Displaying publications 1 - 20 of 34 in total

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  1. Boey CC, Goh KL
    J Gastroenterol Hepatol, 2002 Dec;17(12):1250-3.
    PMID: 12423267
    Recurrent abdominal pain in children is not a single condition but a description of a wide spectrum of clinical manifestations, some of which fit into a definite pattern, such as the irritable bowel syndrome, while others do not. Organic disorders may be present, but in the majority of children they cannot be detected. Although children with recurrent abdominal pain do not generally have psychological or psychiatric illness, there is a growing body of evidence to suggest that psychosocial stress plays an important role in this condition. This review will look into some of this evidence. The precise pathophysiology that results in abdominal pain is still not clearly understood, but the current belief is that visceral hypersensitivity or hyperalgesia and changes in the brain-gut axis linking the central and enteric nervous systems are important mechanisms.
    Matched MeSH terms: Abdominal Pain/psychology*
  2. Maakip I, Oakman J, Stuckey R
    J Occup Rehabil, 2017 Jun;27(2):228-238.
    PMID: 27339144 DOI: 10.1007/s10926-016-9650-5
    Purpose Workers with musculoskeletal pain (MSP) often continue to work despite their condition. Understanding the factors that enable them to remain at work provides insights into the development of appropriate workplace accommodations. This qualitative study aims to explore the strategies utilised by female Malaysian office workers with MSP to maintain productive employment. Methods A qualitative approach using thematic analysis was used. Individual semi-structured interviews were conducted with 13 female Malaysian office workers with MSP. Initial codes were identified and refined through iterative discussion to further develop the emerging codes and modify the coding framework. A further stage of coding was undertaken to eliminate redundant codes and establish analytic connections between distinct themes. Results Two major themes were identified: managing the demands of work and maintaining employment with persistent musculoskeletal pain. Participants reported developing strategies to assist them to remain at work, but most focused on individually initiated adaptations or peer support, rather than systemic changes to work systems or practices. A combination of the patriarchal and hierarchical cultural occupational context emerged as a critical factor in the finding of individual or peer based adaptations rather than organizational accommodations. Conclusions It is recommended that supervisors be educated in the benefits of maintaining and retaining employees with MSP, and encouraged to challenge cultural norms and develop appropriate flexible workplace accommodations through consultation and negotiation with these workers.
    Matched MeSH terms: Chronic Pain/psychology; Musculoskeletal Pain/psychology*
  3. Adnan R, Van Oosterwijck J, Danneels L, Willems T, Meeus M, Crombez G, et al.
    J Back Musculoskelet Rehabil, 2020;33(6):919-930.
    PMID: 33016899 DOI: 10.3233/BMR-191548
    BACKGROUND: Differences in pain processing, muscle structure and function have been reported in patients with low back pain (LBP) with different grades of pain chronicity.

    OBJECTIVE: The present study aims to examine differences in psychological factors, disability and subjective fatigue between subgroups of LBP based on their chronification grade.

    METHODS: Twenty-one healthy controls (HC) and 54 LBP patients (categorized based on the grades of chronicity into recurrent LBP (RLBP), non-continuous chronic LBP (CLBP), or continuous (CLBP)) filled out a set of self-reporting questionnaires.

    RESULTS: The Hospital Anxiety and Depression Scale (HADS) and Multidimensional Pain Inventory (MPI) scores indicated that anxiety, pain severity, pain interference and affective distress were lower in HC and RLBP compared to non-continuous CLBP. Anxiety scores were higher in non-continuous CLBP compared to RLBP, continuous CLBP and HC. The Pain Catastrophizing Scale for Helplessness (PSCH) was higher in non-continuous CLBP compared to HC. The Survey of Pain Attitudes (SOPA) showed no differences in adaptive and maladaptive behaviors across the groups. The Pain Disability Index (PDI) measured a higher disability in both CLBP groups compared to HC. Moreover, the Rolland Morris Disability Questionnaire (RMDQ) showed higher levels of disability in continuous CLBP compared to non-continuous CLBP, RLBP and HC. The Checklist Individual Strength (CIS) revealed that patients with non-continuous CLBP were affected to a higher extent by severe fatigue compared to continuous CLBP, RLBP and HC (subjective fatigue, concentration and physical activity). For all tests, a significance level of 0.05 was used.

    CONCLUSIONS: RLBP patients are more disabled than HC, but have a tendency towards a general positive psychological state of mind. Non-continuous CLBP patients would most likely present a negative psychological mindset, become more disabled and have prolonged fatigue complaints. Finally, the continuous CLBP patients are characterized by more negative attitudes and believes on pain, enhanced disability and interference of pain in their daily lives.

    Matched MeSH terms: Low Back Pain/psychology; Chronic Pain/psychology
  4. Lee SW, Liong ML, Yuen KH, Krieger JN
    Complement Ther Med, 2014 Dec;22(6):965-9.
    PMID: 25453515 DOI: 10.1016/j.ctim.2014.10.010
    Objective: The immune system has been implicated as one mechanism underlying the benefits of acupuncture therapy. Evidence suggests that acupuncture can ameliorate symptoms of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), but the association between clinical response and the immune system has not been investigated.

    Design/setting: We investigated 12 CP/CPPS patients participating in a prospective randomized clinical trial comparing acupuncture versus sham acupuncture for effects on cellular immunity. Blood samples were taken before the first needling and after the last of 20 treatment sessions (week 10). Patients also completed questionnaires examining their CP/CPPS symptoms and mood status at the baseline and end of study visits.

    Results: At the end of study 8 of 12 participants (67%) were classified as treatment responders, four participants each from the acupuncture and sham groups. The acupuncture group averaged a 5% increase in natural killer cell levels compared to corresponding sham (-13%; p=0.03). Similarly, patients randomized to acupuncture reported a reduction in other white blood cell parameters examined, supporting the possibility that immunity might be important in the pathophysiology of CP/CPPS.

    Conclusions: The specific effect of acupuncture on CP/CPPS remains unclear. Further research is warranted to examine the mechanisms by which acupuncture therapy may improve clinical symptoms in patients with CP/CPPS.

    Trial registration: ClinicalTrials.gov number, NCT00260637).

    Keywords: Acupuncture; Chronic prostatitis/chronic pelvic pain syndrome; Immune system; Neuroendocrine system; Traditional Chinese medicine.
    Matched MeSH terms: Pelvic Pain/psychology
  5. Chan A, Malhotra C, Do YK, Malhotra R, Ostbye T
    Eur J Pain, 2011 Nov;15(10):1094-9.
    PMID: 21646030 DOI: 10.1016/j.ejpain.2011.05.006
    The objective of this paper is to test and correct for systematic differences in reporting of pain severity among older adults by age, gender, ethnic group and socio-economic status using anchoring vignettes. Data from a national survey of community-dwelling older Singaporeans (aged 60 years and over) conducted in 2009 was used. Respondents were asked to rate the severity of their own pain as well as that of others described in the vignettes on a five-point scale ranging from none to extreme. An ordered probit model was used to estimate the coefficients of the independent variables (age, gender, ethnic group, education, housing type) on self-reported pain. Reporting heterogeneity in pain severity was then corrected using a Hierarchical Ordered Probit model. The results showed that before correcting for reporting heterogeneity, women, those older, and those of Malay ethnicity reported greater severity of pain, while there was no association of reported pain severity with housing type and education. However, after correcting for reporting heterogeneity, while women and those older were found to have an even greater severity of pain than what they had reported, Malays were found to have a lower severity of pain than what they had reported. We conclude that there are systematic differences in reporting pain severity by age, gender and ethnic group. We propose that pain management may be improved if medical professionals take into account reporting heterogeneity for pain severity among various population sub-groups in Singapore.
    Matched MeSH terms: Pain/psychology*
  6. Urquhart DM, Kelsall HL, Hoe VC, Cicuttini FM, Forbes AB, Sim MR
    Clin J Pain, 2013 Dec;29(12):1015-20.
    PMID: 23370089 DOI: 10.1097/AJP.0b013e31827ff0c0
    OBJECTIVES: To examine the relationship between individual and work-related psychosocial factors and low back pain (LBP) and associated time off work in an occupational cohort.
    METHODS: A self-administered questionnaire was completed by nurses working across 3 major public hospitals. Participants provided sociodemographic data and information on the occurrence of LBP, time off work, and psychosocial factors.
    RESULTS: One thousand one hundred eleven participants (response rate 38.6%) were included in the study. Fifty-six percent of participants reported LBP in the previous year. When individual psychosocial factors were examined in the same model, the relationship between somatization and LBP persisted (OR 1.64; 95% confidence interval [CI], 1.35, 2.01). Low job security was also significantly associated with LBP independent of the other work-related factors (OR 0.82; 95% CI, 0.69, 0.98). Of those participants with LBP, 30% reported absence from work due to LBP. When absence from work was examined, negative beliefs (OR 0.97; 95% CI, 0.94, 1.00) and pain catastrophizing (OR 1.33; 95% CI, 1.04, 1.71) were independently associated with time off work, along with low job satisfaction (OR 0.71; 95% CI, 0.51, 0.97) and high job support (OR 1.35; 95% CI, 1.04, 1.75).
    CONCLUSIONS: Somatization and low job security were found to be independently associated with occupational LBP, whereas negative beliefs, pain catastrophizing, reduced job satisfaction, and high job support were independently related to time off work. Longitudinal studies are needed to determine whether these individual and work-related psychosocial factors predict, or alternatively, are outcomes of pain and time off work associated with LBP.
    Matched MeSH terms: Low Back Pain/psychology*
  7. Rahman F, Lall P, Iqbal S, Vicknasingam B
    Harm Reduct J, 2015 Nov 05;12:52.
    PMID: 26542117 DOI: 10.1186/s12954-015-0086-6
    BACKGROUND: Out of 20,887 persons who use drugs that came into contact with the National Anti-Drugs Agency (NADA) officials in the year 2013, 3.2% were women. Because women who use drugs (WWUD) are often a hidden population, this may be an underestimate. International literature shows that women who use drugs face increased risk of HIV, intimate partner violence, and mental health issues. Similar literature in Malaysia is lacking, and thus, the objective of our study was exploratory in nature.

    METHODS: Thirty-eight women who use drugs were interviewed using a semi-structured topic guide in Kelantan, Penang, Johor, Kuala Lumpur, and Selangor. Locations were chosen purposively. Nineteen women were interviewed individually and the remaining 19 were in focus group discussions (FGDs). All interviews were transcribed verbatim, translated to English, and analyzed with NVivo.

    RESULTS: Median age of respondents was 35.5 years old, 89.5% ethnic Malays, majority having married below the age of 20, and were of low socioeconomic backgrounds. Youngest age of initiation into drug use was 9 years old. Most reported is inhalation of amphetamine-type substances. Seven reported ever injecting. Three themes emerged: (a) repeating patterns of fluid family structures and instability; (b) "pain" and "difficulty" as features of home life; and (c) seeking marriage as a source of stabilization and practices of power within those marriages. Respondents often came from very fluid family environments and married to find stability, only to be drawn into a similar cycle. None of the women who had been separated from their children either institutionally, by family members, or by third parties, had accessed legal recourse for the loss of their parental rights.

    CONCLUSION: Unstable familial relationships or environments contributed to earlier initiation of drug use which raised questions about support services for WWUD and children who use drugs. Respondents were drawn into unstable and/or abusive relationships, perpetuating social inequalities that marked their own familial environments during childhood. These findings support the need for additional services to support the unique needs of WWUD, including domestic violence services, financial and life skills, parental rights assistance, and empowerment programs.

    Matched MeSH terms: Pain/psychology*
  8. Boey CC, Yap SB
    J Paediatr Child Health, 1999 Jun;35(3):303-5.
    PMID: 10404456
    OBJECTIVE: To study the prevalence of complaints of recurrent abdominal pain (RAP) among school children aged 11-12 years in a rural setting in Malaysia.

    METHODOLOGY: Questionnaires were distributed to all parents and teachers of children aged 11-12 years who attended a small rural school in which all the children were Malays. Complaints of RAP were defined as at least three such complaints occurring over a period of at least 3 months.

    RESULTS: One hundred and sixty questionnaires were distributed, of which 148 were returned, giving a response rate of 92.5%. Sixty-one children (41.2%) had RAP. Approximately 45.2% of girls and 35.9% of boys reported having RAP. Compared with children without RAP, there was a significantly larger number of children with RAP (85.2%) who had at least one stress factor (P = 0.0109). There were no significant associations between RAP and total family income (P = 0.0573), a history of abdominal pain in at least one parent (P = 0.1686), a history of abdominal pain in at least one sibling (P = 0.0617), academic performance (P = 0.9967) or the degree of sports participation (P = 0.8469). There was an increased incidence of other systemic complaints in children with RAP when compared with children without RAP.

    CONCLUSION: Recurrent abdominal pain was found to be common among 11- to 12-year-old children in a rural Malay school. There was a significant association found between RAP and the presence of stressful events, as well as with the presence of other systemic complaints.

    Matched MeSH terms: Abdominal Pain/psychology
  9. Boey CC, Omar A, Arul Phillips J
    J Paediatr Child Health, 2003 Jul;39(5):352-7.
    PMID: 12887665
    OBJECTIVE: The present study aimed to investigate the extent to which recurrent abdominal pain and other factors were associated with academic achievement among Year-6 (12 years of age) schoolchildren.

    METHODS: The present study was a cross-sectional survey conducted from September to November 2001. Schoolchildren were recruited from primary schools that were selected randomly from a list of all primary schools in Petaling Jaya, Malaysia, using random sampling numbers. Information concerning recurrent abdominal pain, socio-economic status, life events, demographic and other details was obtained using a combination of questionnaires and interviews. Academic achievement was assessed using a score based on the Malaysian Primary School Achievement Examination. An overall score at or above the mean was taken to indicate high academic achievement while a score below the mean indicated poor academic achievement.

    RESULTS: A total of 1971 children were studied (958 boys and 1013 girls: 1047 Malays, 513 Chinese and 411 Indians). Of these children, 456 (23.1%) fulfilled the criteria for recurrent abdominal pain. Using the method of binary logistic regression analysis, the following factors were found to be independently associated with poor academic performance: a low socio-economic status (odds ratio (OR) 1.30; 95% confidence interval (CI) 1.25-1.35); male sex (OR 1.61; 95% CI 1.26-2.05); the death of a close relative (OR 2.22; 95% CI 1.73-2.85); the divorce or separation of parents (OR 3.05; 95% CI 1.73-5.40); the commencement of work by the mother (OR 1.34; 95% CI 1.02-1.76); hospitalization of the child in the 12 months prior to the study (OR 1.83; 95% CI 1.12-3.01); lack of health-care consultation (OR 1.80; 95% CI 1.36-2.36); missing breakfast (OR 1.47; 95% CI 1.07-2.02); and lack of kindergarten education (OR 1.35; 95% CI 1.04-1.75).

    CONCLUSIONS: Many factors, such as socio-economic status and recent life events, were associated with poor academic performance. Recurrent abdominal pain did not correlate directly to academic performance. Stress may be a means by which various factors cause children to struggle academically.

    Matched MeSH terms: Abdominal Pain/psychology*
  10. Jaafar N, Razak IA, Zain RB
    Ann Acad Med Singap, 1989 Sep;18(5):553-5.
    PMID: 2619246
    The aim of this study is to determine the social impact of oral and facial pain in a sample involving an industrial population. Out of a total of 355 subjects interviewed, nearly one-half claimed to have oral and facial pain in the previous one month prior to the survey. The most common type of pain was that related to hot or cold fluids or sweet things followed by toothache. On the average, the pain lasted for 4.2 days (SD = 4.9) per person in the past one-month. About one in five persons with pain reported that it was severe enough to disrupt sleep. About one in ten persons reporting pain had to take sick leave because of the pain. However, only one in four persons with pain consulted a doctor or dentist. More than one-third tried to cope with the pain and did nothing while the rest tried various means of self-cure. It is therefore postulated that in this population, pain per se is a poor predictor of utilisation of dental services. Further research into pain coping behaviour and how this affects of pattern of utilisation of dental services is indicated in order to formulate a strategy to encourage the habit of seeking prompt dental care by the target population.
    Matched MeSH terms: Facial Pain/psychology*
  11. Zahari Z, Ishak A, Justine M
    J Back Musculoskelet Rehabil, 2020;33(2):245-254.
    PMID: 31356191 DOI: 10.3233/BMR-181305
    OBJECTIVES: This study aimed to gain an overview of patient education and the effects of patient education for older people with low back pain (LBP).

    METHODS: The search strategies were performed via EBSCO MEDLINE, EBSCO CINAHL, Science Direct, PubMed, and PEDro databases from 2006 to 2016. The keywords "patient education", "low back pain", "elderly", "older adults", "older persons" and "older people" were used during the literature search. Boolean operators were used to expand or limit the searching scope and manual exclusion was performed to choose articles eligible for this study.

    RESULTS: A total of 2799 articles were retrieved but only five articles were related with patient education for older people with LBP. Findings suggest that patient education for older people may differ in terms of its contents such as health education, self-management, video education, and postural education. The high methodological quality of the studies revealed that patient education showed improvement in terms of pain, disability and quality of life among older people with LBP.

    CONCLUSIONS: Patient education improved pain and had positive effects on disability and quality of life among older people with LBP. However, due to the limited number of RCTs more studies are needed to provide evidence for its effectiveness.

    Matched MeSH terms: Low Back Pain/psychology
  12. Pahlevan Sharif S, Abaeian V, Khanekharab J
    Int J Health Care Qual Assur, 2018 Jun 11;31(5):391-399.
    PMID: 29865960 DOI: 10.1108/IJHCQA-02-2017-0026
    Purpose The purpose of this paper is to evaluate the Persian version of the Attitude toward Breast Cancer Screening Procedures Scale (ABCSPS) among Iranian women. Design/methodology/approach In this methodological study, 1,000 Iranian women completed a demographic questionnaire and the 14-item Persian ABCSPS. The scale's construct validity was evaluated using exploratory and confirmatory factor analysis. Internal consistency and reliability were assessed using Cronbach's α and McDonald's coefficient ω. Findings The exploratory factor analysis revealed a two-factor solution accounting for 55.1 percent of the variance. The two-factor measurement model had a good fit with all factor loadings greater than 0.5, which were statistically significant. The results showed good reliability and internally consistency ( α=0.767 and 0.872; ω =0.979 and 0.997). Moreover, model structure was invariant across different income groups. Originality/value The Persian ABCSPS translation demonstrated good validity and reliability among Iranian women. The results also showed that the scale had a multidimensional structure. Regarding proper psychometric properties, the validated scale can be used in future studies as a reliable and relevant breast cancer screening attitude measure.
    Matched MeSH terms: Pain/psychology
  13. Boey CC, Goh KL
    Eur J Gastroenterol Hepatol, 2001 Apr;13(4):401-4.
    PMID: 11338070
    OBJECTIVE: The purpose of this study was to look at the correlation between recurrent abdominal pain and the presence of recent stressful life events among schoolchildren in a rural district in Malaysia.

    METHOD: This is a cross-sectional study of schoolchildren aged 9-15 years based in Kuala Langat, a rural district located in the south-west of the Malaysian state of Selangor. Schoolchildren were selected randomly and given questionnaires to fill in. This was followed by interview with the children on the same day by one of the authors (CCMB) to ensure consistency of response. Recurrent abdominal pain was defined as 'at least three episodes of abdominal pain, severe enough to affect their activities over a period longer than three months' [1]. The children were also asked to answer either 'yes' or 'no' to whether they had experienced various life events in the previous year.

    RESULTS: A sample of 1462 schoolchildren (722 boys and 740 girls) aged between 9 and 15 years were included in the study. There were 768 Malays, 393 Chinese and 301 Indians. Of these 1462 children, 161 (11.0%) had recurrent abdominal pain. On performing multiple logistic regression analysis, two life events were significantly associated with recurrent abdominal pain: death of a family member (P = 0.008; odds ratio 0.61, 95% CI 0.43-0.88) and a change in occupation of an immediate family member (P = 0.003; odds ratio 0.53, 95% CI 0.35-0.81).

    CONCLUSION: This study suggests that recurrent abdominal pain in children is associated with recent stressful life events in the children's lives.

    Matched MeSH terms: Abdominal Pain/psychology*
  14. Boey CC, Goh KL
    J Psychosom Res, 2001 Oct;51(4):559-62.
    PMID: 11595243
    This study aimed to look at the link between childhood recurrent abdominal pain (RAP) and the presence of recent life-events in an urban community in Malaysia. School children aged from 9 to 15 years in the city of Petaling Jaya were randomly selected to fill in a questionnaire and to be interviewed. The prevalence of RAP among 1488 school children studied was 9.6% (95% confidence interval (CI), 8.18-11.25). Higher prevalences of RAP were found in children who had experienced the following life-events in the previous year: loss of a family member through death (P
    Matched MeSH terms: Abdominal Pain/psychology*
  15. Nagammai T, Mohazmi M, Liew SM, Chinna K, Lai PS
    Qual Life Res, 2015 Aug;24(8):2031-7.
    PMID: 25648757 DOI: 10.1007/s11136-015-0933-7
    PURPOSE: To assess the validity and reliability of the Malay version of the Quality of Life (QOL) Questionnaire of the European Foundation for Osteoporosis (QUALEFFO-41) in Malaysia.
    METHODS: The QUALEFFO-41 was translated from English to Malay and administered to 215 post-menopausal osteoporotic women ≥50 years who could understand Malay, at baseline and 4 weeks. The SF-36 was administered at baseline to assess convergent validity. To assess discriminative validity, patients with and without back pain were recruited.
    RESULTS: Confirmatory factor analysis showed that the QUALEFFO-41 had five domains. Good internal consistency was seen in all domains (0.752-0.925) except for the social activity domain (0.692). Test-retest reliability showed adequate correlation for all items (0.752-0.964, p < 0.001). Patients with back pain had significantly worse QOL compared with those without (back pain = 42.2 ± 10.9, no back pain = 33.3 ± 8.9; p < 0.001). The total QUALEFFO-41 score and the SF-36 physical and mental composite scores were significantly correlated (-0.636 and -0.529, p < 0.001, respectively).
    CONCLUSIONS: The Malay version of the QUALEFFO-41 was found to be a reliable and valid instrument to evaluate the QOL of osteoporotic patients in Malaysia. To enable the QUALEFFO-41 to be used in a multiracial population, further studies should look into validating other versions of the QUALEFFO-41 in Malaysia.
    Matched MeSH terms: Back Pain/psychology
  16. Mohd Din FH, Hoe VC, Chan CK, Muslan MA
    Qual Life Res, 2015 May;24(5):1275-80.
    PMID: 25373928 DOI: 10.1007/s11136-014-0850-1
    PURPOSE: The Pain Catastrophizing Scale (PCS) is designed to assess negative thoughts in response to pain. It is composed of three domains: helplessness, rumination, and magnification. We report on the translation, adaptation, and validation of scores on a Malay-speaking version of the PCS, the PCS-MY.

    METHOD: Guidelines for the process of cross-cultural adaptations of assessment measures were implemented. A sample of 303 young military recruits participated in the study. Factor structure, reliability, and validity of scores on the PCS-MY were examined. Convergent validity was investigated with the Positive and Negative Affect Scale, Short-form 12 version 2, and Ryff's Psychological Well-being Scale.

    RESULTS: Most participants were men, ranging in age from 19 to 26. The reliability of the PCS-MY scores was adequate (α = 0.90; mean inter-item correlation = 0.43). Confirmatory factor analysis showed that a modified version of the PCS-MY provided best fit estimates to the sample data. The PCS-MY total score was negatively correlated with mental well-being and positively correlated with negative affect (all ps < 0.001).

    CONCLUSION: The PCS-MY was demonstrated to have adequate reliability and validity estimates in the study sample.

    Matched MeSH terms: Pain/psychology*
  17. Masood M, Masood Y, Newton T
    J Dent, 2014 Mar;42(3):249-55.
    PMID: 24373852 DOI: 10.1016/j.jdent.2013.12.004
    This study sought to assess the impact of posterior cross-bite on OHRQoL in young people aged 15-25 and to determine whether the impact on higher domains of Oral Health Impact Profile-14 (physical disability, psychological disability, social disability and handicap) is a direct function of the cross-bite or mediated through the lower domains of OHIP-14 (functional limitation, pain and discomfort).
    Matched MeSH terms: Pain/psychology
  18. Zahari Z, Ismail R
    Drug Metab. Pharmacokinet., 2014;29(1):29-43.
    PMID: 23759977
    CYP2D6 polymorphisms show large geographical and interethnic differences. Variations in CYP2D6 activity may impact upon a patient's pain level and may contribute to interindividual variations in the response to opioids. This paper reviews the evidence on how CYP2D6 polymorphisms might influence pain sensitivity and clinical response to codeine and tramadol. For example, it is shown that (1) CYP2D6 poor metabolizers (PMs) may be less efficient at synthesizing endogenous morphine compared with other metabolizers. In contrast, ultra-rapid metabolizers (UMs) may be more efficient than other metabolizers at synthesizing endogenous morphine, thus strengthening endogenous pain modulation. Additionally, for codeine and tramadol that are bioactivated by CYP2D6, PMs may undergo no metabolite formation, leading to inadequate analgesia. Conversely, UMs may experience quicker analgesic effects but be prone to higher mu-opioid-related toxicity. The literature suggested the potential usefulness of the determination of CYP2D6 polymorphisms in elucidating serious adverse events and in preventing subsequent inappropriate selection or doses of codeine and tramadol. Notably, even though many studies investigated a possible role of the CYP2D6 polymorphisms on pain sensitivity, pharmacokinetics and pharmacodynamics of these drugs, the results of analgesia and adverse effects are conflicting. More studies are required to demonstrate genetically determined unresponsiveness and risk of developing serious adverse events for patients with pain and these should involve larger numbers of patients in different population types.
    Matched MeSH terms: Pain/psychology
  19. Yusof FA, Goh A, Azmi S
    Value Health, 2012 Jan-Feb;15(1 Suppl):S85-90.
    PMID: 22265073 DOI: 10.1016/j.jval.2011.11.024
    OBJECTIVES: To estimate a EQ-5D value set for Malaysia by using time trade-off (TTO) and visual analogue scale (VAS) valuation methods.
    METHODS: TTO and VAS valuations were obtained from face-to-face surveys of a convenience sample of patients, caregivers, and health professionals conducted at nine government hospitals in 2004 and 2005. Forty-five EQ-5D questionnaire health states were valued, divided into five sets of 15 health states. Analysis was conducted by using linear additive regression models applying N3 and D1 specifications. Model selection was based on criteria of coefficient properties, statistical significance, and goodness of fit.
    RESULTS: One hundred fifty-two respondents were interviewed, yielding 2174 TTO and 2265 VAS valuations. Respondents found TTO valuations to be more difficult than VAS valuations, and there were more inconsistencies in TTO valuations. All the independent variables in the models were statistically significant and consistent with expected signs and magnitude, except for the D1 specification modeled on TTO valuations. The N3 model provided the best fit for the VAS valuation data, with a mean absolute error of 0.032.
    CONCLUSION: This study provides a Malaysian EQ-5D questionnaire value set that can be used for cost-utility studies despite survey limitations.
    Study site: convenience sampling from three categories of respondents (patients undergoing dialysis, patients’ carers, and dialysis center staff) from public hospitals
    Matched MeSH terms: Pain/psychology
  20. Ang QQ, Wing YK, He Y, Sulaiman AH, Chiu NY, Shen YC, et al.
    Int J Clin Pract, 2009 Jul;63(7):1041-9.
    PMID: 19570122 DOI: 10.1111/j.1742-1241.2009.02107.x
    Reports from non-Asian populations indicate that painful physical symptoms (PPS) are associated with poorer clinical and functional outcomes in major depressive disorder (MDD). The purpose of this study is to report comparative changes in disease severity, treatment patterns and quality of life observed in East Asian patients with MDD, with and without PPS, as assessed prospectively over a 3-month observation period.
    Matched MeSH terms: Pain/psychology*
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