Thread by @JillPiggott

@CContrarus @hope411adcock @painadvocateAR @tal7291 @fightpaindaily @speakingabtpain @jillyannjiggs @JoeFalzone8 @JSG_54 @LadyAg72 @brent_kellogg @dr4liberty @Irishbrat1966 @ThomasKlineMD @DanLairdMD @D321Debbie @Angelsgal02 @esteckler2 I've been housebound w/ continuous #migraine for 15 yrs, direct @headsUPmigraine, & disagree profoundly w/ overpsychologizing pain.

#Psychologists are wrong to diagnose "catastrophizing" w/ this test w/o telling patients that doctors may use results to taper/deny #opioids.

@CContrarus @hope411adcock @painadvocateAR @tal7291 @fightpaindaily @speakingabtpain @jillyannjiggs @JoeFalzone8 @JSG_54 @LadyAg72 @brent_kellogg @dr4liberty @Irishbrat1966 @ThomasKlineMD @DanLairdMD @D321Debbie @Angelsgal02 @esteckler2 @headsUPmigraine Thread below: @headsUPmigraine's response to "catastrophizing" survey & diagnosis, as well as its "possible predictive value for #opioid prescription" (sec 4: Discussion, Sharifzadeh, Darnall, et al., 2017). ncbi.nlm.nih.gov/pmc/articles/P…

People should be informed if a questionnaire they're given to diagnose a #psychological disorder might potentially be used by a physician to deny them treatment for a physical disease.

In 2017, 3 of the psychologists who published the "Pain Catastrophizing Scale" also published a paper arguing that "catastrophizing" is "associated" with #opioid "craving," long-term opioid use, and opioid misuse (Anesthesiology 2017 July). ncbi.nlm.nih.gov/pmc/articles/P…

Acc'g to those researchers, "pain catastrophizing" is a risk for "prescription #opioid misuse" in people w/ #ChronicPain. They cite a study that concluded "pain catastrophizing was the strongest predictor of post-surgical opioid use 1–2 months after surgery" (Anesth 2017).

"Catastrophizing" researchers also cite studies concluding that "mood disorders" predict the "degree of opioid use" & "likelihood of aberrant opioid use (e.g., opioid abuse or dependence)" in people with "chronic non-cancer pain" (Anesth 2017).

The authors reached several conclusions from their own research. 1> People with more intense pain were more likely to be prescribed #opioids, but those w/ intense pain who also "catastrophize" were the people most likely to be prescribed opioid medicines (Anesth 2017).

2> Among men, those w/ #opioid scripts had higher pain intensity & lower pain "catastrophizing."

Among women, those w/ opioid scripts had moderate to high pain intensity & moderate to high "catastrophizing."

"Our findings suggest that even relatively low levels of negative cognitive & emotional responses to pain may have a greater impact on opioid prescribing in females" & "risks are occurring at lower levels of catastrophizing for females than for males."

3> The authors conclude that even those women with test scores below the diagnostic level for pain catastrophizing may benefit from being treated for pain catastrophizing.

Unfortunately, this potential benefit comes w/ the sting of sexism & stigma.

Researchers found men w/ rx #opioid had lower catastrophizing scores, but reported higher pain. Women w/ rx opioid had moderate-to-severe catastrophizing scores & pain.

#Opioids are approved for treatment of moderate-to-severe pain. mayoclinicproceedings.org/article/S0025-…

#Opioids are approved for the range of pain reported by the women studied (moderate to severe), but the researchers note that women "may be more likely [than men] to influence provider prescribing patterns through behavioral cues during the medical visit."

Really?

That's only HALF the sentence: "prior research has suggested females may engage in pain behavior for extended periods of time and may appraise their pain as more threatening than males."

1 in 5 women has #migraine, the world's #1 cause of working-age disability. Early diagnosis & effective treatment are key to stall or slow disease progression. Many live develop continual #migraine, which WHO/NIH rank among the most disabling diseases.

Pain catastrophizing includes somatization. Every description I've read of somatization is also a description of #migraine. Without effective treatment, some migraine patients progress to continual migraine in 1 year. People wrongly diagnosed might be permanently disabled.

#Migraine symptoms make up 40% of a #psychological survey designed to assess distress, depression, & anxiety. Experts found most migraine can be diagnosed w/ 1 Q: Do you have disruptive headaches w/ light sensitivity &/or nausea?

Some people have migraine w/o #headache.

@threadreaderapp unroll

Damn. This thread got jumbled. I'll do it separately.