Major Depression, Schizophrenia
Conditions
Keywords
Schizophrenia, Major depression, Pain, Past pain experience
Brief summary
Differences in pain perception between subjects with and without psychiatric illness may be influenced by the individual experience, and not primarily by the pathology, although the pathological frame may amplify it.The aim of this study is to establish if the characteristics of experimental pain feeling are influenced by the past pain experience, anxiety and emotion, independently from the diagnosis. The pain experience will be evaluated by an inventory of the potentially painful situations that one can come across through the life, to determine the following points : Number of painful events in the past, number of painful points during the last 6 months, number of painful events lasting more than 6 months, sum of pain intensities (graduated with Visual Analogic Scale VAS from 0 to 10), sum of gravity (evaluated from 0 to 5), the category of pain experience qualification (mostly affective, mostly sensorial, or both). Schizophrenic, depressed and control participants will be recruited, and their pain experience throughout life will be put it in relation to experimental pain tests results (pressure application, ischemia induction), anxiety and emotion (Hospital Anxiety and Depression scale HAD), catastrophizing (Pain Catastrophizing Scale PCS), Heart Rate (HR) variation, Blood Pressure (BP) variation.
Detailed description
The perception of moderated experimental pain (about 3 out of ten with visual analogue scale VAS) in subjects with schizophrenia (Girard et coll., 2011), major depression (ED) (bipolar or isolated/recurrent episode) (to be published) in comparison with controls without psychiatric pathologies show that exploration of pain in situation like medical examination to identify painful points should be done in the same conditions for persons with psychiatric troubles and persons without mental disease. But the risk is that the expression of pain, either in experimental conditions nor in the daily life, is not in relation with the feeling or perception of pain. Numerous factors may interfere in the pain message modulation, like the past pain experience, stress and anxiety, which are not or partially explored in experimental studies. The individual experience of pain is constructed throughout the whole life, from several influences (biological, psychological, and sociocultural). The symptoms interfaces of the different psychiatric troubles seem to be widely involved in the pain process, and its progressive construction. This study aims to better understand the relationships between all those variables. Procedures applied : Anterior pain experience evaluation (questionnaire); Pain tests : 160 kPa pressure application to determine corresponding pain with VAS), and ischemia induction to determine the time necessary to obtain a pain equivalent to 3 out of 10; anxiety and emotional evaluation (Hospital Anxiety and Depression scale), catastrophizing evaluation (Pain Catastrophizing Scale), HR variation and BP variation (vegetative measures linked to anxiety) collection of diagnosis, and therapeutic treatment
Interventions
OTHERexperimental pain tests
Sponsors
Centre Hospitalier Esquirol
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 60 Years
Healthy volunteers
Yes
Inclusion criteria
* subjects with psychiatric trouble : diagnosis of schizophrenia or major depression according to the DSM-IV-TR criteria. * control subjects : without known psychiatric history. * age between 18 and 60.
Exclusion criteria
* absence of consent, hospitalization under constraint, absence of health insurance. * inability to answer the questionnaires * pregnancy * antalgic or analgesic treatment * allergy to latex * non stabilized high blood pressure, bad blood coagulation, * peripheral neuropathy, nerve lesion, dermatosis at the superior extremities, muscular lesion or pathology at the upper member level * non treated alcohol dependence * illegal substance consumption in the past 48 hours * participation to an other biomedical study during the 2 weeks before inclusion, and until the pain tests, if this study can interfere with the realization of the objectives
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Visual Analog Scale Evaluation for the Pre-fixed Pressure Test | one month | pain tests will be realized during the first week of hospitalization for the persons hospitalized for major depression, and during the period of hospitalization (after stabilization) for the persons presenting schizophrenia. The controls are tested within one month of the study information. total range : 0 - 10. The intensity of pain increases with the value of VAS. 10 corresponds to an unbearable pain. |
Countries
France
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Group of Subjects With Schizophrenia SC subjects presenting a schizophrenia according to the DSM-IV-TR and submitted to experimental pain tests | 30 |
| Group of Subjects Presenting Major Depression MD subjects presenting a major depression according to the DSM-IV-TR and submitted to experimental pain tests | 32 |
| Group of Controls Without Psychiatric Disorder subjects without any psychiatric disorder and submitted to experimental pain tests | 30 |
| Total | 92 |
Baseline characteristics
| Characteristic | Group of Subjects With Schizophrenia SC | Group of Subjects Presenting Major Depression MD | Group of Controls Without Psychiatric Disorder | Total |
|---|---|---|---|---|
| Age, Continuous | 43.3 years STANDARD_DEVIATION 9.72 | 44.69 years STANDARD_DEVIATION 10.08 | 41.53 years STANDARD_DEVIATION 10.27 | 43.21 years STANDARD_DEVIATION 10 |
| Region of Enrollment France | 30 participants | 32 participants | 30 participants | 92 participants |
| Sex: Female, Male Female | 7 Participants | 27 Participants | 17 Participants | 51 Participants |
| Sex: Female, Male Male | 23 Participants | 5 Participants | 13 Participants | 41 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk |
|---|---|---|---|
| deaths Total, all-cause mortality | 0 / 30 | 0 / 32 | 0 / 30 |
| other Total, other adverse events | 0 / 30 | 0 / 32 | 0 / 30 |
| serious Total, serious adverse events | 0 / 30 | 0 / 32 | 0 / 30 |
Outcome results
Primary
Visual Analog Scale Evaluation for the Pre-fixed Pressure Test
pain tests will be realized during the first week of hospitalization for the persons hospitalized for major depression, and during the period of hospitalization (after stabilization) for the persons presenting schizophrenia. The controls are tested within one month of the study information. total range : 0 - 10. The intensity of pain increases with the value of VAS. 10 corresponds to an unbearable pain.
Time frame: one month
Population: analysis per arm group
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Group of Subjects Presenting Schizophrenia SC | Visual Analog Scale Evaluation for the Pre-fixed Pressure Test | 2.8 units on a scale | Standard Deviation 3.2 |
| Group of Subjects With Major Depression MD | Visual Analog Scale Evaluation for the Pre-fixed Pressure Test | 2.1 units on a scale | Standard Deviation 1.8 |
| Group of Subjects Without Psychiatric Troubles C | Visual Analog Scale Evaluation for the Pre-fixed Pressure Test | 1.2 units on a scale | Standard Deviation 1.3 |
p-value: 0.121Wilcoxon (Mann-Whitney)