Study on pain catastrophizing and pain improvement rate in patients with rheumatoid arthritis
| Project/Area Number |
19K21429
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| Project/Area Number (Other) |
18H06346 (2018)
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| Research Category |
Grant-in-Aid for Research Activity Start-up
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| Allocation Type | Multi-year Fund (2019)
Single-year Grants (2018) |
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| Review Section |
0908:Society medicine, nursing, and related fields
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| Research Institution | Kyoto Prefectural University of Medicine |
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Principal Investigator |
Yoshida Tamami 京都府立医科大学, 医学部, 客員講師 (30826087)
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| Project Period (FY) |
2018-08-24 – 2021-03-31
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| Project Status |
Completed (Fiscal Year 2020)
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| Budget Amount *help |
¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000)
Fiscal Year 2019: ¥650,000 (Direct Cost: ¥500,000、Indirect Cost: ¥150,000)
Fiscal Year 2018: ¥650,000 (Direct Cost: ¥500,000、Indirect Cost: ¥150,000)
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| Keywords | 関節リウマチ / 心理・認知行動療法 / 破局的思考 / 疼痛 / 臨床的寛解 / 心理的介入 |
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| Outline of Research at the Start |
関節リウマチ患者の中には、関節の炎症がない状態に達成しても疼痛が残存する患者が一定数いることが知られている。慢性疼痛をもつ者には痛みに対する歪んだ認知である破局的思考をもつことがあり、疼痛を助長させる場合がある。しかし、関節リウマチ患者において心因的な要素が疼痛改善を妨げていることを示す明確なエビデンスが不足している。本研究の目的は、関節リウマチの疼痛管理における心理的介入の潜在的な可能性を検討することである。
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| Outline of Final Research Achievements |
This cross-sectional study in patients with rheumatoid arthritis (RA) has two aim; To evaluate the relationship between pain catastrophizing, the state of systemic inflammation, and achievement of remission, to evaluate the relationship between residual pain after improved inflammation and pain catastrophizing.
We showed that pain catastrophizing is a major obstacle to achieving remission. The overestimation of RA disease activity due to elevated patient global assessment, which is one of the index of clinical remission, was more likely in the presence of pain catastrophizing, which was especially observed in patients without systemic inflammation. Moreover, pain catastrophizing was associated with pain VAS scores in patients who achieve remission except patient's oriented report.
These results showed that the presence of high-risk group in which it is difficult to achieve remission due to psychogenic factors and the image of patients suffering from psychogenic pain have become clear.
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| Academic Significance and Societal Importance of the Research Achievements |
本研究で明らかになった「CRPレベルが正常な非寛解患者の約34％の疾患活動性は、破局的思考（心因的要因）に起因した患者主観的評価の上昇により過大評価されている可能性がある」、「腫脹関節・圧痛関節・CRPレベルが正常化したにもかかわらず残存する疼痛強度と破局的思考には正相関があった」、この2点の結果は、痛みの改善に対する心理・認知行動療法が有効である可能性が高い患者像を明確にしたと言える。寛解率のさらなる向上とともに、残存痛への対応というアンメットニーズに貢献すると考える。
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Report
(4 results)
Research Products
(4 results)
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[Presentation] Pain catastrophizing is associated with residual pain after reaching improved conditions of swollen/tender joints and serum C-reactive protein level2021
Author(s)
Tamami Yoshida, Motomu Hashimoto, Kosaku Murakami, Koichi Murata, Kohei Nishitani, Ryu , Teruhide Koyama, Ritei Uehara, Masao Tanaka, Hiromu Ito, Shuichi Matsuda
Organizer
Annual European Congress of Rheumatology EULAR 2021
Related Report
Int'l Joint Research
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