and dexamethasone nonsuppression in patients with chronic pain syndromes. J Nerv Ment Dis (submitted)

  • Almay BGL, von Knorring L, Wetterberg L (1986d) Melatonin in serum and urine in patients with idiopathic pain syndromes. Psychiatr Res (submitted)

  • Åsberg M, Bertilsson L, Mårtensson B, Scalia-Tomba G-P, Thorén P, Träskman-Bendz L (1984) CSF monoamine metabolites in melancholia. Acta Psychiatr Scand 69:201–219

    Google Scholar 

  • Beck-Friis J (1983) Melatonin in depressive disorders — a methodological and clinical study of the pineal-hypothalamic-pituary-adrenal cortex system. Doctoral Dissertation Karolinska Institute, Stockholm

    Google Scholar 

  • Berger M, Pirke K-M, Doer P, Krieg J-C, von Zerssen D (1984) The limited utility of the dexamethasone suppression test for the diagnostic process in psychiatry. Br J Psychiatry 145:372–383

    Google Scholar 

  • Blumer D, Heilbronn M (1982) Chronic pain as a variant of depressive disease. The pain prone patient. J Nerv Ment Dis 170:381–406

    Google Scholar 

  • Brown R, Kocsis JH, Caroff S, Amsterdam J, Winokur A, Stokes PE, Frazer A (1985) Differences in nocturnal melatonin secretion between melancholic depressed patients and control subjects. Am J Psychiatry 142:811–816

    Google Scholar 

  • Carroll BJ, Feinberg M, Greden F, Tarika J, Albala AA, Haskett RF, Mcl James N, Kronfol Z, Lohr M, Steiner M, Paul de Vigne J, Young E (1981) A specific laboratory test for the diagnosis of melancholia - standardization validation and clinical utility. Arch Gen Psychiatry 38:15–22

    Google Scholar 

  • Coppen A (1967) The biochemistry of affective disorders. Br J Psychiatry 113:1237–1264

    Google Scholar 

  • Coppen A, Abou-Saleh M, Milln P, Metcalfe M, Harwood J, Bailey J (1983) Dexamethasone suppression test in depression and other psychiatric illness. Br J Psychiatry 142:498–504

    Google Scholar 

  • Eckert B, Gottfries C-G, von Knorring L, Wiberg Å, Winblad B (1980) Brain and platelet monoamine oxidase activity in mental disorders. I. Schizophrenia and cycloid psychotics. Prog NeuroPsychopharmacol 4:57–68

    Google Scholar 

  • Hällström T, Samuelsson S, Balldin J, Wålinder J, Bengtsson C, Nyström E, andersch B, Lindstedt G, Lundberg P-A (1983) Abnormal dexamethasone suppression test in normal females. Br J Psychiatry 142:489–497

    Google Scholar 

  • Johansson F (1982a) Differences in serum cortisol concentrations in organic and psychogenic pain syndromes. J Psychosom Res 26:351–358

    Google Scholar 

  • Johansson F (1982b) Patients with chronic pain. A clinical, clinical-pharmacological and biochemical study. Umeå University Medical Dissertations, New Series No 87, Umeå

  • Knorring L von (1975) The experience of pain in patients with depressive disorders. Umeå University Medical Dissertations, New Series No 2, Umeå

  • Knorring L von, Almay BGL, Johansson F (1986) Personality traits in patients with idiopathic pain disorders. Eur Arch Psychiatr Neurol Sci (submitted)

  • Knorring L von, Terenius L, Wahlström A (1983) Fraction I endorphin in cerebrospinal fluid. Clinical studies. In: Wood JH (ed) Neurobiology of CSF 2. Plenum Press, London, pp 83–96

    Google Scholar 

  • Knorring L von, Perris C, Eisemann M, Perris H (1984a) Discrimination of former depressed patients from healthy volunteers on the basis of stable personality traits assessed by means of KSP. Arch Psychiatr Neurol Sci 234:202–205

    Google Scholar 

  • Knorring L von, Perris C, Oreland L, Eisemann M, Eriksson U, Perris H (1984b) Pain as a symptom in depressive disorders and its relationship to platelet monoamine oxidase activity. J Neurol Transm 60:1–9

    Google Scholar 

  • Lascelles PT, Evans PR, Mersky H, Sabur MA (1974) Plasma cortisol in psychiatric and neurological patients with pain. Brain 97:533–538

    Google Scholar 

  • Magnusson T, Nilsson LB, Westerlund D (1980) Simultaneous determination of dopamine, DOPAC and homovanillic acid. Direct injection of supernatants from brain tissue homogenates in liquid chromatography-electrochemical detection systems. J Chromatogr 221:237–247

    Google Scholar 

  • Mersky H, Spear FG (1967) Pain. Psychological and psychiatric aspects. Bailliere, Tindall, Cassell, London

    Google Scholar 

  • Oreland L, Wiberg Å, Åsberg M, Träskman L, Sjöstrand L, Thorén P, Bertilsson L, Tybring G (1981) Platelet MAO activity and monoamine metabolites in cerebrospinal fluid in depressed and suicidal patients and in healthy controls. Psychiatry Res 4:21–29

    Google Scholar 

  • Perris C, Eisemann M, Eriksson U, von Knorring L, Perris H (1979) Variations in self-assessment of personality characteristics in depressed patients with special reference to aspects of aggression. Psychiatr Clin 12:209–215

    Google Scholar 

  • Perris C, Eisemann M, von Knorring L, Perris H (1984) Personality traits in former depressed patients and in healthy subjects without past history of depression. Psychopathology 17:178–186

    Google Scholar 

  • Pilowski I, Bassett DL (1985) Pain and depression: Does the evidence support a relationship. Psychol Bull 97:18–34

    Google Scholar 

  • Praag HM von, Korf J, Schut D (1973) Cerebral monoamine and depression. Arch Gen Psychiatry 28:827–831

    Google Scholar 

  • Revely MA, Revely AM, Clifford CA, Murray RM (1983) Genetics of platelet MAO activity in discordant schizophrenic and normal twins. Br J Psychiatry 142:560–565

    Google Scholar 

  • Sachar EJ (1975) Twenty-four hour cortisol patterns in depressed and maniac patients. In: Gispen WH, van Wimersma Greidanus TB, Bohus B, de Wied D (eds) Hormones, homeostasis and the brain. Progr Brain

  • Schalling D, Edman G, Asberg M (1983) Impulsive cognitive style and inability to tolerate boredom: Psychobiological studies of temperamental vulnerability. In: Zuckerman M (ed) Biological basis of sensation seeking, impulsivity and anxiety. Lawrence Erlbaum Assoc, Hillsdale, NJ, pp 123–145

    Google Scholar 

  • Schalling D, Edman G (1986) The Karoliska scales of personality (KSP) - an inventory for assessing temperament dimensions associated with vulnerability for psychosocial deviance. Manuscript

  • Shenkin HA (1964) The effect of pain on the diurnal pattern of plasma cortisol levels. Neurology 14:1112–1117

    Google Scholar 

  • Sternbach RA (1974) Pain patients. Traits and treatment. Academic Press, London

    Google Scholar 

  • Wetterberg L, Beck-Friis J, Aperia B, Petterson U (1979) Melatonin/cortisol ratio in depression. Lancet 11:1361

    Google Scholar 

  • Williams JBW, Spitzer RL (1982) Idiopathic pain disorder: A critique of pain prone disorder and a proposal for a revision of the DSMIII category psychogenic pain disorder. J Nerv Ment Dis 170:415–419

    Google Scholar 

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Supported in part by grants from the Swedish Medical Research Council (grants no. 3371, 4145 and 5740) and by a grant from Stiftelsen Söderström-Königska Sjukhemmet

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von Knorring, L., Almay, B.G.L., Häggendal, J. et al. Discrimination of idiopathic pain syndromes from neurogenic pain syndromes and healthy volunteers by means of clinical rating, personality traits, monoamine metabolites in CSF, serum cortisol, platelet MAO and urinary melatonin. Eur Arch Psychiatr Neurol Sci 236, 131–138 (1986). https://doi.org/10.1007/BF00380940

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