It is acknowledged that the way patients cope with pain may influence treatment outcome. In particular, psychological factors are deemed important when considering patients for suitability for spinal cord stimulation (SCS). The aim of the study is to observe how pre-implantation psychological characteristics impact the effectiveness of SCS for chronic pain. The analysis comprised data from 137 patients who underwent an SCS implant. Screening evaluation included a coping strategies profile (Multidimensional Pain Inventory) and psychiatric disorders (Mini-International Neuropsychiatric Interview). Based on SCS implant outcome collected during follow-up visits, patients were divided into three groups: subjects with long-term pain relief (long-term group), subjects who failed the SCS treatment and decided to explant trial device (trial explanter group [TE]), and those who chose a permanent device (permanent explanter group [PE]). Results showed that most of the patients who failed with the SCS (TE and PE groups) demonstrated a dysfunctional coping profile and showed a higher presence of psychiatric disorders, which significantly influenced the experience and perception of pain. The findings of this study support the value of a multidisciplinary screening. Addressing psychological issues before SCS implantation can reduce the failure rate of SCS.

Background. A few studies have found somatosensory abnormalities in atypical odontalgia (AO) patients. The aim of the study is to explore the presence of specific abnormalities in facial pain patients that can be considered as psychophysical factors predisposing to AO. Materials and Methods. The AO subjects () have been compared to pain-free (), trigeminal neuralgia (), migraine (), and temporomandibular disorder (). The neurometer current perception threshold (CPT) was used to investigate somatosensory perception. Structured clinical interviews based on the DSM-IV axis I and DSM III-R axis II criteria for psychiatric disorders and self-assessment questionnaires were used to evaluate psychopathology and aggressive behavior among subjects. Results. Subjects with AO showed a lower Aβ, Aδ, and C trigeminal fiber pain perception threshold when compared to a pain-free control group. Resentment was determined to be inversely related to Aβ (rho: 0.62, ), Aδ (rho: 0.53, ) and C fibers (rho: 0.54, ), and depression was inversely related with C fiber (rho: 0.52, ) perception threshold only in AO subjects. Conclusion. High levels of depression and resentment can be considered predictive psychophysical factors for the development of AO after dental extraction.

Introduction. The nocebo effect consists in delivering verbal suggestions of negative outcomes so that the subject expects clinical worsening. Several studies indicate that negative verbal suggestions may result in the amplification of pain. Amplification style is one of the most important dimensions in psychosomatic research. Methods. One group of pain therapy unit patients was evaluated at baseline and again after 6 months from the beginning of the pain treatment. Results. Only 43% of 86 chronic pain patients respond positively to the expectation of sham pain. This group shows at baseline higher pain intensity (t value: 2.72, ) and lower cold pain threshold (t value: 2.18, ) than the group of subjects with any response to sham pain stimulus. Somatoform dimensions influence positively the strength of nocebo response in those predisposed to it. Conclusion. Our study shows that the power of the nocebo phenomenon seems to be a dimension belonging to the investigation in psychosomatic. In contrast to what one might expect, the presence of the nocebo phenomenon affects positively pain relief and the outcome of pain treatment. In a clinical setting, and the meaning of nocebo response does not seem to be different from placebo response.

Fibromyalgia symptoms affect the sufferers’ working life; however, through reasonable accommodations in workplaces, they can continue to work satisfactorily. There are no Italian studies on factors that facilitate or hinder fibromyalgia-affected people’s working life. Our objective was to explore, in a pre-pandemic setting, the quality of working life of fibromyalgia sufferers and reasonable accommodations to improve it. Quantitative and qualitative methods were applied; a survey-questionnaire, participatory-developed, was online-administered to a sample of self-reported FM sufferers (N = 1176). Then, two Focus Groups (FGs), involving 15 fibromyalgia-affected women, were held. Data were analyzed by a thematic analysis approach. Among survey-respondents, 20% were unemployed and only 14% went to work gladly. Variability of pain (84%) and fatigue (90%) were the most perceived reasons for difficulties at work. Negative relationships at work were reported by most participants. The FGs’ discussions addressed different strategies for overcoming the main obstacle of “not being believed by colleagues and employers” and reasonable accommodations. However, a negative hopeless attitude towards the solution of problems at work was also apparent. Different critical issues in the workplace emerged from the survey and the FGs. Coordinated actions, according to a transdisciplinary approach, are needed to manage fibromyalgia-induced difficulties in the workplace.