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  • 1.
    Gerdle, Björn
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Dragioti, Elena
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Fischer, Marcelo Rivano
    Skane Univ Hosp, Sweden; Lund Univ, Sweden.
    Ringqvist, Asa
    Skane Univ Hosp, Sweden.
    Acceptance and Fear-Avoidance Mediate Outcomes of Interdisciplinary Pain Rehabilitation Programs at 12-Month Follow-Up: A Clinical Registry-Based Longitudinal Cohort Study from the Swedish Quality Registry for Pain Rehabilitation (SQRP)2024In: Journal of Pain Research, E-ISSN 1178-7090, Vol. 17, p. 83-105Article in journal (Refereed)
    Abstract [en]

    Background: Factors that influence outcomes of interdisciplinary pain rehabilitation programs (IPRP) are poorly known. It is unclear how outcomes are influenced by pain intensity, psychological distress, and coping strategies.Aim: This clinical registry-based longitudinal cohort study has three aims: 1) to determine the relative importance of pain intensity, psychological distress, acceptance, and fear-avoidance for changes in three outcomes of IPRP at 12-month follow-up; 2) to investigate whether the effects of pain intensity and psychological distress on the three outcomes are mediated via acceptance and fear-avoidance; and 3) to determine whether sex is a moderator.Methods: This study uses Patient-Reported Outcome Measures (PROMs) from specialist units reporting data (2008-2016) to the Swedish Quality Registry for Pain Rehabilitation (SQRP). Adult chronic pain patients (N = 1991) answered the PROMs (background, pain, psychological distress, coping, participation, and health-related quality of life (HRQoL)). Partial Least Squares Structural Equation Modelling (PLS-SEM) was used to explore the aims.Results: Changes in acceptance (13:0.424-0.553; all P<0.001) were the strongest predictor of the three outcomes (changes in life control, interference, and HRQoL) at 12-month follow-up. The next strongest predictor was baseline acceptance (13: 0.177-0.233; all P<0.001) and changes in fear-avoidance (13: -0.152- -0.186; all P<0.001). Baseline pain intensity and psychological distress showed weak positive associations. Their effects on the three outcomes were mediated via acceptance aspects. Sex was not a moderator.Discussion and Conclusion: Acceptance aspects (baseline and changes) were important predictors of IPRP outcomes. Changes in fear-avoidance were also important although to a lesser degree. Some of the effects of pain intensity and psychological distress on outcomes were mediated via acceptance at baseline. Future PLS-SEM analysis of real-world IPRP should include more potential mediators (eg, catastrophizing and more facets of psychological flexibility and fear-avoidance) and the components of IPRP.

  • 2.
    Dong, Huan-Ji
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Brain, Katherine
    Univ Newcastle, Australia; Hunter Integrated Pain Serv, Australia.
    Olsson, Max
    Linköping University, Department of Health, Medicine and Caring Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Dragioti, Elena
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center. Univ Ioannina, Greece.
    Gerdle, Björn
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center. Skane Univ Hosp, Sweden.
    Ghafouri, Bijar
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Eating habits and the desire to eat healthier among patients with chronic pain: a registry-based study2024In: Scientific Reports, E-ISSN 2045-2322, Vol. 14, no 1, article id 4705Article in journal (Refereed)
    Abstract [en]

    Healthcare professionals often meet pain patients with a poor nutritional status such as obesity, unhealthy dietary behaviors, and a suboptimal dietary intake. A poor nutritional status may play a significant role in the occurrence, development, and prognosis of chronic pain. This study investigated eating habits in a specialized pain rehabilitation center using data (N = 2152) from the Swedish quality registry for pain rehabilitation during the period 2016-2021. Patients answered a lifestyle questionnaire regarding their eating habits and desire to modify their lifestyle. The mean (SD) patient age was 46.1 (14.6) years, with 24.8% classified as obese. Suboptimal eating habits included irregular mealtimes (27.2%), weekly consumption of fast-food (20.3%) and nearly daily consumption of confectionery (33.3%). Approximately 20% (n = 426) reported a desire to eat healthier. Frequent confectionery intake (Odds ratio [OR] 1.23, 95% Confidence Interval (CI) 1.04-1.47) and fast-food consumption (OR 1.58, 95% CI 1.24-2.02) increased the likelihood to desire healthier eating. Younger patients (18-29 years), those classified as obese, and those with more extended spatial pain were more likely to express a desire to eat healthier. Eating habits should be addressed in pain management and interdisciplinary pain rehabilitation teams are encouraged to provide nutritional care tailored to the patient's needs.

  • 3.
    Molander, Peter
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Novo, Mehmed
    Umea Univ, Sweden.
    Ringqvist, Asa
    Skane Univ Hosp, Sweden.
    Hallstam, Andrea
    Danderyd Hosp, Sweden.
    Hesser, Hugo
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology. Orebro Univ, Sweden.
    Lofgren, Monika
    Danderyd Hosp, Sweden.
    Stalnacke, Britt-Marie
    Umea Univ, Sweden.
    Gerdle, Björn
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    INTERDISCIPLINARY PAIN REHABILITATION FOR PATIENTS WITH EHLERS-DANLOS SYNDROME AND HYPERMOBILITY SPECTRUM DISORDERS2024In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 56, article id jrm12431Article in journal (Refereed)
    Abstract [en]

    Objective: Chronic pain is a common manifestation of Ehlers-Danlos syndrome and hypermobility spectrum disorders; thus it is often suggested that patients undergo generic interdisciplinary pain rehabilitation, despite there being little evidence to support this decision. The aim of this study is to examine the effectiveness of standard rehabilitation programmes for chronic pain on patients with Ehlers-Danlos syndrome and hypermobility spectrum disorders, compared with patients with other chronic pain disorders. Subjects: Data, collected between 2008 and 2016, were extracted from a Swedish national registry. The patient data comprised of 406 cases with Ehlers-Danlos syndrome or hypermobility spectrum disorders, 784 cases with a whiplash -related diagnosis, 3713 cases with diagnoses relating to spinal pain, and 2880 cases of fibromyalgia. Methods: The differences between groups on key outcome measures from pre- to 1 -year follow-up after interdisciplinary pain rehabilitation were analysed using linear mixed effects models. Sensitivity analysis in the form of pattern -mixture modelling was conducted to discern the impact of missing data. Results: No significant differences were found in improvements from pre- to 1 -year follow-up for patients with Ehlers-Danlos syndrome or hypermobility spectrum disorder compared with other diagnostic groups regarding measures of health -related quality of life, mental health, or fatigue. At followup, differences in pain interference (d = -0.34 (95% confidence interval [95% CI] -0.5 to -0.18)), average pain (d = 0.22 (95% CI 0.11-0.62)) and physical functioning (d = 2.19 (95% CI 1.61-2.77)) were detected for the group with spinal -related diagnoses in relation to those with EDS/HSD, largely due to pre-treatment group differences. Sensitivity analysis found little evidence for missing data influencing the results. Conclusion: This study suggests that patients with Ehlers-Danlos syndrome/hypermobility spectrum disorders may benefit from inclusion in an interdisciplinary pain rehabilitation programme.

  • 4.
    Gerdle, Björn
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center. Linköping University, Center for Medical Image Science and Visualization (CMIV).
    Dahlqvist Leinhard, Olof
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Diagnostics and Specialist Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Radiation Physics. Linköping University, Center for Medical Image Science and Visualization (CMIV). AMRA Med AB, Linkoping, Sweden.
    Lund, Eva
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Diagnostics and Specialist Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Medical radiation physics.
    Lundberg, Peter
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Diagnostics and Specialist Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Medical radiation physics. Linköping University, Center for Medical Image Science and Visualization (CMIV).
    Forsgren, Mikael
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Diagnostics and Specialist Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Medical radiation physics. Linköping University, Center for Medical Image Science and Visualization (CMIV). AMRA Med AB, Linkoping, Sweden.
    Ghafouri, Bijar
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Pain and the biochemistry of fibromyalgia: patterns of peripheral cytokines and chemokines contribute to the differentiation between fibromyalgia and controls and are associated with pain, fat infiltration and content2024In: FRONTIERS IN PAIN RESEARCH, ISSN 2673-561X, Vol. 5, article id 1288024Article in journal (Refereed)
    Abstract [en]

    Objectives This explorative study analyses interrelationships between peripheral compounds in saliva, plasma, and muscles together with body composition variables in healthy subjects and in fibromyalgia patients (FM). There is a need to better understand the extent cytokines and chemokines are associated with body composition and which cytokines and chemokines differentiate FM from healthy controls.Methods Here, 32 female FM patients and 30 age-matched female healthy controls underwent a clinical examination that included blood sample, saliva samples, and pain threshold tests. In addition, the subjects completed a health questionnaire. From these blood and saliva samples, a panel of 68 mainly cytokines and chemokines were determined. Microdialysis of trapezius and erector spinae muscles, phosphorus-31 magnetic resonance spectroscopy of erector spinae muscle, and whole-body magnetic resonance imaging for determination of body composition (BC)-i.e., muscle volume, fat content and infiltration-were also performed.Results After standardizing BC measurements to remove the confounding effect of Body Mass Index, fat infiltration and content are generally increased, and fat-free muscle volume is decreased in FM. Mainly saliva proteins differentiated FM from controls. When including all investigated compounds and BC variables, fat infiltration and content variables were most important, followed by muscle compounds and cytokines and chemokines from saliva and plasma. Various plasma proteins correlated positively with pain intensity in FM and negatively with pain thresholds in all subjects taken together. A mix of increased plasma cytokines and chemokines correlated with an index covering fat infiltration and content in different tissues. When muscle compounds were included in the analysis, several of these were identified as the most important regressors, although many plasma and saliva proteins remained significant.Discussion Peripheral factors were important for group differentiation between FM and controls. In saliva (but not plasma), cytokines and chemokines were significantly associated with group membership as saliva compounds were increased in FM. The importance of peripheral factors for group differentiation increased when muscle compounds and body composition variables were also included. Plasma proteins were important for pain intensity and sensitivity. Cytokines and chemokines mainly from plasma were also significantly and positively associated with a fat infiltration and content index.Conclusion Our findings of associations between cytokines and chemokines and fat infiltration and content in different tissues confirm that inflammation and immune factors are secreted from adipose tissue. FM is clearly characterized by complex interactions between peripheral tissues and the peripheral and central nervous systems, including nociceptive, immune, and neuroendocrine processes.

  • 5.
    Bäckryd, Emmanuel
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Themistocleous, Andreas
    Univ Oxford, England.
    Stensson, Niclas
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Rice, Andrew S. C.
    Imperial Coll London, England.
    Tesfaye, Solomon
    Sheffield Teaching Hosp NHS Fdn Trust, England.
    Bennett, David L.
    Univ Oxford, England; John Radcliffe Hosp, England.
    Gerdle, Björn
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Ghafouri, Bijar
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Serum levels of endocannabinoids and related lipids in painful vs painless diabetic neuropathy: results from the Pain in Neuropathy Study2024In: Pain, ISSN 0304-3959, E-ISSN 1872-6623, Vol. 165, no 1, p. 225-232Article in journal (Refereed)
    Abstract [en]

    N-arachidonoylethanolamine (also known as anandamide) and 2-arachidonoylglycerol are activators of the cannabinoid receptors. The endocannabinoid system also includes structurally and functionally related lipid mediators that do not target cannabinoid receptors, such as oleoylethanolamide, palmitoylethanolamide, and stearoylethanolamide. These bioactive lipids are involved in various physiological processes, including regulation of pain. The primary aim of the study was to analyze associations between serum levels of these lipids and pain in participants in the Pain in Neuropathy Study, an observational, cross-sectional, multicentre, research project in which diabetic patients with painless or painful neuropathy underwent deep phenotyping. Our hypothesis was that painful neuropathy would be associated with higher levels of the 5 lipids compared with painless neuropathy. Secondary aims were to analyze other patient-reported outcome measures and clinical data in relationship to lipid levels. The lipid mediators were analyzed in serum samples using liquid chromatography tandem mass spectrometry (LC-MS/MS). Serum levels of anandamide were significantly higher in the painful group, but the effect size was small (Cohen d = 0.31). Using cluster analysis of lipid data, patients were dichotomized into a "high-level" endocannabinoid group and a "low-level" group. In the high-level group, 61% of patients had painful neuropathy, compared with 45% in the low-level group (P = 0.039). This work is of a correlative nature only, and the relevance of these findings to the search for analgesics targeting the endocannabinoid system needs to be determined in future studies.

  • 6.
    Solmi, Marco
    et al.
    Univ Ottawa, Canada; Ottawa Hosp, Canada; Kings Coll London, England; Univ Southampton, England; NHS Trust, England; Charite Univ Med Berlin, Germany.
    De Toffol, Marco
    ASL Lecce, Italy.
    Kim, Jong Yeob
    Yonsei Univ, South Korea.
    Choi, Min Je
    Yonsei Univ, South Korea.
    Stubbs, Brendon
    Kings Coll London, England; South London & Maudsley NHS Fdn Trust, England.
    Thompson, Trevor
    Univ Greenwich, England.
    Firth, Joseph
    Univ Manchester, England; Greater Manchester Mental Hlth NHS Fdn Trust, England.
    Miola, Alessandro
    Univ Padua, Italy.
    Croatto, Giovanni
    AULSS 3 Serenissima, Italy.
    Baggio, Francesca
    AULSS 3 Serenissima, Italy.
    Michelon, Silvia
    AULSS 7 Pedemontana Veneto, Italy.
    Ballan, Luca
    AULSS 7 Pedemontana Veneto, Italy.
    Gerdle, Björn
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Monaco, Francesco
    Asl Salerno, Italy; European Biomed Res Inst Salerno, Italy.
    Simonato, Pierluigi
    Univ Hertfordshire, England; ULSS 6 Euganea, Italy.
    Scocco, Paolo
    ULSS 6 Euganea, Italy.
    Ricca, Valdo
    Univ Florence, Italy.
    Castellini, Giovanni
    Univ Florence, Italy.
    Fornaro, Michele
    Univ Sch Med Federico II, Italy.
    Murru, Andrea
    Univ Barcelona, Spain.
    Vieta, Eduard
    Univ Barcelona, Spain.
    Fusar-Poli, Paolo
    Kings Coll London, England; Univ Pavia, Italy.
    Barbui, Corrado
    Univ Verona, Italy.
    Ioannidis, John P. A.
    Stanford Univ, CA USA; Charite Univ Med Berlin, Germany; Stanford Univ, CA USA; Stanford Univ, CA USA; Stanford Univ, CA USA; Stanford Univ, CA USA.
    Carvalho, Andre F.
    Deakin Univ, Australia.
    Radua, Joaquim
    Univ Barcelona, Spain.
    Correll, Christoph U.
    Charite Univ Med Berlin, Germany; Zucker Hillside Hosp, NY USA; Donald & Barbara Zucker Sch Med Hofstra Northwell, NY USA.
    Cortese, Samuel
    Univ Southampton, England; Solent NHS Trust, England; Univ Nottingham, England; NYU, NY USA.
    Murray, Robin M.
    Kings Coll London, England.
    Castle, David
    Univ Tasmania, Australia; Ctr Mental Hlth Serv Innovat, Australia.
    Il Shin, Jae
    Yonsei Univ, South Korea; Yonsei Univ, South Korea.
    Dragioti, Elena
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center. Univ Ioannina, Greece.
    Balancing risks and benefits of cannabis use: umbrella review of meta-analyses of randomised controlled trials and observational studies2023In: BMJ. British Medical Journal, ISSN 0959-8146, E-ISSN 0959-535X, Vol. 382, article id e072348Article, review/survey (Refereed)
    Abstract [en]

    OBJECTIVE To systematically assess credibility and certainty of associations between cannabis, cannabinoids, and cannabis based medicines and human health, from observational studies and randomised controlled trials (RCTs). DESIGN Umbrella review. DATA SOURCES PubMed, PsychInfo, Embase, up to 9 February 2022. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Systematic reviews with meta-analyses of observational studies and RCTs that have reported on the efficacy and safety of cannabis, cannabinoids, or cannabis based medicines were included. Credibility was graded according to convincing, highly suggestive, suggestive, weak, or not significant (observational evidence), and by GRADE (Grading of Recommendations, Assessment, Development and Evaluations) (RCTs). Quality was assessed with AMSTAR 2 (A Measurement Tool to Assess Systematic Reviews 2). Sensitivity analyses were conducted. RESULTS 101 meta-analyses were included (observational=50, RCTs=51) (AMSTAR 2 high 33, moderate 31, low 32, or critically low 5). From RCTs supported by high to moderate certainty, cannabis based medicines increased adverse events related to the central nervous system (equivalent odds ratio 2.84 (95% confidence interval 2.16 to 3.73)), psychological effects (3.07 (1.79 to 5.26)), and vision (3.00 (1.79 5.03)) in people with mixed conditions (GRADE=high), improved nausea/vomit, pain, spasticity, but increased psychiatric, gastrointestinal adverse event, and somnolence among others (GRADE=moderate). Cannabidiol improved 50% reduction of seizures (0.59 (0.38 to 0.92)) and seizure events (0.59 (0.36 to 0.96)) (GRADE=high), but increased pneumonia, gastrointestinal adverse events, and somnolence (GRADE=moderate). For chronic pain, cannabis based medicines or cannabinoids reduced pain by 30% (0.59 (0.37 to 0.93), GRADE=high), across different conditions (n=7), but increased psychological distress. For epilepsy, cannabidiol increased risk of diarrhoea (2.25 (1.33 to 3.81)), had no effect on sleep disruption (GRADE=high), reduced seizures across different populations and measures (n=7), improved global impression (n=2), quality of life, and increased risk of somnolence (GRADE=moderate). In the general population, cannabis worsened positive psychotic symptoms (5.21 (3.36 to 8.01)) and total psychiatric symptoms (7.49 (5.31 to 10.42)) (GRADE=high), negative psychotic symptoms, and cognition (n=11) (GRADE=moderate). In healthy people, cannabinoids improved pain threshold (0.74 (0.59 to 0.91)), unpleasantness (0.60 (0.41 to 0.88)) (GRADE=high). For inflammatory bowel disease, cannabinoids improved quality of life (0.34 (0.22 to 0.53) (GRADE=high). For multiple sclerosis, cannabinoids improved spasticity, pain, but increased risk of dizziness, dry mouth, nausea, somnolence (GRADE=moderate). For cancer, cannabinoids improved sleep disruption, but had gastrointestinal adverse events (n=2) (GRADE=moderate). Cannabis based medicines, cannabis, and cannabinoids resulted in poor tolerability across various conditions (GRADE=moderate). Evidence was convincing from observational studies (main and sensitivity analyses); in pregnant women, small for gestational age (1.61 (1.41 to 1.83)), low birth weight (1.43 (1.27 to 1.62)); in drivers, car crash (1.27 (1.21 to 1.34)); and in the general population, psychosis (1.71 (1.47 to 2.00)). Harmful effects were noted for additional neonatal outcomes, outcomes related to car crash, outcomes in the general population including psychotic symptoms, suicide attempt, depression, and mania, and impaired cognition in healthy cannabis users (all suggestive to highly suggestive). CONCLUSIONS Convincing or converging evidence supports avoidance of cannabis during adolescence and early adulthood, in people prone to or with mental health disorders, in pregnancy and before and while driving. Cannabidiol is effective in people with epilepsy. Cannabis based medicines are effective in people with multiple sclerosis, chronic pain, inflammatory bowel disease, and in palliative medicine, but not without adverse events.

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  • 7.
    Hallberg, Sara
    et al.
    Quantify Res, Sweden.
    Rolfson, Ola
    Univ Gothenburg, Sweden.
    Karppinen, Jaro
    Oulu Univ Hosp, Finland; Univ Oulu, Finland; Rehabil Serv South Karelia Social & Hlth Care Dis, Finland.
    Schiottz-Christensen, Berit
    Univ Southern Denmark, Denmark.
    Stubhaug, Audun
    Univ Oslo, Norway; Univ Oslo, Norway.
    Fischer, Marcelo Rivano
    Skane Univ Hosp, Sweden; Lund Univ, Sweden.
    Gerdle, Björn
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Grip, Emilie Toresson
    Quantify Res, Sweden.
    Gustavsson, Anders
    Quantify Res, Sweden; Karolinska Inst, Sweden.
    Robinson, Rebecca L.
    Eli Lilly & Co, IN 46285 USA.
    Varenhorst, Christoph
    Pfizer AB, Sweden; Uppsala Univ, Sweden.
    Schepman, Patricia
    Pfizer Inc, NY USA.
    Burden of disease and management of osteoarthritis and chronic low back pain: healthcare utilization and sick leave in Sweden, Norway, Finland and Denmark (BISCUITS): study design and patient characteristics of a real world data study2023In: Scandinavian Journal of Pain, ISSN 1877-8860, E-ISSN 1877-8879, Vol. 23, no 1, p. 126-138Article in journal (Refereed)
    Abstract [en]

    Objectives: Osteoarthritis (OA) and chronic low back pain (CLBP) are common musculoskeletal disorders with substantial patient and societal burden. Nordic administrative registers offer a unique opportunity to study the impact of these conditions in the real-world setting. The Burden of Disease and Management of Osteoarthritis and Chronic Low Back Pain: Health Care Utilization and Sick Leave in Sweden, Norway, Finland and Denmark (BISCUITS) study was designed to study disease prevalence and the societal and economic burden in broad OA and CLBP populations. Methods: Patients in Sweden, Norway, Finland and Denmark with diagnoses of OA or CLBP (low back pain record plus >= 2 pain relief prescriptions to indicate chronicity) were identified in specialty care, in primary care (Sweden and Finland) and in a quality-of-care register (Sweden). Matched controls were identified for the specialty care cohort. Longitudinal data were extracted on prevalence, treatment patterns, patient-reported outcomes, social and economic burden. Results: Almost 1.4 million patients with OA and 0.4 million with CLBP were identified in specialty care, corresponding to a prevalence in the Nordic countries of 6.3 and 1.9%, respectively. The prevalence increased to 11-14% for OA and almost 6% for CLBP when adding patients identified in primary care. OA patients had a higher Elixhauser comorbidity index (0.66 vs. 0.46) and were using opioids (44.7 vs. 10.2%) or long-term nonsteroidal anti-inflammatory drug (NSAIDs) (20.9 vs. 4.5%) more than four times as often as compared to controls. The differences were even larger for CLBP patients compared to their controls (comorbidity index 0.89 vs. 0.39, opioid use 77.7 vs. 9.4%, and long-term NSAID use 37.2 vs. 4.8%). Conclusions: The BISCUITS study offers an unprecedented, longitudinal healthcare data source to quantify the real-world burden of more than 1.8 million patients with OA or CLBP across four countries. In subsequent papers we aim to explore among others additional outcomes and subgroups of patients, primarily those patients who may benefit most from better healthcare management.

  • 8.
    Gerdle, Björn
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Dragioti, Elena
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Rivano Fischer, Marcelo
    Skane Univ Hosp, Sweden; Lund Univ, Sweden.
    Dong, Huan-Ji
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Ringqvist, Asa
    Skane Univ Hosp, Sweden.
    Catastrophizing and acceptance are mediators between insomnia and pain intensity-an SQRP study of more than 6,400 patients with non-malignant chronic pain conditions2023In: FRONTIERS IN PAIN RESEARCH, ISSN 2673-561X, Vol. 4, article id 1244606Article in journal (Refereed)
    Abstract [en]

    BackgroundSleep problems (insomnia) and chronic pain are associated. Chronic pain and insomnia/insufficient sleep quality share similar symptoms and features. Although they have a bidirectional relationship, more research is needed to understand how they interact via mediators and how moderators influence this relationship.AimsIn this large clinical registry-based cohort study (N = 6,497), we investigate important mediators between insomnia and pain intensity in a cross-sectional sample of chronic pain patients using advanced path analysis. In addition, we investigate whether some background variables were moderators of the identified important paths or not and the correlation patterns between insomnia and pain intensity in relation to the mediators.MethodsThis study includes a cohort of adult patients with chronic non-cancer pain from the Swedish Quality Registry for Pain Rehabilitation (SQRP) with data on patient-reported outcome measures (PROMs) (2008-2016). The PROMs cover the background, pain aspects, psychological distress, pain-related cognitions, activity/participation, and health-related quality of life variables of the patients. Partial least squares structural equation modeling was used to explore the direct and indirect (via mediators) relationships between insomnia and pain intensity at baseline.ResultsIn this cohort study, insomnia was prevalent at 62.3%, and both direct and indirect mediating paths were present for the insomnia-pain intensity relationship. All of the mediating effects combined were weaker than the direct effect between insomnia and pain intensity. The mediating effects via catastrophizing and acceptance showed the strongest and equal mediating paths, and mediating effects via fear avoidance were the second strongest. Insomnia showed stronger direct significant correlations with psychological distress, catastrophizing, and acceptance compared with those of pain intensity. Sex, age, education level, spatial extent of pain, or body mass index did not moderate the mediating paths.Discussion and conclusionThis study confirms the existence of significant direct and mediating paths between reported insomnia and pain intensity. Future studies should focus on illuminating how sleep interventions influence pain intensity and other important key factors that contribute to the distress of chronic pain patients.

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  • 9.
    Bäckryd, Emmanuel
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Thordeman, Katarina
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Gerdle, Björn
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Ghafouri, Bijar
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Cerebrospinal Fluid Metabolomics Identified Ongoing Analgesic Medication in Neuropathic Pain Patients2023In: Biomedicines, E-ISSN 2227-9059, Vol. 11, no 9, article id 2525Article in journal (Refereed)
    Abstract [en]

    Background: Cerebrospinal fluid (CSF) can reasonably be hypothesized to mirror central nervous system pathophysiology in chronic pain conditions. Metabolites are small organic molecules with a low molecular weight. They are the downstream products of genes, transcripts and enzyme functions, and their levels can mirror diseased metabolic pathways. The aim of this metabolomic study was to compare the CSF of patients with chronic neuropathic pain (n = 16) to healthy controls (n = 12). Methods: Nuclear magnetic resonance spectroscopy was used for analysis of the CSF metabolome. Multivariate data analysis by projection discriminant analysis (OPLS-DA) was used to separate information from noise and minimize the multiple testing problem. Results: The significant OPLS-DA model identified 26 features out of 215 as important for group separation (R2 = 0.70, Q2 = 0.42, p = 0.017 by CV-ANOVA; 2 components). Twenty-one out of twenty-six features were statistically significant when comparing the two groups by univariate statistics and remained significant at a false discovery rate of 10%. For six out of the top ten metabolite features, the features were absent in all healthy controls. However, these features were related to medication, mainly acetaminophen (=paracetamol), and not to pathophysiological processes. Conclusion: CSF metabolomics was a sensitive method to detect ongoing analgesic medication, especially acetaminophen.

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  • 10.
    Ghafouri, Nazdar
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Bäckryd, Emmanuel
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Dragioti, Elena
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Fischer, Marcelo Rivano
    Skane Univ Hosp, Sweden; Lund Univ, Sweden.
    Ringqvist, Asa
    Skane Univ Hosp, Sweden.
    Gerdle, Björn
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Effects of interdisciplinary pain rehabilitation programs on neuropathic and non-neuropathic chronic pain conditions - a registry-based cohort study from Swedish Quality Registry for Pain Rehabilitation (SQRP)2023In: BMC Musculoskeletal Disorders, E-ISSN 1471-2474, Vol. 24, no 1, article id 357Article in journal (Refereed)
    Abstract [en]

    Background and aimNeuropathic pain arises as a direct consequence of a lesion or disease affecting the somatosensory system. Pharmacological treatments for neuropathic pain often fail despite following guidelines. Interdisciplinary Pain Rehabilitation Programs (IPRP) are an effective intervention for chronic pain conditions. Little research has investigated whether IPRP can benefit patients with chronic neuropathic pain compared to other chronic pain conditions.This study assesses the real-world effects of IPRP on patients with chronic neuropathic pain compared to non-neuropathic patients using Patient-Reported Outcome Measures (PROMs) available in the Swedish Quality Registry for Pain Rehabilitation (SQRP).MethodsA neuropathic group of patients (n = 1,654) were identified in two steps. This group was compared to a non-neuropathic group (n = 14,355) composed of common diagnoses (low back pain, fibromyalgia, whiplash associated disorders, and Ehlers-Danlos Syndrome) in relation to background variables, three overall outcome variables, and mandatory outcome variables (pain intensity, psychological distress symptoms, activity/participation aspects and health-related quality of life variables). Of these patients 43-44% participated in IPRP.ResultsAt assessment, the neuropathic group reported significantly (with small effect sizes (ES)) more physician visits the previous year, older age, shorter pain durations, and less spatial extent of the pain (moderate ES). Moreover, for the 22 mandatory outcome variables, we found only clinically insignificant differences according to ESs between the groups. For patients participating in IPRP, the neuropathic group displayed equal or in some cases slightly superior results compared to the non-neuropathic group.Discussion and conclusionAfter assessing the real-world effects of IPRP, this large study found that neuropathic pain patients can benefit from the IPRP intervention. Both registry studies and RCTs are needed to better understand which patients with neuropathic pain are most suitable for IPRP and to what extent special considerations need to be made for these patients within the framework of IPRP.

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  • 11.
    Hansson, Karin Sall
    et al.
    Linnaeus Univ, Sweden.
    Lindqvist, Gunilla
    Linnaeus Univ, Sweden.
    Stening, Kent
    Linnaeus Univ, Sweden.
    Fohlman, Jan
    Reg Kronoberg, Sweden.
    Wojanowski, Anna
    Reg Kronoberg, Sweden.
    Ponten, Moa
    Karolinska Inst, Sweden.
    Jensen, Karin
    Karolinska Inst, Sweden.
    Gerdle, Björn
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Elmqvist, Carina
    Linnaeus Univ, Sweden; Reg Kronoberg, Sweden.
    Efficacy of mecobalamin (vitamin B-12) in the treatment of long-term pain in women diagnosed with fibromyalgia: protocol for a randomised, placebo-controlled trial2023In: BMJ Open, E-ISSN 2044-6055, Vol. 13, no 3, article id e066987Article in journal (Refereed)
    Abstract [en]

    IntroductionFibromyalgia causes long-term pain. It affects at least 2% of the population, the majority being women. In addition, extended symptoms corresponding to vitamin B-12 deficiency occur. Findings from several studies have indicated that vitamin B-12 may be a possible treatment for pain in fibromyalgia. The aim of the proposed study is to evaluate whether vitamin B-12 decreases pain sensitivity and the experience of pain (ie, hyperalgesia and allodynia) in women with fibromyalgia.Methods and analysisThe study is a randomised, placebo-controlled, single-blind, clinical trial with two parallel groups which are administered mecobalamin (vitamin B-12) or placebo over 12 weeks. 40 Swedish women aged 20-70 years with an earlier recorded diagnosis of fibromyalgia are randomised into the placebo group or the treatment group, each consisting of 20 participants. Outcomes consist of questionnaires measured at baseline and after 12 weeks of treatment. A final re-evaluation will then follow 12 weeks after treatment ends. The primary outcome is tolerance time, maximised to 3min, which is assessed using the cold pressor test. In order to broaden the understanding of the lived experience of participants, qualitative interviews will be conducted using a phenomenological approach on a lifeworld theoretical basis (reflective lifeworld research approach).Ethics and disseminationThe protocol for the study is approved by the local ethical committee at Linkoping (EPM; 2018/294-31, appendices 2019-00347 and 2020-04482). The principles of the Helsinki Declaration are followed regarding oral and written consent to participate, confidentiality and the possibility to withdraw participation from the study at any time. The results will primarily be communicated through peer-reviewed journals and conferences.Trial registration number NCT05008042.

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  • 12.
    Zhao, Xiang
    et al.
    Orebro Univ, Sweden; Orebro Univ, Sweden.
    Boersma, Katja
    Orebro Univ, Sweden.
    Gerdle, Björn
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Molander, Peter
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Hesser, Hugo
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology. Orebro Univ, Sweden.
    Fear network and pain extent: Interplays among psychological constructs related to the fear-avoidance model2023In: Journal of Psychosomatic Research, ISSN 0022-3999, E-ISSN 1879-1360, Vol. 167, article id 111176Article in journal (Refereed)
    Abstract [en]

    Objective: Psychological constructs related to the fear-avoidance model such as fear of movement, pain cata-strophizing, and affective distress have been found to be inter-related among patients with chronic pain. How-ever, relationships of these constructs have mostly been examined using regression-based analyses. This cross-sectional study employs a novel analytical approach, network analysis, to illustrate the complex interplays among these variables as well as pain intensity and pain interference.Methods: This study utilized the Swedish Quality Registry for Pain Rehabilitation, including data from 10,436 participants (76.0% women; Mage = 45.0 years). Networks were analyzed separately for patients with different pain extents (i.e., numbers of pain locations) as the interplays may differ qualitatively depending on pain extent. Results: We found that patients with a larger pain extent showed a worse clinical presentation (i.e., more depression and anxiety, increased fear of movement and pain interference), and their network differed from the patients with a smaller number of pain extent in terms of how strongly key variables were interconnected. In all network models, pain interference and catastrophizing showed consistently influential roles.Conclusion: Our findings highlight the interactive nature of psychological aspects of pain and how interrelated associations differ depending on pain extent. Findings are discussed based on ideas on how both fear and pain become overgeneralized.

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  • 13.
    Bendelin, Nina
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Gerdle, Björn
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Biomedical and Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Karolinska Inst, Sweden.
    Hurdles and potentials when implementing internet-delivered Acceptance and commitment therapy for chronic pain: a retrospective appraisal using the Quality implementation framework2023In: Scandinavian Journal of Pain, ISSN 1877-8860, E-ISSN 1877-8879, Vol. 24, no 1, article id 20220139Article in journal (Refereed)
    Abstract [en]

    Objectives: Internet-delivered psychological interventions can be regarded as evidence-based practices and have been implemented in psychiatric and somatic care at primary and specialist levels. However, challenges as low adherence and poor routinization, have arisen during attempts to implement internet-delivered interventions in chronic pain settings. Internet-delivered Acceptance and Commitment Therapy (IACT) has been found to be helpful for chronic pain patients and might aid in developing pain rehabilitation services. However, the integration of IACT into standard health care has not yet been described from an implementation science perspective. The aim of this hybrid 1 effectiveness-implementation study was to evaluate the process of implementing IACT in a pain rehabilitation setting, to guide future implementation initiatives.Methods: In this retrospective study we described actions taken during an implementation initiative, in which IACT was delivered as part of an interdisciplinary pain rehabilitation program (IPRP) at a specialist level clinic. All documents relevant to the study were reviewed and coded using the Quality Improvement Framework (QIF), focusing on adoption, appropriateness and sustainability.Results: The QIF-analysis of implementation actions resulted in two categories: facilitators and challenges for implementation. Sustainability may be facilitated by sensitivity to the changing needs of a clinical setting and challenged by unfitting capacity building. Appropriateness might be challenged by an insufficient needs assessment and facilitated by aligning routines for communication with the clinics existing infrastructure. Adoption may be facilitated by staff key champions and an ability to adapt to occurring hurdles. Possible influential factors, hypotheses and key process challenges are presented in a logic model to guide future initiatives.Conclusions: Sustainable implementation may depend on both the continuity of facilitating implementation actions and flexibility to the changing needs and interests of patients, caregivers and organization. We conclude that the use of theories, models and frameworks (TMF) as well as a logic model may ease design, planning and evaluation of an implementation process. Lastly, we suggest that IACT may be appropriate for IPRP when given before or after IPRP, focusing on psychiatric comorbidities.

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  • 14.
    Thorell, Oumie
    et al.
    Linköping University, Department of Biomedical and Clinical Sciences, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences. School of Medicine, Western Sydney University, Sydney, NSW, Australia.
    Ydrefors, Johannes
    Linköping University, Department of Biomedical and Clinical Sciences, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences.
    Svantesson, Mats
    Linköping University, Department of Biomedical and Clinical Sciences, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences.
    Gerdle, Björn
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Olausson, Håkan
    Linköping University, Department of Biomedical and Clinical Sciences, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences.
    Mahns, David A.
    School of Medicine, Western Sydney University, Sydney, NSW, Australia.
    Nagi, Saad S.
    Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Biomedical and Clinical Sciences, Center for Social and Affective Neuroscience. School of Medicine, Western Sydney University, Sydney, NSW, Australia.
    Investigations into an overlooked early component of painful nociceptive withdrawal reflex responses in humans2023In: Frontiers in Pain Research, E-ISSN 2673-561X, Vol. 3, article id 1112614Article in journal (Refereed)
    Abstract [en]

    Introduction: The role of pain as a warning system necessitates a rapid transmission of information from the periphery for the execution of appropriate motor responses. The nociceptive withdrawal reflex (NWR) is a physiological response to protect the limb from a painful stimulus and is often considered an objective measure of spinal nociceptive excitability. The NWR is commonly defined by its latency in the presumed Aδ-fiber range consistent with the canonical view that "fast pain" is signaled by Aδ nociceptors. We recently demonstrated that human skin is equipped with ultrafast (Aβ range) nociceptors. Here, we investigated the short-latency component of the reflex and explored the relationship between reflex latency and pain perception.

    Methods: We revisited our earlier work on NWR measurements in which, following convention, only reflex responses in the presumed Aδ range were considered. In our current analysis, we expanded the time window to search for shorter latency responses and compared those with pain ratings.

    Results: In both cohorts, we found an abundance of recordings with short-latency reflex responses. In nearly 90% of successful recordings, only single reflex responses (not dual) were seen which allowed us to compare pain ratings based on reflex latencies. We found that shorter latency reflexes were just as painful as those in the conventional latency range.

    Conclusion: We found a preponderance of short-latency painful reflex responses. Based on this finding, we suggest that short-latency responses must be considered in future studies. Whether these are signaled by the ultrafast nociceptors remains to be determined.

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  • 15.
    Gerdle, Björn
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Dragioti, Elena
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Fischer, Marcelo Rivano
    Skane Univ Hosp, Sweden; Lund Univ, Sweden.
    Ringqvist, Asa
    Skane Univ Hosp, Sweden.
    Pain intensity and psychological distress show different associations with interference and lack of life control: A clinical registry-based cohort study of >40,000 chronic pain patients from SQRP2023In: FRONTIERS IN PAIN RESEARCH, ISSN 2673-561X, Vol. 4, article id 1093002Article in journal (Refereed)
    Abstract [en]

    BackgroundBoth chronic pain and depressive and/or anxiety symptoms are associated with negative impacts on daily living, including interference and lack of life control. However, little is known about how pain and psychological distress affect these impacts.AimThe first aim was to assess how pain intensity, psychological distress, and social support interact with interference and lack of life control. A second aim was to investigate whether the strength of these relationships is moderated by the presence or absence of depression and/or anxiety.Subjects and methodsPatient-Reported Outcome Measures (PROMs), which are available in the Swedish Quality Registry for Pain Rehabilitation (SQRP), were retrieved for patients with chronic pain (N = 40,184). A theoretical model with the constructs/latent variables pain intensity, psychological distress, interference, lack of life control, and social support was proposed and analyzed using Partial Least Squares Structural Equation Modelling (PLS-SEM). Indicators for these constructs were identified from the PROMs of the SQRP. Two models of the total cohort, which differed with respect to the causal relationship between pain intensity and psychological distress, were investigated. The moderating effects of anxiety and/or depression were also analyzed.ResultsRelatively low correlation and explanatory power (R-2 = 0.16) were found for the pain intensity-psychological distress relationship. Pain intensity had a stronger effect on interference than on lack of life control. The reverse was found for psychological distress - i.e., psychological distress seemed to have a higher negative influence on function than on interference. The underlying assumption of the causal relationship between pain intensity and psychological distress determined how strong pain intensity and psychological distress influenced interference and lack of life control. Social support showed very similar absolute significant correlations with interference and lack of life control. Interference and lack of life control showed relatively weak associations. The psychological distress level was a moderating factor for several of the paths investigated.Discussion and conclusionA clinical treatment consequence of the low correlation between pain intensity and psychological distress may be that clinically treating one may not reduce the effect of the other. The relative importance of pain intensity and psychological distress on interference and lack of life control depends on the underlying assumption concerning the pain intensity-psychological distress relationship. Interference and lack of life control showed relatively weak associations, underscoring the need to clinically assess them separately. Social support influenced both impact constructs investigated. The cohort display heterogeneity and thus presence of definite signs of anxiety and/or depression or not was a moderating factor for several of the associations (paths) investigated. The results are important both for the assessments and the design of treatments for patients with chronic pain.

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  • 16.
    Gunnarsson, Stina
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Rehabilitation Medicine.
    Lemming, Dag
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Alehagen, Siw
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Nursing Sciences and Reproductive Health. Linköping University, Faculty of Medicine and Health Sciences.
    Bergenheim, Tommy
    Umes Univ, Sweden.
    Gerdle, Björn
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Samuelsson, Kersti
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Rehabilitation Medicine.
    Patients Expectations Before Initiation of Intrathecal Baclofen Treatment: A Longitudinal Study with 1-Year Follow-Up2023In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 55, article id jrm00371Article in journal (Refereed)
    Abstract [en]

    Objective: To investigate patients expectations, met/unmet expectations and satisfaction with intrathecal baclofen treatment in relation to effect on spasticity, pain intensity, sleep quality, occupational performance, well-being and self-efficacy. Design: A prospective longitudinal study with follow-up at 1 year. Patients: Consecutive patients, age >= 18 years with a disabling spasticity of cerebral or spinal origin selected for intrathecal baclofen treatment at 2 university hospitals in Sweden were included. From August 2016 to June 2019, 35 patients began intrathecal baclofen treatment; 29 patients were included and completed the study. Methods: Baseline and 1-year follow-up included assessment of spasticity by physiotherapists, a semi-structured interview regarding occupational performance using the Canadian Occupational Performance Measure and a questionnaire. Results: Overall satisfaction with treatment and satisfaction with occupational performance were reported as moderate. Important variables that explained satisfaction with occupational performance were improvements in performance, expectations and performance before treatment. Patients had higher expectations compared with the 1-year outcomes regarding occupational performance, spasticity, pain intensity and sleep quality, although improvements were reported. Conclusion: A thorough discussion of goal setting with intrathecal baclofen treatment before implantation is necessary to give patients individual and realistic expectations.

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  • 17.
    Löfgren, Monika
    et al.
    Danderyd Hospital, Sweden.
    Sandström, Angelica
    Karolinska Institutet, Sweden; Karolinska University Hospital, Sweden; Harvard Medical School, USA.
    Bileviciute-Ljungar, Indre
    Danderyd Hospital, Sweden.
    Mannerkorpi, Kaisa
    Gothenburg University, Sweden.
    Gerdle, Björn
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Ernberg, Malin
    Karolinska Institutet, Sweden.
    Fransson, Peter
    Karolinska Institutet, Sweden; Karolinska University Hospital, Sweden.
    Kosek, Eva
    Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Department of Neuroradiology, Karolinska University Hospital, Stockholm, Sweden; Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
    The effects of a 15-week physical exercise intervention on pain modulation in fibromyalgia: Increased pain-related processing within the cortico-striatal- occipital networks, but no improvement of exercise-induced hypoalgesia2023In: Neurobiology of Pain, ISSN 2452-073X, Vol. 13, p. 100114-100114, article id 100114Article in journal (Refereed)
    Abstract [en]

    Dysfunctional top-down pain modulation is a hallmark of fibromyalgia (FM) and physical exercise is a cornerstone in FM treatment. The aim of this study was to explore the effects of a 15-week intervention of strengthening exercises, twice per week, supervised by a physiotherapist, on exercise-induced hypoalgesia (EIH) and cerebral pain processing in FM patients and healthy controls (HC). FM patients (n = 59) and HC (n = 39) who completed the exercise intervention as part of a multicenter study were examined at baseline and following the intervention. Following the exercise intervention, FM patients reported a reduction of pain intensity, fibromyalgia severity and depression. Reduced EIH was seen in FM patients compared to HC at baseline and no improvement of EIH was seen following the 15-week resistance exercise intervention in either group. Furthermore, a subsample (Stockholm site: FM n = 18; HC n = 19) was also examined with functional magnetic resonance imaging (fMRI) during subjectively calibrated thumbnail pressure pain stimulations at baseline and following intervention. A significant main effect of exercise (post > pre) was observed both in FM patients and HC, in pain-related brain activation within left dorsolateral prefrontal cortex and caudate, as well as increased functional connectivity between caudate and occipital lobe bordering cerebellum (driven by the FM patients). In conclusion, the results indicate that 15-week resistance exercise affect pain-related processing within the cortico-striatal-occipital networks (involved in motor control and cognition), rather than directly influencing top-down descending pain inhibition. In alignment with this, exercise-induced hypoalgesia remained unaltered.

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  • 18.
    Ghafouri, Bijar
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Matikhan, Daria
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Christidis, Nikolaos
    Karolinska Inst, Sweden.
    Ernberg, Malin
    Karolinska Inst, Sweden.
    Kosek, Eva
    Karolinska Inst, Sweden; Uppsala Univ, Sweden.
    Mannerkorpi, Kaisa
    Univ Gothenburg, Sweden; Univ Gothenburg, Sweden.
    Gerdle, Björn
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Wåhlén, Karin
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    The Vastus Lateralis Muscle Interstitium Proteome Changes after an Acute Nociception in Patients with Fibromyalgia Compared to Healthy Subjects-A Microdialysis Study2023In: Biomedicines, E-ISSN 2227-9059, Vol. 11, no 1, article id 206Article in journal (Refereed)
    Abstract [en]

    Fibromyalgia (FM) is a complex disorder and a clinical challenge to diagnose and treat. Microdialysis is a valuable tool that has been used to investigate the interstitial proteins and metabolites of muscle in patients with fibromyalgia. The implantation of the catheter in the muscle causes acute tissue trauma and nociception. The aim of this study was to investigate acute proteome changes in the vastus lateralis muscle in women fibromyalgia patients (FM) and healthy subjects (CON). A further aim was to study if a 15-week resistance exercise program in FM had any influence on how chronic painful muscle responds to acute nociception. Twenty-six women patients with FM and twenty-eight CON were included in this study. A microdialysis catheter (100 kilo Dalton cut off, membrane 30 mm) was inserted in the vastus lateralis muscle, and samples were collected every 20 min. Subjects rated pain before catheter insertion, directly after, and every 20 min of sample collection. Dialysate samples from time points 0-120 were pooled and considered trauma samples due to the catheter insertion. The samples were analyzed with nano-liquid chromatography-tandem mass spectrometry (nLC-MS/MS). Advanced multivariate data analysis was used to investigate protein profile changes between the groups. Multivariate data analysis showed significant (CV-ANOVA p = 0.036) discrimination between FM and CON based on changes in 26 proteins. After the 15-week exercise intervention, the expression levels of the 15 proteins involved in muscle contraction, response to stimulus, stress, and immune system were increased to the same expression levels as in CON. In conclusion, this study shows that microdialysis, in combination with proteomics, can provide new insights into the interstitial proteome in the muscle of FM. In response to acute nociception, exercise may alter the innate reactivity in FM. Exercise may also modulate peripheral muscle proteins related to muscle contraction, stress, and immune response in patients with FM.

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  • 19.
    Solmi, Marco
    et al.
    Univ Ottawa, Canada; Ottawa Hosp, Canada; Ottawa Hosp Res Inst OHRI, Canada; Kings Coll London, England; Univ Southampton, England; NHS Trust, England; Charite Univ Med Berlin, Germany.
    Thompson, Trevor
    Univ Greenwich, England.
    Estrade, Andres
    Kings Coll London, England; Univ Catolica, Uruguay.
    Agorastos, Agorastos
    Aristotle Univ Thessaloniki, Greece.
    Radua, Joaquim
    Kings Coll London, England; Univ Barcelona, Spain; Karolinska Inst, Sweden.
    Cortese, Samuele
    Univ Southampton, England.
    Dragioti, Elena
    Ottawa Hosp Res Inst OHRI, Canada; Univ Ioannina, Greece.
    Leisch, Friedrich
    Univ Nat Resources & Life Sci, Austria.
    Vancampfort, Davy
    Katholieke Univ Leuven KU Leuven, Belgium.
    Thygesen, Lau Caspar
    Univ Southern Denmark, Denmark.
    Aschauer, Harald
    Nonprofit Assoc Res Funding Ltd, Austria.
    Schloegelhofer, Monika
    Nonprofit Assoc Res Funding Ltd, Austria.
    Aschauer, Elena
    Nonprofit Assoc Res Funding Ltd, Austria.
    Schneeberger, Andres
    Univ Calif San Diego, CA 92093 USA.
    Huber, Christian G.
    Univ Basel, Switzerland.
    Hasler, Gregor
    Univ Fribourg, Switzerland.
    Conus, Philippe
    Univ Lausanne, Switzerland.
    Do Cuenod, Kim Q.
    Univ Lausanne, Switzerland.
    von Kaenel, Roland
    Univ Zurich, Switzerland.
    Arrondo, Gonzalo
    Univ Southampton, England; Univ Navarra, Spain.
    Fusar-Poli, Paolo
    Kings Coll London, England; South London & Maudsley NHS Fdn Trust, England; Univ Pavia, Italy.
    Gorwood, Philip
    Univ Paris Cite, France; Inst Psychiat & Neurosci Paris, France.
    Llorca, Pierre-Michel
    Univ Clermont Auvergne, France.
    Krebs, Marie-Odile
    Inst Psychiat & Neurosci Paris, France; Univ Paris, France.
    Scanferla, Elisabetta
    Univ Paris Cite, France.
    Kishimoto, Taishiro
    Keio Univ, Japan.
    Rabbani, Golam
    Natl Fdn Mental Hlth Bangladesh, Bangladesh.
    Skonieczna-Zydecka, Karolina
    Pomeranian Med Univ, Poland.
    Brambilla, Paolo
    Univ Milan, Italy; Fdn IRCCS Ca Granda Osped Maggiore Policlin, Italy.
    Favaro, Angela
    Univ Padua, Italy.
    Takamiya, Akihiro
    Keio Univ, Japan.
    Zoccante, Leonardo
    Integrated Univ Hosp Verona, Italy.
    Colizzi, Marco
    Univ Udine, Italy.
    Bourgin, Julie
    GHNE, France.
    Kaminski, Karol
    Med Univ Bialystok, Poland.
    Moghadasin, Maryam
    Kharazmi Univ, Iran.
    Seedat, Soraya
    Stellenbosch Univ, South Africa.
    Matthews, Evan
    South East Technol Univ, Ireland.
    Wells, John
    South East Technol Univ, Ireland.
    Vassilopoulou, Emilia
    Univ Nicosia, Cyprus.
    Gadelha, Ary
    Univ Fed Sao Paulo, Brazil.
    Su, Kuan-Pin
    China Med Univ, Taiwan.
    Kwon, Jun Soo
    Seoul Natl Univ, South Korea.
    Kim, Minah
    Seoul Natl Univ Hosp, South Korea.
    Lee, Tae Young
    Pusan Natl Univ, South Korea.
    Papsuev, Oleg
    Moscow Res Inst Psychiat, Russia.
    Mankova, Denisa
    Natl Inst Mental Hlth, Czech Republic.
    Boscutti, Andrea
    Univ Milan, Italy.
    Gerunda, Cristiano
    Univ Padua, Italy.
    Saccon, Diego
    AULSS4 Veneto Orientale, Italy.
    Righi, Elena
    Univ Modena & Reggio Emilia, Italy.
    Monaco, Francesco
    ASL Salerno, Italy.
    Croatto, Giovanni
    Univ Padua, Italy.
    Cereda, Guido
    Univ Milan, Italy.
    Demurtas, Jacopo
    Univ Modena & Reggio Emilia, Italy.
    Brondino, Natascia
    Univ Pavia, Italy.
    Veronese, Nicola
    Univ Palermo, Italy.
    Enrico, Paolo
    Univ Milan, Italy.
    Politi, Pierluigi
    Univ Pavia, Italy.
    Ciappolino, Valentina
    Fdn IRCCS Ca Granda Osped Maggiore Policlin, Italy.
    Pfennig, Andrea
    Tech Univ Dresden, Germany.
    Bechdolf, Andreas
    Charite Univ Med Berlin, Germany.
    Meyer-Lindenberg, Andreas
    Heidelberg Univ, Germany.
    Kahl, Kai G.
    Hannover Med Sch, Germany.
    Domschke, Katharina
    Univ Freiburg, Germany.
    Bauer, Michael
    Tech Univ Dresden, Germany.
    Koutsouleris, Nikolaos
    Ludwig Maximilians Univ Munchen, Germany.
    Winter, Sibylle
    Charite Univ Med Berlin, Germany.
    Borgwardt, Stefan
    Univ Lubeck, Germany.
    Bitter, Istvan
    Semmelweis Univ, Hungary.
    Balazs, Judit
    Eotvos Lorand Univ, Hungary; Bjorknes Univ Coll, Norway.
    Czobor, Pal
    Semmelweis Univ, Hungary.
    Unoka, Zsolt
    Semmelweis Univ, Hungary.
    Mavridis, Dimitris
    Univ Ioannina, Greece.
    Tsamakis, Konstantinos
    Kings Coll London, England.
    Bozikas, Vasilios P.
    Aristotle Univ Thessaloniki, Greece.
    Tunvirachaisakul, Chavit
    Chulalongkorn Univ, Thailand.
    Maes, Michael
    Chulalongkorn Univ, Thailand.
    Rungnirundorn, Teerayuth
    Chulalongkorn Univ, Thailand.
    Supasitthumrong, Thitiporn
    Chulalongkorn Univ, Thailand.
    Haque, Ariful
    Natl Fdn Mental Hlth Bangladesh, Bangladesh.
    Brunoni, Andre R.
    Univ Sao Paulo, Brazil; Univ Sao Paulo, Brazil.
    Costardi, Carlos Gustavo
    Univ Fed Sao Paulo, Brazil.
    Schuch, Felipe Barreto
    Univ Fed Santa Maria, Brazil; Univ Autonoma Chile, Chile; Univ Fed Rio de Janeiro, Brazil.
    Polanczyk, Guilherme
    Univ Sao Paulo, Brazil; Univ Sao Paulo, Brazil.
    Luiz, Jhoanne Merlyn
    Univ Extremo Catarinense, Brazil.
    Fonseca, Lais
    Univ Fed Sao Paulo, Brazil.
    Aparicio, Luana V.
    Univ Sao Paulo, Brazil; Univ Sao Paulo, Brazil.
    Valvassori, Samira S.
    ASL Salerno, Italy.
    Nordentoft, Merete
    Univ Copenhagen, Denmark.
    Vendsborg, Per
    Psykiatrifonden, Denmark.
    Hoffmann, Sofie Have
    Univ Southern Denmark, Denmark.
    Sehli, Jihed
    Univ Fribourg, Switzerland.
    Sartorius, Norman
    Assoc Improvement Mental Hlth Programmes AMH, Switzerland.
    Heuss, Sabina
    FHNW Univ Appl Sci & Arts Northwestern Switzerlan, Switzerland.
    Guinart, Daniel
    Zucker Hillside Hosp, NY USA; Donald & Barbara Zucker Sch Med Hofstra Northwell, NY USA; Univ Autonoma Barcelona, Spain.
    Hamilton, Jane
    Univ Texas Hlth Sci Ctr Houston, TX USA.
    Kane, John
    Zucker Hillside Hosp, NY USA; Feinstein Inst Med Res, NY USA.
    Rubio, Jose
    Zucker Hillside Hosp, NY USA; Feinstein Inst Med Res, NY USA.
    Sand, Michael
    S2 Consulting LLC, India.
    Koyanagi, Ai
    Parc Sanitari Sant Joan de Deu, Spain.
    Solanes, Aleix
    Univ Barcelona, Spain.
    Andreu-Bernabeu, Alvaro
    Univ Complutense, Spain.
    Jose Caceres, Antonia San
    Univ Complutense, Spain.
    Arango, Celso
    Univ Complutense, Spain.
    Diaz-Caneja, Covadonga M.
    Univ Complutense, Spain.
    Hidalgo-Mazzei, Diego
    Univ Barcelona, Spain.
    Vieta, Eduard
    Univ Barcelona, Spain.
    Gonzalez-Penas, Javier
    Univ Complutense, Spain.
    Fortea, Lydia
    Univ Barcelona, Spain.
    Parellada, Mara
    Univ Complutense, Spain.
    Fullana, Miquel A.
    Univ Barcelona, Spain.
    Verdolini, Norma
    Mental Hlth Ctr Perugia, Italy.
    Andrlikova, Eva
    Natl Inst Mental Hlth, Czech Republic.
    Janku, Karolina
    Natl Inst Mental Hlth, Czech Republic.
    Millan, Mark John
    Univ Glasgow, Scotland.
    Honciuc, Mihaela
    Univ Clermont Auvergne, France.
    Moniuszko-Malinowska, Anna
    Med Univ Bialystok, Poland.
    Loniewski, Igor
    Pomeranian Med Univ, Poland; Sanprobi Sp Zoo Spk, Poland.
    Samochowiec, Jerzy
    Pomeranian Med Univ, Poland.
    Kiszkiel, Lukasz
    Univ Bialystok, Poland.
    Marlicz, Maria
    Pomeranian Med Univ, Poland.
    Sowa, Pawel
    Med Univ Bialystok, Poland.
    Marlicz, Wojciech
    Pomeranian Med Univ, Poland; Ctr Digest Dis Endoklin, Poland.
    Spies, Georgina
    Stellenbosch Univ, South Africa.
    Stubbs, Brendon
    Kings Coll London, England.
    Firth, Joseph
    Univ Manchester, England.
    Sullivan, Sarah
    Univ Bristol, England.
    Darcin, Asli Enez
    Istanbul Topkapi Univ, Turkiye.
    Aksu, Hatice
    Adnan Menderes Univ, Turkiye.
    Dilbaz, Nesrin
    Uskudar Univ, Turkiye.
    Noyan, Onur
    Uskudar Univ, Turkiye.
    Kitazawa, Momoko
    Keio Univ, Japan.
    Kurokawa, Shunya
    Keio Univ, Japan.
    Tazawa, Yuki
    Keio Univ, Japan.
    Anselmi, Alejandro
    Univ Catolica, Uruguay.
    Cracco, Cecilia
    Univ Catolica, Uruguay.
    Ines Machado, Ana
    Univ Catolica, Uruguay.
    Estrade, Natalia
    Univ Catolica, Uruguay.
    De Leo, Diego
    Griffith Univ, Australia.
    Curtis, Jackie
    Mindgardens Neurosci Network, Australia.
    Berk, Michael
    Deakin Univ, Australia.
    Ward, Philip
    UNSW Sydney, Australia.
    Teasdale, Scott
    Deakin Univ, Australia.
    Rosenbaum, Simon
    UNSW Sydney, Australia.
    Marx, Wolfgang
    Deakin Univ, Australia.
    Horodnic, Adrian Vasile
    Univ Med & Pharm Grigore T Popa, Romania.
    Oprea, Liviu
    Univ Med & Pharm Grigore T Popa, Romania.
    Alexinschi, Ovidiu
    Inst Psychiat Socola, Romania.
    Ifteni, Petru
    Transilvania Univ Brasov, Romania.
    Turliuc, Serban
    Univ Med & Pharm Grigore T Popa, Romania.
    Ciuhodaru, Tudor
    Emergency Hosp Nicolae Oblu, Romania.
    Bolos, Alexandra
    Univ Med & Pharm Grigore T Popa, Romania.
    Matei, Valentin
    Univ Med & Pharm Carol Davila Bucharest, Romania.
    Nieman, Dorien H.
    Acad Med Ctr Univ Amsterdam, Netherlands.
    Sommer, Iris
    Univ Groningen, Netherlands; Univ Groningen, Netherlands.
    van Os, Jim
    Utrecht Univ Med Ctr, Netherlands.
    van Amelsvoort, Therese
    Maastricht Univ, Netherlands.
    Sun, Ching-Fang
    China Med Univ Hosp, Taiwan; Virginia Tech, VA USA.
    Guu, Ta-wei
    China Med Univ, Taiwan.
    Jiao, Can
    Shenzhen Univ, Peoples R China.
    Zhang, Jieting
    Shenzhen Univ, Peoples R China.
    Fan, Jialin
    Shenzhen Univ, Peoples R China.
    Zou, Liye
    Shenzhen Univ, Peoples R China.
    Yu, Xin
    Peking Univ, Peoples R China.
    Chi, Xinli
    Shenzhen Univ, Peoples R China.
    de Timary, Philippe
    UCLouvain, Belgium; Clin Univ St Luc, Belgium.
    van Winkel, Ruud
    Katholieke Univ Leuven KU Leuven, Belgium.
    Ng, Bernardo
    Asoc Psiquiatrica Mexicana, Mexico.
    Pena, Edilberto
    Asoc Psiquiatrica Mexicana, Mexico.
    Arellano, Ramon
    Asoc Psiquiatrica Mexicana, Mexico.
    Roman, Raquel
    Asoc Psiquiatrica Mexicana, Mexico.
    Sanchez, Thelma
    Asoc Psiquiatrica Mexicana, Mexico.
    Movina, Larisa
    Moscow Res Inst Psychiat, Russia.
    Morgado, Pedro
    Univ Minho, Portugal; ICVS 3Bs PT Govt Assoc Lab, Portugal.
    Brissos, Sofia
    Lisbons Psychiat Hosp Ctr, Portugal.
    Aizberg, Oleg
    Belarusian Med Acad Postgraduate Educ, BELARUS.
    Mosina, Anna
    Clienia AG, Switzerland.
    Krinitski, Damir
    Integrated Psychiat Winterthur IPW, Switzerland.
    Mugisha, James
    Kyambogo Univ, Uganda.
    Sadeghi-Bahmani, Dena
    Stanford Univ, CA USA; Univ Psychiat Kliniken Basel UPK, Switzerland.
    Sheybani, Farshad
    Mashhad Univ Med Sci, Iran.
    Sadeghi, Masoud
    Kermanshah Univ Med Sci, Iran.
    Hadi, Samira
    Kharazmi Univ, Iran.
    Brand, Serge
    Univ Psychiat Kliniken Basel UPK, Switzerland; Univ Basel, Switzerland; Kermanshah Univ Med Sci, Iran; Kermanshah Univ Med Sci, Iran; Univ Tehran Med Sci, Iran.
    Errazuriz, Antonia
    Pontificia Univ Catolica Chile, Chile.
    Crossley, Nicolas
    Pontificia Univ Catolica Chile, Chile.
    Ristic, Dragana Ignjatovic
    Univ Kragujevac, Serbia.
    Lopez-Jaramillo, Carlos
    Univ Antioquia, Colombia.
    Efthymiou, Dimitris
    Univ Nicosia, Cyprus.
    Kuttichira, Praveenlal
    Jubilee Miss Med Coll & Res Inst, India.
    Kallivayalil, Roy Abraham
    Pushpagiri Inst Med Sci, India.
    Javed, Afzal
    Pakistan Psychiat Res Ctr Fountain House, Pakistan.
    Afridi, Muhammad Iqbal
    Coll Phys & Surg, Pakistan; Jinnah Postgrad Med Ctr, Pakistan; Jinnah Sindh Med Univ, Pakistan.
    James, Bawo
    Fed Neuropsychiat Hosp, Nigeria.
    Seb-Akahomen, Omonefe Joy
    Irrua Specialist Teaching Hosp, Nigeria.
    Fiedorowicz, Jess
    Univ Ottawa, Canada; Ottawa Hosp, Canada; Ottawa Hosp Res Inst OHRI, Canada.
    Carvalho, Andre F.
    Deakin Univ, Australia.
    Daskalakis, Jeff
    Univ Calif San Diego, CA USA.
    Yatham, Lakshmi N.
    Univ British Columbia, Canada.
    Yang, Lin
    Univ Calgary, Canada; Univ Calgary, Canada; Alberta Hlth Serv, Canada.
    Okasha, Tarek
    Ain Shams Univ, Egypt.
    Dahdouh, Aicha
    Oran 1 Univ, Algeria.
    Gerdle, Bjoern
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Tiihonen, Jari
    Karolinska Inst, Sweden; Univ Eastern Finland, Finland.
    Il Shin, Jae
    Yonsei Univ, South Korea.
    Lee, Jinhee
    Yonsei Univ, South Korea.
    Mhalla, Ahmed
    Univ Monastir, Tunisia.
    Gaha, Lotfi
    Univ Monastir, Tunisia.
    Brahim, Takoua
    Univ Monastir, Tunisia.
    Altynbekov, Kuanysh
    Republ Sci & Pract Ctr Mental Hlth, Kazakhstan.
    Negay, Nikolay
    Republ Sci & Pract Ctr Mental Hlth, Kazakhstan.
    Nurmagambetova, Saltanat
    Republ Sci & Pract Ctr Mental Hlth, Kazakhstan.
    Abu Jamei, Yasser
    Gaza Community Mental Hlth Programme, Palestine.
    Weiser, Mark
    Sheba Med Ctr, Israel.
    Correll, Christoph U.
    Charite Univ Med Berlin, Germany; Zucker Hillside Hosp, NY USA; Donald & Barbara Zucker Sch Med Hofstra Northwell, NY USA; Feinstein Inst Med Res, NY USA.
    Validation of the Collaborative Outcomes study on Health and Functioning during Infection Times (COH-FIT) questionnaire for adults2023In: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 326, p. 249-261Article in journal (Refereed)
    Abstract [en]

    Background: The Collaborative Outcome study on Health and Functioning during Infection Times (COH-FIT; www.coh-fit.com) is an anonymous and global online survey measuring health and functioning during the COVID-19 pandemic. The aim of this study was to test concurrently the validity of COH-FIT items and the in-ternal validity of the co-primary outcome, a composite psychopathology "P-score". Methods: The COH-FIT survey has been translated into 30 languages (two blind forward-translations, consensus, one independent English back-translation, final harmonization). To measure mental health, 1-4 items ("COH-FIT items") were extracted from validated questionnaires (e.g. Patient Health Questionnaire 9). COH-FIT items measured anxiety, depressive, post-traumatic, obsessive-compulsive, bipolar and psychotic symptoms, as well as stress, sleep and concentration. COH-FIT Items which correlated r >= 0.5 with validated companion question-naires, were initially retained. A P-score factor structure was then identified from these items using exploratory factor analysis (EFA) and confirmatory factor analyses (CFA) on data split into training and validation sets. Consistency of results across languages, gender and age was assessed. Results: From >150,000 adult responses by May 6th, 2022, a subset of 22,456 completed both COH-FIT items and validated questionnaires. Concurrent validity was consistently demonstrated across different languages for COH-FIT items. CFA confirmed EFA results of five first-order factors (anxiety, depression, post-traumatic, psychotic, psychophysiologic symptoms) and revealed a single second-order factor P-score, with high internal reliability (omega = 0.95). Factor structure was consistent across age and sex. Conclusions: COH-FIT is a valid instrument to globally measure mental health during infection times. The P-score is a valid measure of multidimensional mental health.

  • 20.
    Svanholm, Frida
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Björk, Mathilda
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Lofgren, Monika
    Karolinska Inst, Sweden; Danderyd Hosp, Sweden.
    Gerdle, Björn
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Hedevik, Henrik
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Molander, Peter
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Work Interventions Within Interdisciplinary Pain Rehabilitation Programs (IPRP) - Frequency, Patient Characteristics, and Association with Self-Rated Work Ability2023In: Journal of Pain Research, E-ISSN 1178-7090, Vol. 16, p. 421-436Article in journal (Refereed)
    Abstract [en]

    Background: Interdisciplinary pain rehabilitation programs (IPRPs) help people with chronic pain improve their health and manage their work; however, the way IPRPs address sick leave could be improved. Although work interventions can be a part of IPRP, it is not well known how and to what extent.Aim: This study explores the frequency of work interventions and the characteristics of patients who participate in work interventions as part of IPRP at specialist pain rehabilitation departments in Sweden. In addition, this study explores the association between participation in work interventions and change in patients self-rated work ability after IPRP.Methods: Data from the Swedish quality registry for pain rehabilitation (SQRP), which includes 3809 patients between 2016 and 2018, were analysed with descriptive statistics and regression analyses.Results: The results indicate a high participation rate in work interventions (90%). Some differences were evident concerning characteristics of patients who participated in different work interventions. The return-to-work (RTW) plan, the most frequently used work intervention, had the strongest association with change in self-rated work ability after IPRP. However, the effect sizes were small, and the initial score best explained the change. Furthermore, there were differences between employed and unemployed patients and employment had a positive association with change in self-rated work ability.Conclusion: More research is needed to understand IPRPs mechanisms and work interventions to support patients with chronic pain, reduce sick leave, and manage work. Employment status needs to be considered and interventions should be tailored to match the individual needs.

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  • 21.
    Ghafouri, Bijar
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Thordeman, Katarina
    Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center. Linköping University, Department of Health, Medicine and Caring Sciences. Linköping University, Faculty of Medicine and Health Sciences.
    Hadjikani, Romina
    Linköping University, Department of Health, Medicine and Caring Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Bay Nord, Anders
    Swedish NMR Centre at the University of Gothenburg, Gothenburg, Sweden.
    Gerdle, Björn
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Bäckryd, Emmanuel
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    An investigation of metabolome in blood in patients with chronic peripheral, posttraumatic/postsurgical neuropathic pain.2022In: Scientific Reports, E-ISSN 2045-2322, Vol. 12, no 1, article id 21714Article in journal (Refereed)
    Abstract [en]

    Neuropathic pain (NP) is a chronic pain condition resulting from a lesion or disease in the somatosensory nervous system. The aim of this study was to investigate the metabolome in plasma from patients with chronic peripheral, posttraumatic/postsurgical NP compared to healthy controls. Further, we aimed to investigate the correlation between pain intensity and the metabolome in plasma. The metabolic profile in plasma samples from 16 patients with chronic NP and 12 healthy controls was analyzed using a nuclear magnetic resonance spectroscopy method. Information about pain intensity, pain duration, body mass index (BMI), age, sex, and blood pressure were obtained through a questionnaire and clinical examination. Multivariate data analysis was used to identify metabolites significant for group separation and their correlation with pain intensity and duration, BMI, and age. We found 50 out of 326 features in plasma significantly contributing to group discrimination between NP and controls. Several of the metabolites that significantly differed were involved in inflammatory processes, while others were important for central nervous system functioning and neural signaling. There was no correlation between pain intensity and levels of metabolite in NP. These findings indicate that there seems to be peripheral/systemic differences in the metabolic profile between patients with chronic NP and healthy individuals.

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  • 22.
    Lukas, Peter
    et al.
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Children's and Women's Health. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
    Gerdle, Björn
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Nilsson, Lena
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Nursing Sciences and Reproductive Health. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, ANOPIVA US.
    Borendal Wodlin, Ninnie
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Children's and Women's Health. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
    Fredrikson, Mats
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Inflammation and Infection. Linköping University, Faculty of Medicine and Health Sciences, Forum Östergötland.
    Arendt-Nielsen, Lars
    Aalborg Univ, Denmark; Aalborg Univ Hosp, Denmark.
    Kjölhede, Preben
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Children's and Women's Health. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
    Association Between Experimental Pain Thresholds and Trajectories of Postoperative Recovery Measures After Benign Hysterectomy2022In: Journal of Pain Research, E-ISSN 1178-7090, Vol. 15, p. 3657-3674Article in journal (Refereed)
    Abstract [en]

    Purpose: Quantitative sensory testing (QST) can be applied to quantify the sensitivity to different painful stimuli. This study aims to evaluate the association between preoperative pressure and thermal pain thresholds and trajectories of measurements of postoperative recovery (patient-reported daily maximum and average pain intensity, sum score of symptoms, and analgesic consumption) after benign hysterectomy.Patients and Methods: A prospective, longitudinal single-blinded, observational multicenter study was conducted in five hospitals in the southeast of Sweden between 2011 and 2017. A total of 406 women scheduled for abdominal or vaginal hysterectomy for benign conditions were enrolled in the study. QST measuring pressure (PPT), heat (HPT), and cold pain thresholds (CPT) were performed preoperatively. The cut-off levels for dichotomizing the pain thresholds (low/high) were set at the 25-percentile for PPT and HPT and the 75-percentile for CPT. The Swedish Postoperative Symptom Questionnaire was used to measure postoperative pain and other symptoms of discomfort (symptom sum score) on 13 occasions for six weeks postoperatively. Daily analgesic consumption of opioids and non-opioids was registered.Results: A CPT above the 75-percentile was associated with high postoperative maximum pain intensity (p = 0.04), high symptom sum score (p = 0.03) and greater consumption of non-opioids (p = 0.03). A HPT below the 25-percentile was only associated with greater consumption of non-opioids (p = 0.02). PPT was not associated with any of the outcome measures.Conclusion: CPT seemed to be predictive for postoperative pain and symptoms of discomfort after benign hysterectomy. Preoperative QST may be used to individualize the management of postoperative recovery for low pain threshold individuals.

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  • 23.
    Jönsson, Mika
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Bäckryd, Emmanuel
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Jonasson, Lena
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Diagnostics and Specialist Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart Center, Department of Cardiology in Linköping.
    Gerdle, Björn
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Ghafouri, Bijar
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Differences in plasma lipoprotein profiles between patients with chronic peripheral neuropathic pain and healthy controls: an exploratory pilot study2022In: Pain Reports, E-ISSN 2471-2531, Vol. 7, no 5, article id e1036Article in journal (Refereed)
    Abstract [en]

    Introduction: Little is still known about the underlying mechanisms that drive and maintain neuropathic pain (NeuP). Recently, lipids have been implicated as endogenous proalgesic ligands affecting onset and maintenance of pain; however, in the case of NeuP, the relationship is largely unexplored. Objectives: The aim of this study was to investigate the lipoprotein profile in patients with chronic peripheral NeuP compared with healthy controls. Methods: The concentrations of 112 lipoprotein fractions in plasma from patients with NeuP (n = 16) and healthy controls (n = 13) were analyzed using proton nuclear magnetic resonance spectroscopy. A multiplex immunoassay based on an electrochemiluminescent detection method was used to measure the concentration of 71 cytokines in plasma from patients with NeuP (n = 10) and healthy controls (n = 11). Multivariate data analysis was used to identify patterns of protein intercorrelations and proteins significant for group discrimination. Results: We found 23 lipoproteins that were significantly upregulated in patients with NeuP compared with healthy controls. When the influence of cytokines was included in a regression model, 30 proteins (8 cytokines and 22 lipoprotein fractions) were significantly upregulated or downregulated in patients with NeuP. Both conditions presented lipoprotein profiles consistent with inflammation. Body mass index did not affect lipoprotein profiles in either group. No relationship between age and lipoprotein pattern was found in NeuP, but a significant relationship was found in healthy controls. Conclusion: Patients with NeuP presented a lipoprotein profile consistent with systemic low-grade inflammation, like that seen in autoimmune, cardiometabolic, and neuroprogressive diseases. These preliminary results emphasize the importance of chronic low-grade inflammation in NeuP.

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  • 24.
    Järemo, Pirjo
    et al.
    Karolinska Inst, Sweden.
    Arman, Maria
    Karolinska Inst, Sweden.
    Gerdle, Björn
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Gottberg, Kristina
    Karolinska Inst, Sweden.
    Facing Invalidation: A Further Challenge when Living with Chronic Widespread Pain2022In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 54, article id jrm00280Article in journal (Refereed)
    Abstract [en]

    Objective: The concept of "invalidation" refers to the patients perception that the social environment does not recognize their medical condition. This study explores and describes invalidation experiences among Swedish patients with chronic widespread pain with regard to sociodemographic and pain characteristics, impact of pain, self-reported health, and symptoms of anxiety and depressive. Methods: A cross-sectional design using questionnaires, including sociodemographic and pain variables, the Illness Invalidation Inventory (Likert scale items regarding 5 sources), the Hospital Anxiety and Depression Scale, and the Short-Form General Health Survey. Descriptive and univariate analyses were applied. Results: Of the 152 respondents, 91% were women. Swedish patients with chronic widespread pain experienced invalidation to a large extent from all sources. The highest scores for invalidation were reported from contacts with social services (68%), and the lowest from spouses (30%). Being younger (p < 0.006), having periodic pain (p = 0.011), and having had more frequent visits to a doctor in the previous year (p = 0.007) were characteristics associated with higher invalidation scores. Experiences of invalidation were associated with worse self-reported mental health scores (r = -0.29 to -0.46). Conclusion: Since patients with chronic widespread pain frequently experience invalidation from the social environment, this further challenge in daily life must be taken into consideration in pain management within multimodal pain rehabilitation.

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  • 25.
    Gerdle, Björn
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center. Linköping University, Center for Medical Image Science and Visualization (CMIV).
    Dahlqvist Leinhard, Olof
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Diagnostics and Specialist Medicine. Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Center for Medical Image Science and Visualization (CMIV). Region Östergötland, Center for Diagnostics, Medical radiation physics. AMRA Med AB, Linkoping, Sweden.
    Lund, Eva
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Diagnostics and Specialist Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Medical radiation physics.
    Bengtsson, Ann
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Lundberg, Peter
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Diagnostics and Specialist Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Medical radiation physics. Linköping University, Center for Medical Image Science and Visualization (CMIV).
    Ghafouri, Bijar
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Forsgren, Mikael
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Diagnostics and Specialist Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Medical radiation physics. AMRA Med AB, Linkoping, Sweden.
    Fibromyalgia: Associations Between Fat Infiltration, Physical Capacity, and Clinical Variables2022In: Journal of Pain Research, E-ISSN 1178-7090, Vol. 15, p. 2517-2535Article in journal (Refereed)
    Abstract [en]

    Background: Obesity is a risk factor for the development of fibromyalgia (FM) and generally most studies report increased Body Mass Index (BMI) in FM. Obesity in FM is associated with a worse clinical presentation. FM patients have low physical conditioning and obesity further exacerbates these aspects. Hitherto studies of FM have focused upon a surrogate for overall measure of fat content, ie, BMI. This study is motivated by that ectopic fat and adipose tissues are rarely investigated in FM including their relationships to physical capacity variables. Moreover, their relationships to clinical variables including are not known. Aims were to 1) compare body composition between FM and healthy controls and 2) investigate if significant associations exist between body composition and physical capacity aspects and important clinical variables.Methods: FM patients (n = 32) and healthy controls (CON; n = 30) underwent a clinical examination that included pressure pain thresholds and physical tests. They completed a health questionnaire and participated in whole-body magnetic resonance imaging (MRI) to determine body composition aspects.Results: Abdominal adipose tissues, muscle fat, and BMI were significantly higher in FM, whereas muscle volumes of quadriceps were smaller. Physical capacity variables correlated negatively with body composition variables in FM. Both body composition and physical capacity variables were significant regressors of group belonging; the physical capacity variables alone showed stronger relationships with group membership. A mix of body composition variables and physical capacity variables were significant regressors of pain intensity and impact in FM. Body composition variables were the strongest regressors of blood pressures, which were increased in FM.Conclusion: Obesity has a negative influence on FM symptomatology and increases the risk for other serious conditions. Hence, obesity, dietary habits, and physical activity should be considered when developing clinical management plans for patients with FM.

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  • 26.
    Ghafouri, Bijar
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Edman, Emelie
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Löf, Marie
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences. Karolinska Inst, Sweden.
    Lund, Eva
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Diagnostics and Specialist Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Medical radiation physics.
    Dahlqvist Leinhard, Olof
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Diagnostics and Specialist Medicine. Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Center for Medical Image Science and Visualization (CMIV). Region Östergötland, Center for Diagnostics, Medical radiation physics. AMRA Medical AB.
    Lundberg, Peter
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Diagnostics and Specialist Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Medical radiation physics. Linköping University, Center for Medical Image Science and Visualization (CMIV).
    Forsgren, Mikael
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Diagnostics and Specialist Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Medical radiation physics. AMRA Medical AB.
    Gerdle, Björn
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Dong, Huan-Ji
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Fibromyalgia in women: association of inflammatory plasma proteins, muscle blood flow, and metabolism with body mass index and pain characteristics2022In: Pain Reports, E-ISSN 2471-2531, Vol. 7, no 6, article id e1042Article in journal (Refereed)
    Abstract [en]

    Introduction: Obesity is a common comorbidity in fibromyalgia (FM). Both FM and obesity have been connected to low-grade inflammation, although it is possible that previously reported inflammatory alterations in FM primarily may be linked to increased body mass index (BMI). Objective: This study aimed to investigate whether the inflammatory plasma protein profile, muscle blood flow, and metabolism and pain characteristics (clinical parameters and patient-reported outcome measurements) differed between female patients with FM with and without obesity. Methods: Patients with FM underwent clinical examinations, physical tests, and answered questionnaires. They were dichotomized according to BMI (<30 kg/m(2) [n = 14]; >= 30 kg/m(2) [n = 13]). Blood samples were collected and analyzed using a panel of 71 inflammatory plasma proteins. Results: There were significant (P < 0.05) differences in blood pressure, pulse, max VO2, pain intensity, physical capacity, and Fibromyalgia Impact Questionnaire between the groups; the obese group had higher blood pressure, pulse, pain intensity, and Fibromyalgia Impact Questionnaire. There were 14 proteins that contributed to the group belonging. The 4 most important proteins for the group discrimination were MIP1 beta, MCP4, IL1RA, and IL6, which showed higher concentrations in obese patients with FM. Significantly decreased blood flow and increased concentration of pyruvate were detected in obese patients compared with nonobese patients. There was significant correlation between inflammatory proteins and sedentary behavior and health status in obese patients with FM. Conclusions: These findings suggest that metabolism and inflammation interact in female patients with FM with obesity and might cause chronic low-grade inflammation. Screening for obesity and monitoring of BMI changes should be considered in the treatment of patients with FM.

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  • 27.
    Bäckryd, Emmanuel
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Themistocleous, Andreas
    Univ Oxford, England.
    Larsson, Anders
    Uppsala Univ, Sweden.
    Gordh, Torsten
    Uppsala Univ, Sweden.
    Rice, Andrew S. C.
    Imperial Coll London, England.
    Tesfaye, Solomon
    Sheffield Teaching Hosp NHS Fdn Trust, England.
    Bennett, David L.
    Univ Oxford, England.
    Gerdle, Björn
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Hepatocyte growth factor, colony-stimulating factor 1, CD40, and 11 other inflammation-related proteins are associated with pain in diabetic neuropathy: exploration and replication serum data from the Pain in Neuropathy Study2022In: Pain, ISSN 0304-3959, E-ISSN 1872-6623, Vol. 163, no 5, p. 897-909Article in journal (Refereed)
    Abstract [en]

    One in 5 patients with diabetes suffers from chronic pain with neuropathic characteristics, but the pathophysiological mechanisms underlying the development of neuropathic pain in patients with diabetic distal symmetrical polyneuropathy (DSP) are poorly understood. Systemic low-grade inflammation has been implicated, but there is still a considerable knowledge gap concerning its scope and meaning in this context. The aim of the study was to establish the broad inflammatory signature of painful diabetic DSP in serum samples from the Pain in Neuropathy Study, an observational cross-sectional multicentre study in which participants underwent deep phenotyping. In the present two cohorts exploration-replication study (180 participants in each cohort), serum samples from Pain in Neuropathy Study participants were analyzed with the Olink INFLAMMATION panel (Olink Bioscience, Uppsala, Sweden) that enables the simultaneous measurement of 92 inflammation-related proteins (mainly cytokines, chemokines, and growth factors). In both the exploration and the replication cohort, we identified a high-inflammation subgroup where 14 inflammation-related proteins in particular were associated with more neuropathy and higher pain intensity. The top 3 proteins were hepatocyte growth factor, colony-stimulating factor 1, and CD40 in both cohorts. In the exploratory cohort, additional clinical data were available, showing an association of inflammation with insomnia and self-reported psychological distress. Hence, this cross-sectional exploration-replication study seems to confirm that low-grade systemic inflammation is related to the severity of neuropathy and neuropathic pain in a subgroup of patients with diabetic DSP. The pathophysiological relevance of these proteins for the development of neuropathic pain in patients with diabetic DSP must be explored in more depth in future studies.

  • 28.
    Wiklund, Tobias
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Molander, Peter
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Lindner, Philip
    Karolinska Inst, Sweden; Stockholm Hlth Care Serv, Sweden.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Biomedical and Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Karolinska Inst, Sweden; Stockholm Hlth Care Serv, Sweden.
    Gerdle, Björn
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Dragioti, Elena
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Internet-Delivered Cognitive Behavioral Therapy for Insomnia Comorbid With Chronic Pain: Randomized Controlled Trial2022In: Journal of Medical Internet Research, E-ISSN 1438-8871, Vol. 24, no 4, article id e29258Article in journal (Refereed)
    Abstract [en]

    Background: Patients with chronic pain often experience insomnia symptoms. Pain initiates, maintains, and exacerbates insomnia symptoms, and vice versa, indicating a complex situation with an additional burden for these patients. Hence, the evaluation of insomnia-related interventions for patients with chronic pain is important. Objective: This randomized controlled trial examined the effectiveness of internet-based cognitive behavioral therapy for insomnia (ICBT-i) for reducing insomnia severity and other sleep- and pain-related parameters in patients with chronic pain. Participants were recruited from the Swedish Quality Registry for Pain Rehabilitation. Methods: We included 54 patients (mean age 49.3, SD 12.3 years) who were randomly assigned to the ICBT-i condition and 24 to an active control condition (applied relaxation). Both treatment conditions were delivered via the internet. The Insomnia Severity Index (ISI), a sleep diary, and a battery of anxiety, depression, and pain-related parameter measurements were assessed at baseline, after treatment, and at a 6-month follow-up (only ISI, anxiety, depression, and pain-related parameters). For the ISI and sleep diary, we also recorded weekly measurements during the 5-week treatment. Negative effects were also monitored and reported. Results: Results showed a significant immediate interaction effect (time by treatment) on the ISI and other sleep parameters, namely, sleep efficiency, sleep onset latency, early morning awakenings, and wake time after sleep onset. Participants in the applied relaxation group reported no significant immediate improvements, but both groups exhibited a time effect for anxiety and depression at the 6-month follow-up. No significant improvements on pain-related parameters were found. At the 6-month follow-up, both the ICBT-i and applied relaxation groups had similar sleep parameters. For both treatment arms, increased stress was the most frequently reported negative effect. Conclusions: In patients with chronic pain, brief ICBT-i leads to a more rapid decline in insomnia symptoms than does applied relaxation. As these results are unique, further research is needed to investigate the effect of ICBT-i on a larger sample size of people with chronic pain. Using both treatments might lead to an even better outcome in patients with comorbid insomnia and chronic pain.

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  • 29.
    Stensson, Niclas
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Gerdle, Björn
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Rönne-Petersén, Linn
    Karolinska Inst, Sweden.
    Yang, Liu L.
    Karolinska Inst, Sweden; Karolinska Univ Hosp, Sweden.
    Lavebratt, Catharina
    Karolinska Inst, Sweden; Karolinska Univ Hosp, Sweden.
    Falkenberg, Torkel
    Karolinska Inst, Sweden.
    Ghafouri, Bijar
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Investigating the Long-Term Effect of an Interdisciplinary Multimodal Rehabilitation Program on Levels of Bioactive Lipids and Telomerase Activity in Blood from Patients with Chronic Pain2022In: Journal of Clinical Medicine, E-ISSN 2077-0383, Vol. 11, no 5, article id 1291Article in journal (Refereed)
    Abstract [en]

    Mechanism-based diagnosis and therapies for chronic pain are lacking. However, bio-psycho-social interventions such as interdisciplinary multimodal rehabilitation programs (IPRPs) have shown to be relatively effective treatments. In this context we aim to investigate the effects of IPRP on the changes in levels of bioactive lipids and telomerase activity in plasma, and if these changes are associated with changes in pain intensity and psychological distress. This exploratory study involves 18 patients with complex chronic pain participating in an IPRP. Self-reports of pain, psychological distress, physical activity, and blood samples were collected before the IPRP and at a six-month follow-up. Levels of arachidonoylethanolamide (AEA) and 2-arachidonoylglycerol (2-AG), palmitoylethanolamide (PEA), oleoylethanolamide (OEA), stearoylethanolamide (SEA), and telomerase activity were measured. Pain intensity was decreased, and SEA levels were increased at the six-month follow up. A significant correlation existed between changes in SEA levels and pain intensity. AEA levels, were inversely correlated with physical activity. Furthermore, 2-AG and telomerase activity was significantly correlated at the six-month follow-up. This study confirms that IPRP is relatively effective for reduction in chronic pain. Changes in SEA were correlated with changes in pain intensity, which might indicate that SEA changes reflect the pain reduction effects of IPRP.

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  • 30.
    Lind, Jonas
    et al.
    Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Biomedical and Clinical Sciences, Division of Neurobiology. Department of Neurology, Internal Medicine, County Hospital Ryhov, Jönköping, Sweden.
    Stensson, Niclas
    Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Gerdle, Björn
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Ghafouri, Nazdar
    Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center. Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine.
    Levels of bioactive endogenous lipids and health-related quality of life in Chronic Idiopathic Axonal Polyneuropathy2022In: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967, Vol. 127Article in journal (Refereed)
    Abstract [en]

    Background: Although neuropathic pain is a significant problem in polyneuropathy, the underlying molecular mechanisms are poorly understood. The endogenous bioactive lipids 2-arachidonoyl-glycerol (2-AG), oleoylethanolamide (OEA), palmitoylethanolamide (PEA), and stearoylethanolamide (SEA) are known to influence pain and inflammation in the peripheral nervous system. The aim of this study was to explore the plasma levels of endocannabinoids and related lipids and health-related quality of life in patients with polyneuropathy with and without pain.

    Methods: Patients (n = 48) with Chronic Idiopathic Axonal Neuropathy were included. Clinical data were retrieved from medical files. All patients filled out the SF-36 and EQ-5D questionnaires. In addition, blood samples were analyzed for 2-AG, OEA, PEA, and SEA.

    Results: Neuropathic pain was reported in 21 of the patients. There were significantly lower levels of 2-AG in patients with neuropathic pain (P = 0.03), but there were no significant differences in OEA (P = 0.61), PEA (P = 0.95), or SEA (P = 0.97) levels. The patients reporting pain in the hands had significantly lower SEA levels, 10.0 versus 15.0 (P = 0.03). The levels of 2-AG were significantly higher among patients reporting paresthesia in their feet (80.1 vs. 56.3; P = 0.02). Levels of PEA, SEA, and 2-AG were decreased in patients with loss of vibration. PEA and SEA were decreased in patients with loss of pain and temperature, and SEA decreased in patients with loss of sense of touch. However, the differences in the levels of bioactive endogenous lipids were not statistically significant when corrected for multiple comparisons.

    Conclusion: Alterations of 2-AG levels between polyneuropathy patients with and without neurogenic pain indicate that it could play an essential role. Further studies are warranted.

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  • 31.
    Skogberg, Olle
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Karlsson, Linn
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Börsbo, Björn
    Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Health, Medicine and Caring Sciences.
    Arendt-Nielsen, Lars
    Aalborg Univ, Denmark; Aalborg Univ Hosp, Denmark.
    Graven-Nielsen, Thomas
    Aalborg Univ, Denmark.
    Gerdle, Björn
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Bäckryd, Emmanuel
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Lemming, Dag
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center. Swedish Transport Agcy, Sweden.
    Pain Tolerance in Chronic Pain Patients Seems to be More Associated with Physical Activity than with Depression and Anxiety2022In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 54, article id jrm00286Article in journal (Refereed)
    Abstract [en]

    Objective: To explore the associations between habitual self-reported physical activity, pain sensitivity and patient-reported outcomes (including pain intensity) in patients with chronic pain. Design: Cross-sectional, experimental study. Subjects: Patients (n = 78), age range 18-65 years, with different chronic pain conditions (> 3 months) were compared with age- and sex-matched healthy controls (n = 98). Methods: Multivariate correlations between selfreported physical activity, pressure pain sensitivity, and patient-reported outcome measures were assessed. Results: Lower perceived health status (p <0.001, Cohens d =2.34), higher levels of depression (p< 0.001, Cohens d = 1.77), and lower pain tolerance threshold (p < 0.001, Cohens d = 1.66) were the most prominent variables discriminating patients from controls. In patients, bivariate and multivariate analyses showed that higher pressure pain tolerance was associated with male sex, lower pain intensity and fewer painful regions, higher self-efficacy and more self-reported physical activity, but not with lower levels of anxiety and depression. Conclusion: Pain tolerance thresholds, as well as degree of depression and perceived health status discriminated between patients and controls, and there was an association between pain tolerance thresholds and level of self-reported physical activity in patients. This study highlights the importance of further research into how increased physical activity may improve pain sensitivity in patients with chronic pain.

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  • 32.
    Solmi, Marco
    et al.
    Univ Ottawa, Canada; Ottawa Hosp, Canada; Univ Ottawa, Canada; Kings Coll London, England; Univ Southampton & NHS Trust, England.
    Estrade, Andres
    Kings Coll London, England; Univ Southampton & NHS Trust, England.
    Thompson, Trevor
    Univ Greenwich, England.
    Agorastos, Agorastos
    Aristotle Univ Thessaloniki, Greece.
    Radua, Joaquim
    Kings Coll London, England; CIBERSAM, Spain; Karolinska Inst, Sweden.
    Cortese, Samuele
    Univ Southampton, England.
    Dragioti, Elena
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center. Univ Ioannina, Greece.
    Leisch, Friedrich
    Univ Nat Resources & Life Sci, Austria.
    Vancampfort, Davy
    Katholieke Univ Leuven KU Leuven, Belgium.
    Thygesen, Lau Caspar
    Univ Southern Denmark, Denmark.
    Aschauer, Harald
    BioPsyC Biopsychosocial Corp, Austria.
    Schloegelhofer, Monika
    BioPsyC Biopsychosocial Corp, Austria.
    Akimova, Elena
    BioPsyC Biopsychosocial Corp, Austria.
    Schneeberger, Andres
    Psychiat Serv Grisons, Switzerland.
    Huber, Christian G.
    Univ Basel, Switzerland.
    Hasler, Gregor
    Univ Fribourg, Switzerland.
    Conus, Philippe
    Univ Lausanne, Switzerland.
    Do Cuenod, Kim Q.
    Univ Lausanne, Switzerland.
    von Kanel, Roland
    Univ Hosp Zurich, Switzerland.
    Arrondo, Gonzalo
    Univ Southampton, England; Univ Navarra, Spain.
    Fusar-Poli, Paolo
    Kings Coll London, England; South London & Maudsley NHS Fdn Trust, England; Univ Pavia, Italy.
    Gorwood, Philip
    Univ Paris, France; Inst Psychiat & Neurosci Paris, France.
    Llorca, Pierre-Michel
    Univ Clermont Auvergne, France.
    Krebs, Marie-Odile
    Inst Psychiat & Neurosci Paris, France; Univ Paris, France.
    Scanferla, Elisabetta
    Univ Paris, France.
    Kishimoto, Taishiro
    Keio Univ, Japan.
    Rabbani, Golam
    Natl Fdn Mental Hlth Bangladesh, Bangladesh.
    Skonieczna-Zydecka, Karolina
    Pomeranian Med Univ, Poland.
    Brambilla, Paolo
    Univ Milan, Italy; Fdn IRCCS Ca Granda Osped Maggiore Policlin, Italy.
    Favaro, Angela
    Univ Padua, Italy.
    Takamiya, Akihiro
    Keio Univ, Japan.
    Zoccante, Leonardo
    Integrated Univ Hosp Verona, Italy.
    Colizzi, Marco
    Univ Verona, Italy.
    Bourgin, Julie
    GHNE, France.
    Kaminski, Karol
    Med Univ Bialystok, Poland.
    Moghadasin, Maryam
    Kharazmi Univ, Iran.
    Seedat, Soraya
    Stellenbosch Univ, South Africa.
    Matthews, Evan
    Waterford Inst Technol, Ireland.
    Wells, John
    Waterford Inst Technol, Ireland.
    Vassilopoulou, Emilia
    Univ Nicosia, Cyprus.
    Gadelha, Ary
    Univ Fed Sao Paulo, Brazil.
    Su, Kuan-Pin
    China Med Univ, Taiwan; Maastricht Univ, Netherlands.
    Kwon, Jun Soo
    Seoul Natl Univ, South Korea.
    Kim, Minah
    Seoul Natl Univ Hosp, South Korea.
    Lee, Tae Young
    Pusan Natl Univ, South Korea.
    Papsuev, Oleg
    Moscow Res Inst Psychiat, Russia.
    Mankova, Denisa
    Natl Inst Mental Hlth, Czech Republic.
    Boscutti, Andrea
    Univ Milan, Italy.
    Gerunda, Cristiano
    Univ Padua, Italy.
    Saccon, Diego
    AULSS4 Veneto Orientale, Italy.
    Righi, Elena
    Univ Modena & Reggio Emilia, Italy.
    Monaco, Francesco
    ASL Salerno, Italy.
    Croatto, Giovanni
    Univ Padua, Italy.
    Cereda, Guido
    Univ Milan, Italy.
    Demurtas, Jacopo
    Univ Modena & Reggio Emilia, Italy.
    Brondino, Natascia
    Univ Pavia, Italy.
    Veronese, Nicola
    Univ Palermo, Italy.
    Enrico, Paolo
    Univ Milan, Italy.
    Politi, Pierluigi
    Univ Pavia, Italy.
    Ciappolino, Valentina
    Fdn IRCCS Ca Granda Osped Maggiore Policlin, Italy.
    Pfennig, Andrea
    Tech Univ Dresden, Germany.
    Bechdolf, Andreas
    Univ Cologne, Germany.
    Meyer-Lindenberg, Andreas
    Heidelberg Univ, Germany.
    Kahl, Kai G.
    Hannover Med Sch, Germany.
    Domschke, Katharina
    Univ Freiburg, Germany.
    Bauer, Michael
    Tech Univ Dresden, Germany.
    Koutsouleris, Nikolaos
    Ludwig Maximilians Univ Munchen, Germany.
    Winter, Sibylle
    Charite Univ Med Berlin, Germany.
    Borgwardt, Stefan
    Univ Lubeck, Germany.
    Bitter, Istvan
    Semmelweis Univ, Hungary.
    Balazs, Judit
    Eotvos Lorand Univ, Hungary; Bjorknes Univ Coll, Norway.
    Czobor, Pal
    Semmelweis Univ, Hungary.
    Unoka, Zsolt
    Semmelweis Univ, Hungary.
    Mavridis, Dimitris
    Univ Ioannina, Greece.
    Tsamakis, Konstantinos
    Kings Coll London, England.
    Bozikas, Vasilios P.
    Aristotle Univ Thessaloniki, Greece.
    Tunvirachaisakul, Chavit
    Chulalongkorn Univ, Thailand.
    Maes, Michael
    Chulalongkorn Univ, Thailand.
    Rungnirundorn, Teerayuth
    Chulalongkorn Univ, Thailand.
    Supasitthumrong, Thitiporn
    Chulalongkorn Univ, Thailand.
    Haque, Ariful
    Natl Fdn Mental Hlth Bangladesh, Bangladesh.
    Brunoni, Andre R.
    Univ Sao Paulo, Brazil; Univ Sao Paulo, Brazil.
    Costardi, Carlos Gustavo
    Univ Fed Sao Paulo, Brazil.
    Schuch, Felipe Barreto
    Univ Fed Santa Maria, Brazil.
    Polanczyk, Guilherme
    Univ Sao Paulo, Brazil; Univ Sao Paulo, Brazil.
    Luiz, Jhoanne Merlyn
    Univ Extremo Sul Catarinense, Brazil.
    Fonseca, Lais
    Univ Fed Sao Paulo, Brazil.
    Aparicio, Luana V
    Univ Sao Paulo, Brazil; Univ Sao Paulo, Brazil.
    Valvassori, Samira S.
    Univ Extremo Sul Catarinense, Brazil.
    Nordentoft, Merete
    Univ Copenhagen, Denmark.
    Vendsborg, Per
    Psykiatrifonden, Denmark.
    Hoffmann, Sofie Have
    Univ Southern Denmark, Denmark.
    Sehli, Jihed
    Univ Fribourg, Switzerland.
    Sartorius, Norman
    Assoc Improvement Mental Hlth Programmes AMH, Switzerland.
    Heuss, Sabina
    FHNW Univ Appl Sci & Arts Northwestern Switzerlan, Switzerland.
    Guinart, Daniel
    Northwell Hlth, NY USA; Donald & Barbara Zucker Sch Med Hofstra Northwell, NY USA; Univ Autonoma Barcelona, Spain.
    Hamilton, Jane
    Univ Texas Hlth Sci Ctr Houston, TX 77030 USA.
    Kane, John
    Northwell Hlth, NY USA; Feinstein Inst Med Res, NY USA.
    Rubio, Jose
    Northwell Hlth, NY USA; Feinstein Inst Med Res, NY USA.
    Sand, Michael
    Boehringer Ingelheim GmbH & Co KG, CT USA.
    Koyanagi, Ai
    ICREA, Spain.
    Solanes, Aleix
    CIBERSAM, Spain.
    Andreu-Bernabeu, Alvaro
    Hosp Gen Univ Gregorio Maranon, Spain.
    Caceres, Antonia San Jose
    Hosp Gen Univ Gregorio Maranon, Spain.
    Arango, Celso
    Hosp Gen Univ Gregorio Maranon, Spain.
    Diaz-Caneja, Covadonga M.
    Hosp Gen Univ Gregorio Maranon, Spain.
    Hidalgo-Mazzei, Diego
    Univ Barcelona, Spain.
    Vieta, Eduard
    Univ Barcelona, Spain.
    Gonzalez-Penas, Javier
    Hosp Gen Univ Gregorio Maranon, Spain.
    Fortea, Lydia
    CIBERSAM, Spain.
    Parellada, Mara
    Hosp Gen Univ Gregorio Maranon, Spain.
    Fullana, Miquel A.
    CIBERSAM, Spain.
    Verdolini, Norma
    Univ Barcelona, Spain.
    Farkova, Eva
    Natl Inst Mental Hlth, Czech Republic.
    Janku, Karolina
    Natl Inst Mental Hlth, Czech Republic.
    Millan, Mark
    Inst Rech Servier IDRS, France.
    Honciuc, Mihaela
    Univ Clermont Auvergne, France.
    Moniuszko-Malinowska, Anna
    Med Univ Bialystok, Poland.
    Loniewski, Igor
    Pomeranian Med Univ, Poland; Sanprobi Sp Zoo Sp K, Poland.
    Samochowiec, Jerzy
    Pomeranian Med Univ, Poland.
    Kiszkiel, Lukasz
    Univ Bialystok, Poland.
    Marlicz, Maria
    Pomeranian Med Univ, Poland.
    Sowa, Pawel
    Med Univ Bialystok, Poland.
    Marlicz, Wojciech
    Pomeranian Med Univ, Poland; Ctr Digest Dis Endoklin, Poland.
    Spies, Georgina
    Stellenbosch Univ, South Africa.
    Stubbs, Brendon
    Kings Coll London, England.
    Firth, Joseph
    Univ Manchester, England.
    Sullivan, Sarah
    Univ Bristol, England.
    Darcin, Asli Enez
    Istanbul Basaksehir Cam & Sakura City Hosp, Turkey.
    Aksu, Hatice
    Adnan Menderes Univ, Turkey.
    Dilbaz, Nesrin
    Uskudar Univ, Turkey.
    Noyan, Onur
    Uskudar Univ, Turkey.
    Kitazawa, Momoko
    Keio Univ, Japan.
    Kurokawa, Shunya
    Keio Univ, Japan.
    Tazawa, Yuki
    Keio Univ, Japan.
    Anselmi, Alejandro
    Univ Catolica, Uruguay.
    Cracco, Cecilia
    Univ Catolica, Uruguay.
    Machado, Ana Ines
    Univ Catolica, Uruguay.
    Estrade, Natalia
    Univ Catolica, Uruguay.
    De Leo, Diego
    Griffith Univ, Australia.
    Curtis, Jackie
    Mindgardens Neurosci Network, Australia.
    Berk, Michael
    Deakin Univ, Australia.
    Ward, Philip
    UNSW Sydney, Australia.
    Teasdale, Scott
    Deakin Univ, Australia.
    Rosenbaum, Simon
    UNSW Sydney, Australia.
    Marx, Wolfgang
    Deakin Univ, Australia.
    Horodnic, Adrian Vasile
    Univ Med & Pharm Grigore T Popa, Romania.
    Oprea, Liviu
    Univ Med & Pharm Grigore T Popa, Romania.
    Alexinschi, Ovidiu
    Inst Psychiat Socola, Romania.
    Ifteni, Petru
    Transilvania Univ Brasov, Romania.
    Turliuc, Serban
    Univ Med & Pharm Grigore T Popa, Romania.
    Ciuhodaru, Tudor
    Emergency Hosp Nicolae Oblu, Romania.
    Bolos, Alexandra
    Univ Med & Pharm Grigore T Popa, Romania.
    Matei, Valentin
    Univ Med & Pharm Carol Davila Bucharest, Romania.
    Nieman, Dorien H.
    Univ Amsterdam, Netherlands.
    Sommer, Iris
    Univ Groningen, Netherlands; Univ Groningen, Netherlands.
    van Os, Jim
    Univ Utrecht, Netherlands.
    van Amelsvoort, Therese
    Maastricht Univ, Netherlands.
    Sun, Ching-Fang
    China Med Univ Hosp, Taiwan; Virginia Tech, VA USA.
    Guu, Ta-Wei
    China Med Univ, Taiwan.
    Jiao, Can
    Shenzhen Univ, Peoples R China.
    Zhang, Jieting
    Shenzhen Univ, Peoples R China.
    Fan, Jialin
    Shenzhen Univ, Peoples R China.
    Zou, Liye
    Shenzhen Univ, Peoples R China.
    Yu, Xin
    Peking Univ, Peoples R China.
    Chi, Xinli
    Shenzhen Univ, Peoples R China.
    de Timary, Philippe
    UCLouvain, Belgium; Clin Univ St Luc, Belgium.
    van Winke, Ruud
    Katholieke Univ Leuven KU Leuven, Belgium.
    Ng, Bernardo
    Asociac Psiquiatr Mexicana, Mexico.
    Pena, Edilberto
    Asociac Psiquiatr Mexicana, Mexico.
    Arellano, Ramon
    Asociac Psiquiatr Mexicana, Mexico.
    Roman, Raquel
    Asociac Psiquiatr Mexicana, Mexico.
    Sanchez, Thelma
    Asociac Psiquiatr Mexicana, Mexico.
    Movina, Larisa
    Moscow Res Inst Psychiat, Russia.
    Morgado, Pedro
    Univ Minho, Portugal; ICVS 3Bs PT Govt Associate Lab, Portugal.
    Brissos, Sofia
    Lisbons Psychiat Hosp Ctr, Portugal.
    Aizberg, Oleg
    Belarusian Med Acad Postgrad Educ, BELARUS.
    Mosina, Anna
    Clienia AG, Switzerland.
    Krinitski, Damir
    Integrated Psychiat Winterthur IPW, Switzerland.
    Mugisha, James
    Kyambogo Univ, Uganda.
    Sadeghi-Bahmani, Dena
    Stanford Univ, CA 94305 USA; Univ Psychiat Kliniken Basel UPK, Switzerland.
    Sadeghi, Masoud
    Kermanshah Univ Med Sci, Iran.
    Hadi, Samira
    Kharazmi Univ, Iran.
    Brand, Serge
    Univ Psychiat Kliniken Basel UPK, Switzerland; Univ Basel, Switzerland; Kermanshah Univ Med Sci, Iran; Kermanshah Univ Med Sci, Iran; Univ Tehran Med Sci, Iran.
    Errazuriz, Antonia
    Pontificia Univ Catolica Chile, Chile.
    Crossley, Nicolas
    Pontificia Univ Catolica Chile, Chile.
    Ristic, Dragana Ignjatovic
    Univ Kragujevac, Serbia.
    Lopez-Jaramillo, Carlos
    Univ Antioquia, Colombia.
    Efthymiou, Dimitris
    Univ Nicosia, Cyprus.
    Kuttichira, Praveenlal
    Jubilee Mission Med Coll & Res Inst, India.
    Kallivayalil, Roy Abraham
    Pushpagiri Inst Med Sci, India.
    Javed, Afzal
    Pakistan Psychiat Res Ctr Fountain House, Pakistan.
    Afridi, Muhammad Iqbal
    Coll Phys & Surg, Pakistan; Jinnah Postgrad Med Ctr, Pakistan; Jinnah Sindh Med Univ, Pakistan.
    James, Bawo
    Fed Neuropsychiat Hosp, Nigeria.
    Seb-Akahomen, Omonefe Joy
    Irrua Specialist Teaching Hosp, Nigeria.
    Fiedorowicz, Jess
    Univ Ottawa, Canada.
    Carvalho, Andre F.
    Ctr Addict & Mental Hlth CAMH, Canada.
    Daskalakis, Jeff
    Univ Toronto, Canada.
    Yatham, Lakshmi N.
    Univ British Columbia, Canada.
    Yang, Lin
    Univ Calgary, Canada.
    Okasha, Tarek
    Ain Shams Univ, Egypt.
    Dahdouh, Aicha
    Oran 1 Univ, Algeria.
    Gerdle, Björn
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Tiihonen, Jari
    Karolinska Inst, Sweden.
    Shin, Jae Il
    Yonsei Univ, South Korea.
    Lee, Jinhee
    Yonsei Univ, South Korea.
    Mhalla, Ahmed
    Univ Monastir, Tunisia.
    Gaha, Lotfi
    Univ Monastir, Tunisia.
    Brahim, Takoua
    Univ Monastir, Tunisia.
    Altynbekov, Kuanysh
    Republican Sci & Pract Ctr Mental Hlth, Kazakhstan.
    Negay, Nikolay
    Republican Sci & Pract Ctr Mental Hlth, Kazakhstan.
    Nurmagambetova, Saltanat
    Republican Sci & Pract Ctr Mental Hlth, Kazakhstan.
    Abu Jamei, Yasser
    Gaza Community Mental Hlth Programme, Palestine.
    Weiser, Mark
    Sheba Med Ctr, Israel.
    Correll, Christoph U.
    Charite Univ Med Berlin, Germany; Northwell Hlth, NY USA; Donald & Barbara Zucker Sch Med Hofstra Northwell, NY USA.
    Physical and mental health impact of COVID-19 on children, adolescents, and their families: The Collaborative Outcomes study on Health and Functioning during Infection Times - Children and Adolescents (COH-FIT-C&A)2022In: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 299, p. 367-376Article in journal (Refereed)
    Abstract [en]

    Background: The COVID-19 pandemic has altered daily routines and family functioning, led to closing schools, and dramatically limited social interactions worldwide. Measuring its impact on mental health of vulnerable children and adolescents is crucial. Methods: The Collaborative Outcomes study on Health and Functioning during Infection Times (COH-FIT - www. coh-fit.com) is an on-line anonymous survey, available in 30 languages, involving >230 investigators from 49 countries supported by national/international professional associations. COH-FIT has thee waves (until the pandemic is declared over by the WHO, and 6-18 months plus 24-36 months after its end). In addition to adults, COH-FIT also includes adolescents (age 14-17 years), and children (age 6-13 years), recruited via nonprobability/snowball and representative sampling and assessed via self-rating and parental rating. Nonmodifiable/modifiable risk factors/treatment targets to inform prevention/intervention programs to promote health and prevent mental and physical illness in children and adolescents will be generated by COH-FIT. Co primary outcomes are changes in well-being (WHO-5) and a composite psychopathology P-Score. Multiple behavioral, family, coping strategy and service utilization factors are also assessed, including functioning and quality of life. Results: Up to June 2021, over 13,000 children and adolescents from 59 countries have participated in the COHFIT project, with representative samples from eleven countries. Limitations: Cross-sectional and anonymous design. Conclusions: Evidence generated by COH-FIT will provide an international estimate of the COVID-19 effect on childrens, adolescents and families, mental and physical health, well-being, functioning and quality of life, informing the formulation of present and future evidence-based interventions and policies to minimize adverse effects of the present and future pandemics on youth.

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  • 33.
    Gerdle, Björn
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Wåhlén, Karin
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Gordh, Torsten
    Uppsala Univ, Sweden.
    Bäckryd, Emmanuel
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Carlsson, Anders
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Ghafouri, Bijar
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Plasma proteins from several components of the immune system differentiate chronic widespread pain patients from healthy controls - an exploratory case-control study combining targeted and non-targeted protein identification2022In: Medicine, ISSN 0025-7974, E-ISSN 1536-5964, Vol. 101, no 46, article id e31013Article in journal (Refereed)
    Abstract [en]

    Chronic widespread pain (CWP), including fibromyalgia (FM), is characterized by generalized musculoskeletal pain and hyperalgesia. Plasma proteins from proteomics (non-targeted) and from targeted inflammatory panels (cytokines/chemokines) differentiate CWP/FM from controls. The importance of proteins obtained from these two sources, the protein-protein association network, and the biological processes involved were investigated. Plasma proteins from women with CWP (n = 15) and CON (n = 23) were analyzed using two-dimensional gel electrophoresis analysis and a multiplex proximity extension assay for analysis of cytokines/chemokines. Associations between the proteins and group were multivarietly analyzed. The protein-protein association network and the biological processes according to the Gene Ontology were investigated. Proteins from both sources were important for group differentiation; the majority from the two-dimensional gel electrophoresis analysis. 58 proteins significantly differentiated the two groups (R-2 = 0.83). A significantly enriched network was found; biological processes were acute phase response, complement activation, and innate immune response. As with other studies, this study shows that plasma proteins can differentiate CWP from healthy subjects. Focusing on cytokines/chemokines is not sufficient to grasp the peripheral biological processes that maintain CWP/FM since our results show that other components of the immune and inflammation systems are also highly significant.

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  • 34.
    Wåhlén, Karin
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Yan, Hong
    Lund Univ, Sweden.
    Welinder, Charlotte
    Lund Univ, Sweden.
    Ernberg, Malin
    Karolinska Inst, Sweden; Scandinavian Ctr Orofacial Neurosci SCON, Sweden.
    Kosek, Eva
    Karolinska Inst, Sweden; Uppsala Univ, Sweden.
    Mannerkorpi, Kaisa
    Univ Gothenburg, Sweden.
    Gerdle, Björn
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Ghafouri, Bijar
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Proteomic Investigation in Plasma from Women with Fibromyalgia in Response to a 15-wk Resistance Exercise Intervention2022In: Medicine & Science in Sports & Exercise, ISSN 0195-9131, E-ISSN 1530-0315, Vol. 54, no 2, p. 232-246Article in journal (Refereed)
    Abstract [en]

    Purpose: Fibromyalgia (FM) is a complex pain condition, and exercise is considered the first option of treatment. Few studies have examined the effect of exercise on molecular mechanisms in FM. The aim of this study was to analyze the plasma proteome in women with FM and healthy controls (CON) before and after 15 wk of resistance exercise. This study further investigated whether clinical and exercises-related outcomes correlated with identified plasma proteins in FM.

    Methods: Plasma samples from 40 FM/25 CON (baseline) and 21 FM/24 CON (postexercise) were analyzed using shotgun proteomics. Clinical/background data were retrieved through questionnaires. Exercise-related variables and pressure pain thresholds were assessed using standardized instruments. Multivariate statistics were applied to analyze the proteomic profile at baseline and postexercise, and correlation with clinical/exercise-related data.

    Results: Fifteen weeks of resistance exercises improved clinical symptoms and muscle strength, and affected circulating proteins related to immunity, stress, mRNA stability, metabolic processes, and muscle structure development in FM. Pressure pain threshold was related to a specific protein profile, with proteins involved in metabolic and immune response. Subgroups of FM based on plasma proteins, FM duration, and improved muscle strength were identified.

    Conclusions: Exercise seems to affect circulating proteins, clinical characteristics, and muscle strength in FM. This study contributes to better understanding of systemic protein changes in FM compared with CON and how resistance exercise affects such changes.

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  • 35.
    Dong, Huan-Ji
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Gerdle, Björn
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Dragioti, Elena
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Reported Outcomes in Interdisciplinary Pain Treatment: An Overview of Systematic Reviews and Meta-Analyses of Randomised Controlled Trials2022In: Journal of Pain Research, E-ISSN 1178-7090, Vol. 15, p. 2557-2576Article, review/survey (Refereed)
    Abstract [en]

    Background: There is considerable diversity of outcome selections and methodologies for handling the multiple outcomes across all systematic reviews (SRs) of Interdisciplinary Pain Treatment (IPT) due to the complexity. This diversity presents difficulties for healthcare decision makers. Better recommendations about how to select outcomes in SRs (with or without meta-analysis) are needed to explicitly demonstrate the effectiveness of IPT.Objective: This overview systematically collates the reported outcomes and measurements of IPT across published SRs and identifies the methodological characteristics. Additionally, we provide some suggestions on framing the selection of outcomes and on conducting SRs of IPT.Methods: Three electronic databases (PubMed, Cochrane Library, and Epistemonikos) and the PROSPERO registry for ongoing SR were supplemented with hand-searching ending on 30 September 2021. Results: We included 18 SRs with data on 49007 people from 356 primary randomised controlled trials (RCTs); eight were followed by meta-analysis and ten used narrative syntheses of data. For all the SRs, pain was the most common reported outcome (72%), followed by disability/functional status (61%) and working status (61%). Psychological well-being and quality of life were also reported in half of the included SR (50%). The core outcome domains according to VAPAIN, IMMPACT, and PROMIS were seldom met. The methodological quality varied from critically low to moderate according to AMSTAR2. The AMSTAR2 rating was negatively correlated to the number of outcome domains in PROMIS, and VAPAIN was positively correlated with IMMPACT and PROMIS, indicating the intercorrelations between the reported outcomes. Conclusion: This systematic overview showed wide-ranging disparity in reported outcomes and applied outcome domains in SRs evaluating IPT interventions for chronic pain conditions. The intercorrelations between the reported outcomes should be appropriately handled in future research. Some approaches are discussed as well.

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  • 36.
    Gerdle, Björn
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Björk, Mathilda
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Dahlström, Örjan
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Vixner, Linda
    School of Health and Welfare, Dalarna University, Falun, Sweden.
    Ang, Bjorn O.
    School of Health and Welfare, Dalarna University, Falun, Sweden; Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden; Department of Research and Higher Education, Center for Clinical Research Dalarna, Uppsala University, Region Dalarna, Falun, Sweden.
    Senior authors' reply to the comment by Andréll et al2022In: European Journal of Pain, ISSN 1090-3801, E-ISSN 1532-2149, Vol. 26, no 3, p. 766-767Article in journal (Other academic)
  • 37.
    Gerdle, Björn
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Björk, Mathilda
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Dahlström, Örjan
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Vixner, Linda
    Dalarna Univ, Sweden.
    Ang, Bjorn O.
    Dalarna Univ, Sweden; Karolinska Inst, Sweden; Uppsala Univ, Sweden.
    Senior authors reply to the comment by Rivano-Fischer and Stalnacke2022In: European Journal of Pain, ISSN 1090-3801, E-ISSN 1532-2149, Vol. 26, no 2, p. 545-546Article in journal (Other academic)
    Abstract [en]

    n/a

  • 38.
    Ghafouri, Bijar
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Ernberg, Malin
    Karolinska Inst, Sweden; Karolinska Inst, Sweden.
    Andrell, Paulin
    Sahlgrens Acad, Sweden; Univ Gothenburg, Sweden.
    Bäckryd, Emmanuel
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Fisher, Marcelo Rivano
    Lund Univ, Sweden; Lund Univ, Sweden; Lund Univ, Sweden.
    Freund-Levi, Yvonne
    Orebro Univ, Sweden; Univ Hosp Orebro, Sweden; Sodertalje Hosp, Sweden; Karolinska Inst, Sweden.
    Grelz, Henrik
    Lund Univ, Sweden; Lund Univ, Sweden.
    Grabel, Olaf
    Sahlgrens Acad, Sweden.
    Karlsten, Rolf
    Uppsala Univ Hosp, Sweden.
    Kosek, Eva
    Uppsala Univ, Sweden; Karolinska Inst, Sweden.
    Lofgren, Monika
    Karolinska Inst, Sweden; Danderyd Hosp, Sweden.
    Ringqvist, Asa
    Lund Univ, Sweden; Lund Univ, Sweden.
    Rudling, Karin
    Univ Hosp Orebro, Sweden.
    Stalnacke, Britt-Marie
    Karolinska Inst, Sweden; Danderyd Hosp, Sweden; Umea Univ, Sweden.
    Sorlen, Niklas
    Umea Univ, Sweden.
    Uhlin, Karin
    Karolinska Inst, Sweden; Danderyd Hosp, Sweden.
    Westergren, Hans
    Lund Univ, Sweden; Lund Univ, Sweden; Lund Univ, Sweden.
    Gerdle, Björn
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Swedish Chronic Pain Biobank: protocol for a multicentre registry and biomarker project2022In: BMJ Open, E-ISSN 2044-6055, Vol. 12, no 11, article id e066834Article in journal (Refereed)
    Abstract [en]

    IntroductionAbout 20% of the adult population have chronic pain, often associated with psychological distress, sick leave and poor health. There are large variations in the clinical picture. A biopsychosocial approach is used in investigation and treatment. The concept of personalised medicine, that is, optimising medication types and dosages for individual patients based on biomarkers and other patient-related factors, has received increasing attention in different diseases but used less in chronic pain. This cooperative project from all Swedish University Hospitals will investigate whether there are changes in inflammation and metabolism patterns in saliva and blood in chronic pain patients and whether the changes correlate with clinical characteristics and rehabilitation outcomes.Methods and analysisPatients at multidisciplinary pain centres at University Hospitals in Sweden who have chosen to participate in the Swedish Quality Registry for Pain Rehabilitation and healthy sex-matched and age-matched individuals will be included in the study. Saliva and blood samples will be collected in addition to questionnaire data obtained from the register. From the samples, proteins, lipids, metabolites and micro-RNA will be analysed in relation to, for example, diagnosis, pain characteristics, psychological distress, body weight, pharmacological treatment and clinical rehabilitation results using advanced multivariate data analysis and bioinformatics.Ethics and disseminationThe study is approved by the Swedish Ethical Review Authority (Dnr 2021-04929) and will be conducted in accordance with the declaration of Helsinki.The results will be published in open access scientific journals and in popular scientific relevant journals such as those from patient organisations. Data will be also presented in scientific meetings, meeting with healthcare organisations and disseminated in different lecturers at the clinics and universities.

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  • 39.
    Solmi, Marco
    et al.
    Univ Ottawa, Canada; Ottawa Hosp, Canada; Univ Ottawa, Canada; Kings Coll London, England; Univ Southampton, England; NHS Trust, England.
    Estrade, Andres
    Kings Coll London, England; Univ Catolica, Uruguay.
    Thompson, Trevor
    Univ Greenwich, England.
    Agorastos, Agorastos
    Aristotle Univ Thessaloniki, Greece.
    Radua, Joaquim
    Kings Coll London, England; Inst Invest Biomed August Pi & Sunyer IDIBAPS, Spain; Karolinska Inst, Sweden.
    Cortese, Samuele
    Univ Southampton, England.
    Dragioti, Elena
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center. Univ Ioannina, Greece.
    Leisch, Friedrich
    Univ Nat Resources & Life Sci, Austria.
    Vancampfort, Davy
    Katholieke Univ Leuven, Belgium.
    Thygesen, Lau Caspar
    Univ Southern Denmark, Denmark.
    Aschauer, Harald
    BioPsyC Biopsychosocial Corp, Austria.
    Schloegelhofer, Monika
    BioPsyC Biopsychosocial Corp, Austria.
    Akimova, Elena
    BioPsyC Biopsychosocial Corp, Austria.
    Schneeberger, Andres
    Psychiat Serv Grisons, Switzerland.
    Huber, Christian G.
    Univ Basel, Switzerland.
    Hasler, Gregor
    Univ Fribourg, Switzerland.
    Conus, Philippe
    Univ Lausanne, Switzerland.
    Do Cuenod, Kim Q.
    Univ Lausanne, Switzerland.
    von Kanel, Roland
    Univ Hosp Zurich, Switzerland.
    Arrondo, Gonzalo
    Univ Southampton, England; Univ Navarra, Spain.
    Fusar-Poli, Paolo
    Kings Coll London, England; South London & Maudsley NHS Fdn Trust, England; Univ Pavia, Italy.
    Gorwood, Philip
    Univ Paris, France; Inst Psychiat & Neurosci Paris, France.
    Llorca, Pierre-Michel
    Univ Clermont Auvergne, France.
    Krebs, Marie-Odile
    Inst Psychiat & Neurosci Paris, France; Univ Paris, France.
    Scanferla, Elisabetta
    Univ Paris, France.
    Kishimoto, Taishiro
    Keio Univ, Japan.
    Rabbani, Golam
    Natl Fdn Mental Hlth Bangladesh, Bangladesh.
    Skonieczna-Zydecka, Karolina
    Pomeranian Med Univ, Poland.
    Brambilla, Paolo
    Univ Milan, Italy; Fdn IRCCS Ca Granda Osped Maggiore Policlin, Italy.
    Favaro, Angela
    Univ Padua, Italy.
    Takamiya, Akihiro
    Keio Univ, Japan.
    Zoccante, Leonardo
    Integrated Univ Hosp Verona, Italy.
    Colizzi, Marco
    Univ Verona, Italy.
    Bourgin, Julie
    GHNE, France.
    Kaminski, Karol
    Med Univ Bialystok, Poland.
    Moghadasin, Maryam
    Kharazmi Univ, Iran.
    Seedat, Soraya
    Stellenbosch Univ, South Africa.
    Matthews, Evan
    Waterford Inst Technol, Ireland.
    Wells, John
    Waterford Inst Technol, Ireland.
    Vassilopoulou, Emilia
    Univ Nicosia, Cyprus.
    Gadelha, Ary
    Univ Fed Sao Paulo, Brazil.
    Su, Kuan-Pin
    China Med Univ, Taiwan; Maastricht Univ, Netherlands.
    Kwon, Jun Soo
    Seoul Natl Univ, South Korea.
    Kim, Minah
    Seoul Natl Univ Hosp, South Korea.
    Lee, Tae Young
    Pusan Natl Univ, South Korea.
    Papsuev, Oleg
    Moscow Res Inst Psychiat, Russia.
    Mankova, Denisa
    Natl Inst Mental Hlth, Czech Republic.
    Boscutti, Andrea
    Univ Milan, Italy.
    Gerunda, Cristiano
    Univ Padua, Italy.
    Saccon, Diego
    AULSS4 Veneto Orientale, Italy.
    Righi, Elena
    Univ Modena & Reggio Emilia, Italy.
    Monaco, Francesco
    ASL Salerno, Italy.
    Croatto, Giovanni
    Univ Padua, Italy.
    Cereda, Guido
    Univ Milan, Italy.
    Demurtas, Jacopo
    Univ Modena & Reggio Emilia, Italy.
    Brondino, Natascia
    Univ Pavia, Italy.
    Veronese, Nicola
    Univ Palermo, Italy.
    Enrico, Paolo
    Univ Milan, Italy.
    Politi, Pierluigi
    Univ Pavia, Italy.
    Ciappolino, Valentina
    Fdn IRCCS Ca Granda Osped Maggiore Policlin, Italy.
    Pfennig, Andrea
    Tech Univ Dresden, Germany.
    Bechdolf, Andreas
    Univ Cologne, Germany.
    Meyer-Lindenberg, Andreas
    Heidelberg Univ, Germany.
    Kahl, Kai G.
    Hannover Med Sch, Germany.
    Domschke, Katharina
    Univ Freiburg, Germany.
    Bauer, Michael
    Tech Univ Dresden, Germany.
    Koutsouleris, Nikolaos
    Ludwig Maximilians Univ Munchen, Germany.
    Winter, Sibylle
    Charite Univ Med Berlin, Germany.
    Borgwardt, Stefan
    Univ Lubeck, Germany.
    Bitter, Istvan
    Semmelweis Univ, Hungary.
    Balazs, Judit
    Eotvos Lorand Univ, Hungary; Bjorknes Univ Coll, Norway.
    Czobor, Pal
    Semmelweis Univ, Hungary.
    Unoka, Zsolt
    Semmelweis Univ, Hungary.
    Mavridis, Dimitris
    Univ Ioannina, Greece.
    Tsamakis, Konstantinos
    Kings Coll London, England.
    Bozikas, Vasilios P.
    Aristotle Univ Thessaloniki, Greece.
    Tunvirachaisakul, Chavit
    Chulalongkorn Univ, Thailand.
    Maes, Michael
    Chulalongkorn Univ, Thailand.
    Rungnirundorn, Teerayuth
    Chulalongkorn Univ, Thailand.
    Supasitthumrong, Thitiporn
    Chulalongkorn Univ, Thailand.
    Haque, Ariful
    Natl Fdn Mental Hlth Bangladesh, Bangladesh.
    Brunoni, Andre R.
    Univ Sao Paulo, Brazil; Univ Sao Paulo, Brazil.
    Costardi, Carlos Gustavo
    Univ Fed Sao Paulo, Brazil.
    Schuch, Felipe Barreto
    Univ Fed Santa Maria, Brazil.
    Polanczyk, Guilherme
    Univ Sao Paulo, Brazil; Univ Sao Paulo, Brazil.
    Luiz, Jhoanne Merlyn
    Univ Extremo Sul Catarinense, Brazil.
    Fonseca, Lais
    Univ Fed Sao Paulo, Brazil.
    Aparicio, Luana V
    Univ Sao Paulo, Brazil; Univ Sao Paulo, Brazil.
    Valvassori, Samira S.
    Univ Extremo Sul Catarinense, Brazil.
    Nordentoft, Merete
    Univ Copenhagen, Denmark.
    Vendsborg, Per
    Psykiatrifonden, Denmark.
    Hoffmann, Sofie Have
    Univ Southern Denmark, Denmark.
    Sehli, Jihed
    Univ Fribourg, Switzerland.
    Sartorius, Norman
    Assoc Improvement Mental Hlth Programmes AMH, Switzerland.
    Heuss, Sabina
    FHNW Univ Appl Sci & Arts Northwestern Switzerlan, Switzerland.
    Guinart, Daniel
    Northwell Hlth, NY USA; Donald & Barbara Zucker Sch Med Hofstra Northwell, NY USA; Univ Autonoma Barcelona, Spain.
    Hamilton, Jane
    Univ Texas Hlth Sci Ctr Houston, TX 70030 USA.
    Kane, John
    Northwell Hlth, NY USA; Feinstein Inst Med Res, NY USA.
    Rubio, Jose
    Northwell Hlth, NY USA; Feinstein Inst Med Res, NY USA.
    Sand, Michael
    Boehringer Ingelheim GmbH & Co KG, CT USA.
    Koyanagi, Ai
    ICREA, Spain.
    Solanes, Aleix
    Inst Invest Biomed August Pi & Sunyer IDIBAPS, Spain.
    Andreu-Bernabeu, Alvaro
    Hosp Gen Univ Gregorio Maranon, Spain.
    San Jose Caceres, Antonia
    Hosp Gen Univ Gregorio Maranon, Spain.
    Arango, Celso
    Hosp Gen Univ Gregorio Maranon, Spain.
    Diaz-Caneja, Covadonga M.
    Hosp Gen Univ Gregorio Maranon, Spain.
    Hidalgo-Mazzei, Diego
    Univ Barcelona, Spain.
    Vieta, Eduard
    Univ Barcelona, Spain.
    Gonzalez-Penas, Javier
    Hosp Gen Univ Gregorio Maranon, Spain.
    Fortea, Lydia
    Inst Invest Biomed August Pi & Sunyer IDIBAPS, Spain.
    Parellada, Mara
    Hosp Gen Univ Gregorio Maranon, Spain.
    Fullana, Miquel A.
    Inst Invest Biomed August Pi & Sunyer IDIBAPS, Spain.
    Verdolini, Norma
    Univ Barcelona, Spain.
    Farkova, Eva
    Natl Inst Mental Hlth, Czech Republic.
    Janku, Karolina
    Natl Inst Mental Hlth, Czech Republic.
    Millan, Mark
    Inst Rech Servier IDRS, France.
    Honciuc, Mihaela
    Univ Clermont Auvergne, France.
    Moniuszko-Malinowska, Anna
    Med Univ Bialystok, Poland.
    Loniewski, Igor
    Pomeranian Med Univ, Poland; Sanprobi Spzoo Spk, Poland.
    Samochowiec, Jerzy
    Pomeranian Med Univ, Poland.
    Kiszkiel, Lukasz
    Univ Bialystok, Poland.
    Marlicz, Maria
    Pomeranian Med Univ, Poland.
    Sowa, Pawel
    Med Univ Bialystok, Poland.
    Marlicz, Wojciech
    Pomeranian Med Univ, Poland; Ctr Digest Dis Endoklin, Poland.
    Spies, Georgina
    Stellenbosch Univ, South Africa.
    Stubbs, Brendon
    Kings Coll London, England.
    Firth, Joseph
    Univ Manchester, England.
    Sullivan, Sarah
    Univ Bristol, England.
    Darcin, Asli Enez
    Istanbul Basaksehir Cam & Sakura City Hosp, Turkey.
    Aksu, Hatice
    Adnan Menderes Univ, Turkey.
    Dilbaz, Nesrin
    Uskudar Univ, Turkey.
    Noyan, Onur
    Uskudar Univ, Turkey.
    Kitazawa, Momoko
    Keio Univ, Japan.
    Kurokawa, Shunya
    Keio Univ, Japan.
    Tazawa, Yuki
    Keio Univ, Japan.
    Anselmi, Alejandro
    Univ Catolica, Uruguay.
    Cracco, Cecilia
    Univ Catolica, Uruguay.
    Ines Machado, Ana
    Univ Catolica, Uruguay.
    Estrade, Natalia
    Univ Catolica, Uruguay.
    De Leo, Diego
    Griffith Univ, Australia.
    Curtis, Jackie
    Mindgardens Neurosci Network, Australia.
    Berk, Michael
    Deakin Univ, Australia.
    Ward, Philip
    UNSW Sydney, Australia.
    Teasdale, Scott
    Deakin Univ, Australia.
    Rosenbaum, Simon
    UNSW Sydney, Australia.
    Marx, Wolfgang
    Deakin Univ, Australia.
    Horodnic, Adrian Vasile
    Univ Med & Pharm Grigore T Popa, Romania.
    Oprea, Liviu
    Univ Med & Pharm Grigore T Popa, Romania.
    Alexinschi, Ovidiu
    Inst Psychiat Socola, Romania.
    Ifteni, Petru
    Transilvania Univ Brasov, Romania.
    Turliuc, Serban
    Univ Med & Pharm Grigore T Popa, Romania.
    Ciuhodaru, Tudor
    Emergency Hosp Nicolae Oblu, Romania.
    Bolos, Alexandra
    Univ Med & Pharm Grigore T Popa, Romania.
    Matei, Valentin
    Univ Med & Pharm Carol Davila Bucharest, Romania.
    Nieman, Dorien H.
    Univ Amsterdam, Netherlands.
    Sommer, Iris
    Univ Groningen, Netherlands; Univ Groningen, Netherlands.
    van Os, Jim
    Univ Utrecht, Netherlands.
    van Amelsvoort, Therese
    Maastricht Univ, Netherlands.
    Sun, Ching-Fang
    China Med Univ Hosp, Taiwan; Virginia Tech, VA USA.
    Guu, Ta-wei
    China Med Univ, Taiwan.
    Jiao, Can
    Shenzhen Univ, Peoples R China.
    Zhang, Jieting
    Shenzhen Univ, Peoples R China.
    Fan, Jialin
    Shenzhen Univ, Peoples R China.
    Zou, Liye
    Shenzhen Univ, Peoples R China.
    Yu, Xin
    Peking Univ, Peoples R China.
    Chi, Xinli
    Shenzhen Univ, Peoples R China.
    de Timary, Philippe
    UCLouvain, Belgium; Clin Univ St Luc, Belgium.
    van Winke, Ruud
    Katholieke Univ Leuven KU Leuven, Belgium.
    Ng, Bernardo
    Asociac Psiquiatr Mexicana, Mexico.
    Pena, Edilberto
    Asociac Psiquiatr Mexicana, Mexico.
    Arellano, Ramon
    Asociac Psiquiatr Mexicana, Mexico.
    Roman, Raquel
    Asociac Psiquiatr Mexicana, Mexico.
    Sanchez, Thelma
    Asociac Psiquiatr Mexicana, Mexico.
    Movina, Larisa
    Moscow Res Inst Psychiat, Russia.
    Morgado, Pedro
    Univ Minho, Portugal; ICVS 3Bs PT Govt Associate Lab, Portugal.
    Brissos, Sofia
    Lisbons Psychiat Hosp Ctr, Portugal.
    Aizberg, Oleg
    Belarusian Med Acad Postgrad Educ, BELARUS.
    Mosina, Anna
    Clienia AG, Switzerland.
    Krinitski, Damir
    Integrated Psychiat Winterthur IPW, Switzerland.
    Mugisha, James
    Kyambogo Univ, Uganda.
    Sadeghi-Bahmani, Dena
    Stanford Univ, CA 94305 USA; Univ Psychiat Kliniken Basel UPK, Switzerland.
    Sadeghi, Masoud
    Kermanshah Univ Med Sci, Iran.
    Hadi, Samira
    Kharazmi Univ, Iran.
    Brand, Serge
    Univ Psychiat Kliniken Basel UPK, Switzerland; Univ Basel, Switzerland; Kermanshah Univ Med Sci, Iran; Kermanshah Univ Med Sci, Iran; Univ Tehran Med Sci, Iran.
    Errazuriz, Antonia
    Pontificia Univ Catolica Chile, Chile.
    Crossley, Nicolas
    Pontificia Univ Catolica Chile, Chile.
    Ristic, Dragana Ignjatovic
    Univ Kragujevac, Serbia.
    Lopez-Jaramillo, Carlos
    Univ Antioquia, Colombia.
    Efthymiou, Dimitris
    Univ Nicosia, Cyprus.
    Kuttichira, Praveenlal
    Jubilee Mission Med Coll & Res Inst, India.
    Kallivayalil, Roy Abraham
    Pushpagiri Inst Med Sci, India.
    Javed, Afzal
    Pakistan Psychiat Res Ctr Fountain House, Pakistan.
    Afridi, Muhammad Iqbal
    Coll Phys & Surg, Pakistan; Jinnah Postgrad Med Ctr, Pakistan; Jinnah Sindh Med Univ, Pakistan.
    James, Bawo
    Fed Neuropsychiat Hosp, Nigeria.
    Seb-Akahomen, Omonefe Joy
    Irrua Specialist Teaching Hosp, Nigeria.
    Fiedorowicz, Jess
    Univ Ottawa, Canada.
    Carvalho, Andre F.
    Ctr Addict & Mental Hlth CAMH, Canada.
    Daskalakis, Jeff