Skip to main content
Erschienen in: Zeitschrift für Rheumatologie 7/2015

01.09.2015 | Originalien

Psychological defensive profile of sciatica patients with neuropathic pain and its relationship to quality of life

verfasst von: Prof. A. Tutoglu, MD, A. Boyaci, İ.F. Karababa, I. Koca, E. Kaya, A. Kucuk, A. Yetisgin

Erschienen in: Zeitschrift für Rheumatologie | Ausgabe 7/2015

Einloggen, um Zugang zu erhalten

Abstract

Aim

To identify differences between defense styles and mechanisms in sciatica patients with or without neuropathic pain and their relationship to quality of life.

Study design

The study included 37 sciatica patients with neuropathic pain (SNP), 36 sciatica patients without neuropathic pain and 38 healthy subjects. Pain severity was measured using the Visual Analogue Scale (VAS). Psychological condition was assessed using the Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI). Defense mechanisms were assessed using a 40-item Defense Style Questionnaire (DSQ-40) and quality of life was assessed using Short Form-36 (SF-36).

Results

BDI and BAI scores were significantly higher in the SNP group (p < 0.001). Idealization and immature defense styles, as well as isolation, displacement and somatization were significantly higher in the SNP group (p < 0.05). SF-36 parameters also differed significantly between the groups, with controls having the best scores and the SNP group the worst. In linear regression analysis, acting out and BDI were found to affect the pain domain of the SF-36 (p < 0.001).

Conclusion

The acting out defensive style and BDI were independently associated with pain-related quality of life. In the SNP group, significant differences were found in the immature and neurotic styles of the defense mechanisms.
Literatur
1.
Zurück zum Zitat Treede RD, Jensen TS, Campbell JN et al (2008) Neuropathic pain: redefinition and a grading system for clinical and research purposes. Neurology 70(18):1630–1635. doi:01.wnl.0000282763.29778.59CrossRefPubMed Treede RD, Jensen TS, Campbell JN et al (2008) Neuropathic pain: redefinition and a grading system for clinical and research purposes. Neurology 70(18):1630–1635. doi:01.wnl.0000282763.29778.59CrossRefPubMed
2.
Zurück zum Zitat Binder A, Koroschetz J, Baron R (2008) Disease mechanisms in neuropathic itch. Nat Clin Pract Neurol 4(6):329–337. doi:ncpneuro0806CrossRefPubMed Binder A, Koroschetz J, Baron R (2008) Disease mechanisms in neuropathic itch. Nat Clin Pract Neurol 4(6):329–337. doi:ncpneuro0806CrossRefPubMed
3.
Zurück zum Zitat Hansson P (2002) Neuropathic pain: clinical characteristics and diagnostic workup. Eur J Pain 6(Suppl A):47–50. doi:10.1053/eujp.2001.0322CrossRefPubMed Hansson P (2002) Neuropathic pain: clinical characteristics and diagnostic workup. Eur J Pain 6(Suppl A):47–50. doi:10.1053/eujp.2001.0322CrossRefPubMed
4.
Zurück zum Zitat Jensen TS, Gottrup H, Sindrup SH, Bach FW (2001) The clinical picture of neuropathic pain. Eur J Pharmacol 429(1–3):1–11. doi:S0014299901013024 [pii] Jensen TS, Gottrup H, Sindrup SH, Bach FW (2001) The clinical picture of neuropathic pain. Eur J Pharmacol 429(1–3):1–11. doi:S0014299901013024 [pii]
5.
Zurück zum Zitat Davis MP (2007) What is new in neuropathic pain? Support Care Cancer 15(4):363–372. doi:10.1007/s00520-006-0156-0CrossRefPubMed Davis MP (2007) What is new in neuropathic pain? Support Care Cancer 15(4):363–372. doi:10.1007/s00520-006-0156-0CrossRefPubMed
6.
Zurück zum Zitat Straube S, Derry S, McQuay HJ, Moore RA (2008) Enriched enrollment: definition and effects of enrichment and dose in trials of pregabalin and gabapentin in neuropathic pain. A systematic review. Br J Clin Pharmacol 66 (2):266–275. doi:BCP3200PubMedCentralCrossRefPubMed Straube S, Derry S, McQuay HJ, Moore RA (2008) Enriched enrollment: definition and effects of enrichment and dose in trials of pregabalin and gabapentin in neuropathic pain. A systematic review. Br J Clin Pharmacol 66 (2):266–275. doi:BCP3200PubMedCentralCrossRefPubMed
7.
Zurück zum Zitat McDermott AM, Toelle TR, Rowbotham DJ et al (2006) The burden of neuropathic pain: results from a cross-sectional survey. Eur J Pain 10(2):127–135. doi:S1090-3801(05)00023-6CrossRefPubMed McDermott AM, Toelle TR, Rowbotham DJ et al (2006) The burden of neuropathic pain: results from a cross-sectional survey. Eur J Pain 10(2):127–135. doi:S1090-3801(05)00023-6CrossRefPubMed
9.
Zurück zum Zitat Konstantinou K, Dunn KM (2008) Sciatica: review of epidemiological studies and prevalence estimates. Spine (Phila Pa 1976) 33 (22):2464–2472. doi:10.1097/BRS.0b013e318183a4a2 Konstantinou K, Dunn KM (2008) Sciatica: review of epidemiological studies and prevalence estimates. Spine (Phila Pa 1976) 33 (22):2464–2472. doi:10.1097/BRS.0b013e318183a4a2
10.
Zurück zum Zitat Tarulli AW, Raynor EM (2007) Lumbosacral radiculopathy. Neurol Clin 25(2):387–405. doi:S0733-8619(07)00009-6CrossRefPubMed Tarulli AW, Raynor EM (2007) Lumbosacral radiculopathy. Neurol Clin 25(2):387–405. doi:S0733-8619(07)00009-6CrossRefPubMed
11.
Zurück zum Zitat Baron R, Binder A (2004) How neuropathic is sciatica? The mixed pain concept. Orthopade 33(5):568–575. doi:10.1007/s00132-004-0645-0CrossRefPubMed Baron R, Binder A (2004) How neuropathic is sciatica? The mixed pain concept. Orthopade 33(5):568–575. doi:10.1007/s00132-004-0645-0CrossRefPubMed
12.
Zurück zum Zitat Jacobs WC, Tulder M van, Arts M et al (2011) Surgery versus conservative management of sciatica due to a lumbar herniated disc: a systematic review. Eur Spine J 20(4):513–522. doi:10.1007/s00586-010-1603-7PubMedCentralCrossRefPubMed Jacobs WC, Tulder M van, Arts M et al (2011) Surgery versus conservative management of sciatica due to a lumbar herniated disc: a systematic review. Eur Spine J 20(4):513–522. doi:10.1007/s00586-010-1603-7PubMedCentralCrossRefPubMed
13.
Zurück zum Zitat Stafford MA, Peng P, Hill DA (2007) Sciatica: a review of history, epidemiology, pathogenesis, and the role of epidural steroid injection in management. Br J Anaesth 99 (4):461–473. doi:aem238CrossRefPubMed Stafford MA, Peng P, Hill DA (2007) Sciatica: a review of history, epidemiology, pathogenesis, and the role of epidural steroid injection in management. Br J Anaesth 99 (4):461–473. doi:aem238CrossRefPubMed
14.
Zurück zum Zitat Dworkin RH, O’Connor AB, Backonja M et al (2007) Pharmacologic management of neuropathic pain: evidence-based recommendations. Pain 132(3):237–251. doi:S0304-3959(07)00469-1CrossRefPubMed Dworkin RH, O’Connor AB, Backonja M et al (2007) Pharmacologic management of neuropathic pain: evidence-based recommendations. Pain 132(3):237–251. doi:S0304-3959(07)00469-1CrossRefPubMed
15.
Zurück zum Zitat Martinez-Lavin M, Lopez S, Medina M, Nava A (2003) Use of the leeds assessment of neuropathic symptoms and signs questionnaire in patients with fibromyalgia. Semin Arthritis Rheum 32(6):407–411. doi:10.1053/sarh.2003.50017CrossRefPubMed Martinez-Lavin M, Lopez S, Medina M, Nava A (2003) Use of the leeds assessment of neuropathic symptoms and signs questionnaire in patients with fibromyalgia. Semin Arthritis Rheum 32(6):407–411. doi:10.1053/sarh.2003.50017CrossRefPubMed
16.
Zurück zum Zitat Attal N, Perrot S, Fermanian J, Bouhassira D (2011) The neuropathic components of chronic low back pain: a prospective multicenter study using the DN4 Questionnaire. J Pain 12(10):1080–1087. doi:S1526-5900(11)00630-4CrossRefPubMed Attal N, Perrot S, Fermanian J, Bouhassira D (2011) The neuropathic components of chronic low back pain: a prospective multicenter study using the DN4 Questionnaire. J Pain 12(10):1080–1087. doi:S1526-5900(11)00630-4CrossRefPubMed
17.
Zurück zum Zitat Smith BH, Torrance N, Bennett MI, Lee AJ (2007) Health and quality of life associated with chronic pain of predominantly neuropathic origin in the community. Clin J Pain 23 (2):143–149. doi:10.1097/01.ajp.0000210956.31997.89CrossRefPubMed Smith BH, Torrance N, Bennett MI, Lee AJ (2007) Health and quality of life associated with chronic pain of predominantly neuropathic origin in the community. Clin J Pain 23 (2):143–149. doi:10.1097/01.ajp.0000210956.31997.89CrossRefPubMed
18.
Zurück zum Zitat Smart KM, Blake C, Staines A, Doody C (2012) Self-reported pain severity, quality of life, disability, anxiety and depression in patients classified with ‘nociceptive’, ‘peripheral neuropathic’ and ‘central sensitisation’ pain. The discriminant validity of mechanisms-based classifications of low back (+ /−leg) pain. Man Ther 17(2):119–125. doi:S1356-689X(11)00188-3CrossRefPubMed Smart KM, Blake C, Staines A, Doody C (2012) Self-reported pain severity, quality of life, disability, anxiety and depression in patients classified with ‘nociceptive’, ‘peripheral neuropathic’ and ‘central sensitisation’ pain. The discriminant validity of mechanisms-based classifications of low back (+ /−leg) pain. Man Ther 17(2):119–125. doi:S1356-689X(11)00188-3CrossRefPubMed
19.
Zurück zum Zitat Vaillant G (1992) Ego mechanisms of defense: a guide for clinicians and researchers. American Psychiatric Press, Washington, DC Vaillant G (1992) Ego mechanisms of defense: a guide for clinicians and researchers. American Psychiatric Press, Washington, DC
20.
Zurück zum Zitat Hyphantis TN, Tomenson B, Bai M et al (2010) Psychological distress, somatization, and defense mechanisms associated with quality of life in inflammatory bowel disease patients. Dig Dis Sci 55(3):724–732. doi:10.1007/s10620-009-0762-zCrossRefPubMed Hyphantis TN, Tomenson B, Bai M et al (2010) Psychological distress, somatization, and defense mechanisms associated with quality of life in inflammatory bowel disease patients. Dig Dis Sci 55(3):724–732. doi:10.1007/s10620-009-0762-zCrossRefPubMed
21.
Zurück zum Zitat Carvalho AF, Ramirez SP, Macedo DS et al (2013) The psychological defensive profile of hemodialysis patients and its relationship to health-related quality of life. J Nerv Ment Dis 201(7):621–628. doi:10.1097/NMD.0b013e318298294dCrossRefPubMed Carvalho AF, Ramirez SP, Macedo DS et al (2013) The psychological defensive profile of hemodialysis patients and its relationship to health-related quality of life. J Nerv Ment Dis 201(7):621–628. doi:10.1097/NMD.0b013e318298294dCrossRefPubMed
22.
Zurück zum Zitat Bai M, Tomenson B, Creed F et al (2009) The role of psychological distress and personality variables in the disablement process in rheumatoid arthritis. Scand J Rheumatol 38(6):419–430. doi:10.3109/03009740903015135CrossRefPubMed Bai M, Tomenson B, Creed F et al (2009) The role of psychological distress and personality variables in the disablement process in rheumatoid arthritis. Scand J Rheumatol 38(6):419–430. doi:10.3109/03009740903015135CrossRefPubMed
23.
Zurück zum Zitat Unal-Cevik I, Sarioglu-Ay S, Evcik D (2010) A comparison of the DN4 and LANSS questionnaires in the assessment of neuropathic pain: validity and reliability of the Turkish version of DN4. J Pain 11(11):1129–1135. doi:S1526-5900(10)00324-XCrossRefPubMed Unal-Cevik I, Sarioglu-Ay S, Evcik D (2010) A comparison of the DN4 and LANSS questionnaires in the assessment of neuropathic pain: validity and reliability of the Turkish version of DN4. J Pain 11(11):1129–1135. doi:S1526-5900(10)00324-XCrossRefPubMed
24.
Zurück zum Zitat Beck AT, Ward CH, Mendelson M et al (1961) An inventory for measuring depression. Arch Gen Psychiatry 4:561–571CrossRefPubMed Beck AT, Ward CH, Mendelson M et al (1961) An inventory for measuring depression. Arch Gen Psychiatry 4:561–571CrossRefPubMed
25.
Zurück zum Zitat Beck AT, Epstein N, Brown G, Steer RA (1988) An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol 56(6):893–897CrossRefPubMed Beck AT, Epstein N, Brown G, Steer RA (1988) An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol 56(6):893–897CrossRefPubMed
26.
Zurück zum Zitat Andrews G, Singh M, Bond M (1993) The defense style questionnaire. J Nerv Ment Dis 181(4):246–256CrossRefPubMed Andrews G, Singh M, Bond M (1993) The defense style questionnaire. J Nerv Ment Dis 181(4):246–256CrossRefPubMed
27.
Zurück zum Zitat Hisli N (1989) Beck Depresyon envanterinin üniversite öğrencileri için geçerliliği ve güvenilirliği. Psikoloji Dergisi 7:3–13 Hisli N (1989) Beck Depresyon envanterinin üniversite öğrencileri için geçerliliği ve güvenilirliği. Psikoloji Dergisi 7:3–13
28.
Zurück zum Zitat Ulusoy M, Sahin NH (1998) Turkish version of the beck anxiety inventory: psychometric properties. J Cog Psychother 12:163–172 Ulusoy M, Sahin NH (1998) Turkish version of the beck anxiety inventory: psychometric properties. J Cog Psychother 12:163–172
29.
Zurück zum Zitat Yılmaz N, Gençöz T, Ak M (2007) Savunma Biçimleri Testi’nin Psikometrik Özellikleri: Güvenirlik ve Geçerlik Çalışması. Türk Psikiyatri Dergisi 18(3):244–253PubMed Yılmaz N, Gençöz T, Ak M (2007) Savunma Biçimleri Testi’nin Psikometrik Özellikleri: Güvenirlik ve Geçerlik Çalışması. Türk Psikiyatri Dergisi 18(3):244–253PubMed
30.
Zurück zum Zitat Koçyiğit H, Aydemir Ö, Ölmez N, Memiş A (1999) The validity and reliability of Turkish version of short form 36 (SF-36). Turkish J Drugs Therap 112:102–106 Koçyiğit H, Aydemir Ö, Ölmez N, Memiş A (1999) The validity and reliability of Turkish version of short form 36 (SF-36). Turkish J Drugs Therap 112:102–106
31.
Zurück zum Zitat Keefe FJ, Rumble ME, Scipio CD et al (2004) Psychological aspects of persistent pain: current state of the science. J Pain 5(4):195–211. doi:10.1016/j.jpain.2004.02.576CrossRefPubMed Keefe FJ, Rumble ME, Scipio CD et al (2004) Psychological aspects of persistent pain: current state of the science. J Pain 5(4):195–211. doi:10.1016/j.jpain.2004.02.576CrossRefPubMed
32.
Zurück zum Zitat Kraus MR, Schafer A, Csef H et al (2000) Emotional state, coping styles, and somatic variables in patients with chronic hepatitis C. Psychosomatics 41(5):377–384. doi:S0033-3182(00)70580-9CrossRefPubMed Kraus MR, Schafer A, Csef H et al (2000) Emotional state, coping styles, and somatic variables in patients with chronic hepatitis C. Psychosomatics 41(5):377–384. doi:S0033-3182(00)70580-9CrossRefPubMed
33.
Zurück zum Zitat Berger A, Toelle T, Sadosky A et al (2009) Clinical and economic characteristics of patients with painful neuropathic disorders in Germany. Pain Pract 9(1):8–17. doi:PPR244CrossRefPubMed Berger A, Toelle T, Sadosky A et al (2009) Clinical and economic characteristics of patients with painful neuropathic disorders in Germany. Pain Pract 9(1):8–17. doi:PPR244CrossRefPubMed
34.
Zurück zum Zitat Bouhassira D, Lanteri-Minet M, Attal N et al (2008) Prevalence of chronic pain with neuropathic characteristics in the general population. Pain 136(3):380–387. doi:S0304-3959(07)00449-6CrossRefPubMed Bouhassira D, Lanteri-Minet M, Attal N et al (2008) Prevalence of chronic pain with neuropathic characteristics in the general population. Pain 136(3):380–387. doi:S0304-3959(07)00449-6CrossRefPubMed
35.
Zurück zum Zitat Yamashita T, Takahashi K, Yonenobu K, Kikuchi S (2014) Prevalence of neuropathic pain in cases with chronic pain related to spinal disorders. J Orthop Sci 19(1):15–21. doi:10.1007/s00776-013-0496-9CrossRefPubMed Yamashita T, Takahashi K, Yonenobu K, Kikuchi S (2014) Prevalence of neuropathic pain in cases with chronic pain related to spinal disorders. J Orthop Sci 19(1):15–21. doi:10.1007/s00776-013-0496-9CrossRefPubMed
36.
Zurück zum Zitat Taylor R, Lovibond PF, Nicholas MK et al (2005) The utility of somatic items in the assessment of depression in patients with chronic pain: a comparison of the Zung self-rating depression scale and the depression anxiety stress scales in chronic pain and clinical and community samples. Clin J Pain 21(1):91–100. doi:00002508-200501000-00011CrossRefPubMed Taylor R, Lovibond PF, Nicholas MK et al (2005) The utility of somatic items in the assessment of depression in patients with chronic pain: a comparison of the Zung self-rating depression scale and the depression anxiety stress scales in chronic pain and clinical and community samples. Clin J Pain 21(1):91–100. doi:00002508-200501000-00011CrossRefPubMed
Metadaten
Titel
Psychological defensive profile of sciatica patients with neuropathic pain and its relationship to quality of life
verfasst von
Prof. A. Tutoglu, MD
A. Boyaci
İ.F. Karababa
I. Koca
E. Kaya
A. Kucuk
A. Yetisgin
Publikationsdatum
01.09.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
Zeitschrift für Rheumatologie / Ausgabe 7/2015
Print ISSN: 0340-1855
Elektronische ISSN: 1435-1250
DOI
https://doi.org/10.1007/s00393-014-1527-4

Weitere Artikel der Ausgabe 7/2015

Zeitschrift für Rheumatologie 7/2015 Zur Ausgabe

Mitteilungen der DGRh

Mitteilungen

CME Zertifizierte Fortbildung

Hämochromatose

Update Rheumatologie

Update Rheumatologie

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Blutdrucksenkung könnte Uterusmyome verhindern

Frauen mit unbehandelter oder neu auftretender Hypertonie haben ein deutlich erhöhtes Risiko für Uterusmyome. Eine Therapie mit Antihypertensiva geht hingegen mit einer verringerten Inzidenz der gutartigen Tumoren einher.

„Jeder Fall von plötzlichem Tod muss obduziert werden!“

17.05.2024 Plötzlicher Herztod Nachrichten

Ein signifikanter Anteil der Fälle von plötzlichem Herztod ist genetisch bedingt. Um ihre Verwandten vor diesem Schicksal zu bewahren, sollten jüngere Personen, die plötzlich unerwartet versterben, ausnahmslos einer Autopsie unterzogen werden.

Hirnblutung unter DOAK und VKA ähnlich bedrohlich

17.05.2024 Direkte orale Antikoagulanzien Nachrichten

Kommt es zu einer nichttraumatischen Hirnblutung, spielt es keine große Rolle, ob die Betroffenen zuvor direkt wirksame orale Antikoagulanzien oder Marcumar bekommen haben: Die Prognose ist ähnlich schlecht.

Schlechtere Vorhofflimmern-Prognose bei kleinem linken Ventrikel

17.05.2024 Vorhofflimmern Nachrichten

Nicht nur ein vergrößerter, sondern auch ein kleiner linker Ventrikel ist bei Vorhofflimmern mit einer erhöhten Komplikationsrate assoziiert. Der Zusammenhang besteht nach Daten aus China unabhängig von anderen Risikofaktoren.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.