Psychosocial characteristics and pain burden of patients with suspected sphincter of oddi dysfunction in the EPISOD multicenter Trial

Olga Brawman-Mintzer, Valerie Durkalski, Qi Wu, Joseph Romagnuolo, Evan Fogel, Paul Tarnasky, Giuseppe Aliperti, Martin Freeman, Richard Kozarek, Priya Jamidar, Mel Wilcox, Grace Elta, Kyle Orrell, April Wood, Patrick Mauldin, Jose Serrano, Douglas Drossman, Patricia Robuck, Peter Cotton

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

OBJECTIVES: Patients with several painful functional gastrointestinal disorders (FGIDs) are reported to have a high prevalence of psychosocial disturbance. These aspects have not been studied extensively in patients with suspected Sphincter of Oddi dysfunction (SOD). METHODS: A total of 214 patients with post-cholecystectomy pain and suspected SOD were enrolled in seven US centers in a multicenter-randomized trial (Evaluating Predictors and Interventions in Sphincter of Oddi Dysfunction). Baseline assessments included pain descriptors and burden, structured psychosocial assessments of anxiety/depression, coping, trauma, and health-related quality of life. Patients with high levels of depression, suicidal ideation, or psychosis were excluded. RESULTS: The study population (92% female, mean age 38) reported anxiety (9%), depression (8%), past sexual trauma (18%), and physical abuse (10%). Of the total screened population (n=1460), 3.9% of the patients were excluded because of the presence of defined severe psychological problems. The mean medical outcomes study short-form-36 (SF-36) physical and mental composite scores were 38.70 (s.d.=7.89) and 48.74 (s.d.=9.60), respectively. Most subjects reported symptoms of other FGIDs. There were no correlations between the extent of the pain burden in the 3 months before enrollment and the baseline anxiety scores or victimization history. However, those with greater pain burden were significantly more depressed. There were no meaningful differences in the psychosocial parameters in subjects with or without irritable bowel, and those who had cholecystectomy for stones or functional gallbladder disease. Those declining randomization were comparable to those randomized. CONCLUSIONS: Psychosocial comorbidity in SOD is high. However, it does not appear to differ significantly from that reported in surveys of age-and gender-matched general populations, and may be lower than reported with other FGIDs.

Original languageEnglish
Pages (from-to)436-442
Number of pages7
JournalAmerican Journal of Gastroenterology
Volume109
Issue number3
DOIs
StatePublished - 2014

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Sphincter of Oddi Dysfunction
Multicenter Studies
Gastrointestinal Diseases
Pain
Anxiety
Cholecystectomy
Depression
Population
Gallbladder Diseases
Suicidal Ideation
Crime Victims
Wounds and Injuries
Pain Measurement
Random Allocation
Psychotic Disorders
Comorbidity
Quality of Life
Outcome Assessment (Health Care)
Psychology

ASJC Scopus subject areas

  • Gastroenterology

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Psychosocial characteristics and pain burden of patients with suspected sphincter of oddi dysfunction in the EPISOD multicenter Trial. / Brawman-Mintzer, Olga; Durkalski, Valerie; Wu, Qi; Romagnuolo, Joseph; Fogel, Evan; Tarnasky, Paul; Aliperti, Giuseppe; Freeman, Martin; Kozarek, Richard; Jamidar, Priya; Wilcox, Mel; Elta, Grace; Orrell, Kyle; Wood, April; Mauldin, Patrick; Serrano, Jose; Drossman, Douglas; Robuck, Patricia; Cotton, Peter.

In: American Journal of Gastroenterology, Vol. 109, No. 3, 2014, p. 436-442.

Research output: Contribution to journalArticle

Brawman-Mintzer, O, Durkalski, V, Wu, Q, Romagnuolo, J, Fogel, E, Tarnasky, P, Aliperti, G, Freeman, M, Kozarek, R, Jamidar, P, Wilcox, M, Elta, G, Orrell, K, Wood, A, Mauldin, P, Serrano, J, Drossman, D, Robuck, P & Cotton, P 2014, 'Psychosocial characteristics and pain burden of patients with suspected sphincter of oddi dysfunction in the EPISOD multicenter Trial', American Journal of Gastroenterology, vol. 109, no. 3, pp. 436-442. https://doi.org/10.1038/ajg.2013.467
Brawman-Mintzer, Olga ; Durkalski, Valerie ; Wu, Qi ; Romagnuolo, Joseph ; Fogel, Evan ; Tarnasky, Paul ; Aliperti, Giuseppe ; Freeman, Martin ; Kozarek, Richard ; Jamidar, Priya ; Wilcox, Mel ; Elta, Grace ; Orrell, Kyle ; Wood, April ; Mauldin, Patrick ; Serrano, Jose ; Drossman, Douglas ; Robuck, Patricia ; Cotton, Peter. / Psychosocial characteristics and pain burden of patients with suspected sphincter of oddi dysfunction in the EPISOD multicenter Trial. In: American Journal of Gastroenterology. 2014 ; Vol. 109, No. 3. pp. 436-442.
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abstract = "OBJECTIVES: Patients with several painful functional gastrointestinal disorders (FGIDs) are reported to have a high prevalence of psychosocial disturbance. These aspects have not been studied extensively in patients with suspected Sphincter of Oddi dysfunction (SOD). METHODS: A total of 214 patients with post-cholecystectomy pain and suspected SOD were enrolled in seven US centers in a multicenter-randomized trial (Evaluating Predictors and Interventions in Sphincter of Oddi Dysfunction). Baseline assessments included pain descriptors and burden, structured psychosocial assessments of anxiety/depression, coping, trauma, and health-related quality of life. Patients with high levels of depression, suicidal ideation, or psychosis were excluded. RESULTS: The study population (92{\%} female, mean age 38) reported anxiety (9{\%}), depression (8{\%}), past sexual trauma (18{\%}), and physical abuse (10{\%}). Of the total screened population (n=1460), 3.9{\%} of the patients were excluded because of the presence of defined severe psychological problems. The mean medical outcomes study short-form-36 (SF-36) physical and mental composite scores were 38.70 (s.d.=7.89) and 48.74 (s.d.=9.60), respectively. Most subjects reported symptoms of other FGIDs. There were no correlations between the extent of the pain burden in the 3 months before enrollment and the baseline anxiety scores or victimization history. However, those with greater pain burden were significantly more depressed. There were no meaningful differences in the psychosocial parameters in subjects with or without irritable bowel, and those who had cholecystectomy for stones or functional gallbladder disease. Those declining randomization were comparable to those randomized. CONCLUSIONS: Psychosocial comorbidity in SOD is high. However, it does not appear to differ significantly from that reported in surveys of age-and gender-matched general populations, and may be lower than reported with other FGIDs.",
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T1 - Psychosocial characteristics and pain burden of patients with suspected sphincter of oddi dysfunction in the EPISOD multicenter Trial

AU - Brawman-Mintzer, Olga

AU - Durkalski, Valerie

AU - Wu, Qi

AU - Romagnuolo, Joseph

AU - Fogel, Evan

AU - Tarnasky, Paul

AU - Aliperti, Giuseppe

AU - Freeman, Martin

AU - Kozarek, Richard

AU - Jamidar, Priya

AU - Wilcox, Mel

AU - Elta, Grace

AU - Orrell, Kyle

AU - Wood, April

AU - Mauldin, Patrick

AU - Serrano, Jose

AU - Drossman, Douglas

AU - Robuck, Patricia

AU - Cotton, Peter

PY - 2014

Y1 - 2014

N2 - OBJECTIVES: Patients with several painful functional gastrointestinal disorders (FGIDs) are reported to have a high prevalence of psychosocial disturbance. These aspects have not been studied extensively in patients with suspected Sphincter of Oddi dysfunction (SOD). METHODS: A total of 214 patients with post-cholecystectomy pain and suspected SOD were enrolled in seven US centers in a multicenter-randomized trial (Evaluating Predictors and Interventions in Sphincter of Oddi Dysfunction). Baseline assessments included pain descriptors and burden, structured psychosocial assessments of anxiety/depression, coping, trauma, and health-related quality of life. Patients with high levels of depression, suicidal ideation, or psychosis were excluded. RESULTS: The study population (92% female, mean age 38) reported anxiety (9%), depression (8%), past sexual trauma (18%), and physical abuse (10%). Of the total screened population (n=1460), 3.9% of the patients were excluded because of the presence of defined severe psychological problems. The mean medical outcomes study short-form-36 (SF-36) physical and mental composite scores were 38.70 (s.d.=7.89) and 48.74 (s.d.=9.60), respectively. Most subjects reported symptoms of other FGIDs. There were no correlations between the extent of the pain burden in the 3 months before enrollment and the baseline anxiety scores or victimization history. However, those with greater pain burden were significantly more depressed. There were no meaningful differences in the psychosocial parameters in subjects with or without irritable bowel, and those who had cholecystectomy for stones or functional gallbladder disease. Those declining randomization were comparable to those randomized. CONCLUSIONS: Psychosocial comorbidity in SOD is high. However, it does not appear to differ significantly from that reported in surveys of age-and gender-matched general populations, and may be lower than reported with other FGIDs.

AB - OBJECTIVES: Patients with several painful functional gastrointestinal disorders (FGIDs) are reported to have a high prevalence of psychosocial disturbance. These aspects have not been studied extensively in patients with suspected Sphincter of Oddi dysfunction (SOD). METHODS: A total of 214 patients with post-cholecystectomy pain and suspected SOD were enrolled in seven US centers in a multicenter-randomized trial (Evaluating Predictors and Interventions in Sphincter of Oddi Dysfunction). Baseline assessments included pain descriptors and burden, structured psychosocial assessments of anxiety/depression, coping, trauma, and health-related quality of life. Patients with high levels of depression, suicidal ideation, or psychosis were excluded. RESULTS: The study population (92% female, mean age 38) reported anxiety (9%), depression (8%), past sexual trauma (18%), and physical abuse (10%). Of the total screened population (n=1460), 3.9% of the patients were excluded because of the presence of defined severe psychological problems. The mean medical outcomes study short-form-36 (SF-36) physical and mental composite scores were 38.70 (s.d.=7.89) and 48.74 (s.d.=9.60), respectively. Most subjects reported symptoms of other FGIDs. There were no correlations between the extent of the pain burden in the 3 months before enrollment and the baseline anxiety scores or victimization history. However, those with greater pain burden were significantly more depressed. There were no meaningful differences in the psychosocial parameters in subjects with or without irritable bowel, and those who had cholecystectomy for stones or functional gallbladder disease. Those declining randomization were comparable to those randomized. CONCLUSIONS: Psychosocial comorbidity in SOD is high. However, it does not appear to differ significantly from that reported in surveys of age-and gender-matched general populations, and may be lower than reported with other FGIDs.

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