Pharmacologic and non-pharmacologic treatments for chronic pain in individuals with HIV: a systematic review

Chronic pain occurs in as many as 85% of individuals with HIV and is associated with substantial functional impairment. Little guidance is available for HIV providers seeking to address their patients’ chronic pain. We conducted a systematic review to identify clinical trials and observational studies that examined the impact of pharmacologic or non-pharmacologic interventions on pain and/or functional outcomes among HIV-infected individuals with chronic pain in high-development countries. Eleven studies met inclusion criteria and were mostly low or very low quality. Seven examined pharmacologic interventions (gabapentin, pregabalin, capsaicin, analgesics including opioids) and four examined non-pharmacologic interventions (cognitive behavioral therapy, self-hypnosis, smoked cannabis). The only controlled studies with positive results were of capsaicin and cannabis, and had short-term follow-up (≤12 weeks). Among the seven studies of pharmacologic interventions, five had substantial pharmaceutical industry sponsorship. These findings highlight several important gaps in the HIV/chronic pain literature that require further research.     

Non-pharmacological treatments in the irritable bowel syndrome

INTRODUCTION The irritable bowel syndrome (IBS) is a gastrointestinal disorder characteried by chronic lower abdominal pain and disordered defaecation associated with bloating ,tenesmus and extra-intestinal symptoms including and functional upper gastrointestinal symptoms .Currently there is nounifying hypothesis which adepuately explains the pathogenesis of the disorder although a number of physiological and psychological abmormalites have been described.     

Fostering Internal Cooperation Through the Use of Imagery in the Treatment of Dissociative Identity Disorder

ABSTRACT

Most clinicians working with dissociative identity disorder (D.I.D.) recognize the importance of working towards a cooperative system especially during the initial stages of treatment. However, achieving this can be a monumental task given the inner war that goes on inside the mind of an individual diagnosed with D.I.D. From an ego-state theoretical framework, this article will demonstrate through clinical cases and artwork, the value of imagery techniques in changing internal perceptions, especially with regards to introject ego states. These changes can assist in eliciting more internal cooperation, a necessary task prior to working towards a collaborative, co-conscious system or what some theorists would call integration.     

What Do People Believe About Memory? Implications for the Science and Pseudoscience of Clinical Practice

We examine the evidence concerning what people believe about memory. We focus on beliefs regarding the permanence of memory and whether memory can be repressed and accurately recovered. We consider beliefs about memory among the undergraduate and general population, mental health professionals, judges, jurors, and law enforcement officers to provide a broad canvass that extends to the forensic arena, as well as to psychiatry, psychology, and allied disciplines. We discuss the implications of these beliefs for the education of the general public and mental health professionals regarding the science and pseudoscience of memory and the use of suggestive procedures in psychotherapy.     

Post-traumatic stress in the medical setting

ABSTRACT

This article addresses the prevalence of posttraumatic stress arising from serious illness and injury. Its purpose is to underscore the importance of assessment and treatment of this population. The article reviews literature about patient stress responses to intensive care experiences and hospitalization. Above all, serious illness and injury hamper the individual’s ability to maintain their ongoing lifestyle and interpersonal relationships; the experience raises the specter of vulnerability and mortality and can obstruct the experience of a familiar “self”. Issues to be assessed and areas to be addressed therapeutically using hypnosis are suggested.     

Hypnotic suggestion and placebo for the treatment of chronic headache in a university volunteer sample

Following a 3-week baseline, university student volunteers who reported chronic headache were administered ether one or four sessions of imagery-based hypnotic treatment, one or four sessions of a placebo treatment (i.e., subliminal reconditioning), or no treatment (i.e., monitoring controls). Subjects monitored headache activity daily during baseline and followup periods. Monitoring controls reported no significant changes in headache activity from baseline to 8-week followup. Hypnotic and placebo subjects reported significant and equivalent decrements in headache pain between these intervals. Magnitude of headache reduction was unrelated to expectancy of treatment success. Implications are discussed.This research was supported by a grant to the first author from the Social Sciences and Humanities Research Council of Canada.