Review Psychological intervention in patients with central sensitization syndromes and comorbid psychosocial trauma: ... 2025 Maire et al

Andy

Senior Member (Voting rights)
Full title: Psychological intervention in patients with central sensitization syndromes and comorbid psychosocial trauma: a systematic review and meta-analysis

Abstract​

The co-occurrence of central sensitization syndromes (CSS) and post-traumatic symptoms (PTSS) or post-traumatic stress disorder (PTSD) exacerbates impairment, and treatment is unsatisfactory in many cases. This systematic review and meta-analysis examined the effectiveness of psychological therapy in individuals with CSS and comorbid PTSS/PTSD.

A search of Medline, PsycInfo, Web of Science, Pubmed, and Scopus databases (2000 to 2023) was conducted following PRISMA guidelines. Nineteen articles were selected, including nine for meta-analysis. The main psychological therapies were pain-focused cognitive-behavioral therapy (P-CBT), and trauma-focused interventions, mainly written emotional disclosure (WED) and emotional awareness and expression therapy (EAET). Both EAET and P-CBT showed potential benefits in improving pain severity (specially EAET), PTSS/PTSD, emotional distress, fatigue, sleep disturbances, CSS-related symptoms, and quality of life.

Overall, no significant differences were found between the two interventions. The meta-analysis revealed a large effect size for EAET in reducing pain and emotional distress; however, most comparison were against inactive controls, so results should be interpreted cautiously. These findings underscore the importance of distinguishing CSS patients with PTSS/PTSD. Tailored treatments such as EAET can address the additive impact of these conditions and contribute to improving patients’ quality of life.

Open access
 
"In the field of chronic pain, which is pain that lasts more than 3 months1, there is a relevant set of conditions where medical tests fail to detect abnormalities that can be proven to be their cause. These pain syndromes have been referred to by various term, including unexplained chronic pain or nociplastic pain, although central sensitization syndromes (CSS) is the most widely used term2. Conditions classified as CSS include fibromyalgia, chronic fatigue syndrome, irritable bowel syndrome, tension headaches and migraines, and most cases of temporomandibular, pelvic, abdominal and back chronic pain"
 
I have only read the abstract. I wonder whether the authors ever reflect on the 'comorbid psychosocial trauma' being at least in part the fault of themselves and their colleagues for attributing physical pain to psychosomatic causes and refusing to treat with adequate investigation and drugs.
 
"In the field of chronic pain, which is pain that lasts more than 3 months1, there is a relevant set of conditions where medical tests fail to detect abnormalities that can be proven to be their cause. These pain syndromes have been referred to by various term, including unexplained chronic pain or nociplastic pain, although central sensitization syndromes (CSS) is the most widely used term2. Conditions classified as CSS include fibromyalgia, chronic fatigue syndrome, irritable bowel syndrome, tension headaches and migraines, and most cases of temporomandibular, pelvic, abdominal and back chronic pain"
What are the odds they are including endometriosis and prostatitis here?
 
I have only read the abstract. I wonder whether the authors ever reflect on the 'comorbid psychosocial trauma' being at least in part the fault of themselves and their colleagues for attributing physical pain to psychosomatic causes and refusing to treat with adequate investigation and drugs.
Considering that there is plenty of published evidence of this, and it keeps being ignored in favor of fake efforts at addressing it (causing the problem, then getting paid to pretend to solve it, now that's a devious business model), one can only conclude that this is a desirable thing to them. The only alternative explanation is total ineptitude. Which, frankly, also fits the evidence perfectly.

But it's not as if any of those concepts were any more formally defined than zodiac signs anyway.
 
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