clinical significant systemic adverse effects occurredeven if used long term or in an elderly population.

doi:10.1016/j.ejpain.2007.03.114

Workshop – Assessment And Diagnosis 5: ANXIETY,DEPRESSION AND QUALITY OF LIFE IN

NEUROPATHIC PAIN

101Workshop Summary: ANXIETY, DEPRESSION AND

QUALITY OF LIFE IN NEUROPATHIC PAIN

P. Murphy

Department of Pain Management, The Walton Centre for

Neurology and Neurosurgery NHS Trust, Liverpool, UK

Whilst there is an extensive body of literatureaddressing the influence of psychological factors in themanagement of chronic pain in general, there is rela-tively little that addresses specifically neuropathic pain.The question therefore arises whether there is a needfor measures specific to neuropathic and if so what fromwould they take?

The aim of the workshop is to provide a review of evi-dence that indicates psychological factors may influencetreatment options in neuropathic pain, focusing on anx-iety and depression.

Further, to consider the appropriateness of psychoso-cial assessment tools in neuropathic pain, whether thereis a need to develop neuropathic pain specific measuresas opposed to generic pain measures given the uniquequalities of neuropathic pain.

In addition, to consider the nature and utility of qual-ity of life measures in neuropathic pain. Whether there isan argument for such measures to be considered as pri-mary rather than secondary outcome measures.

Finally, pain management programmes are contin-uing to grow as a major source of treatment for chronicpain sufferers. Are neuropathic pain sufferers well servedby such PMPs? Or there is a need to develop PMPs spe-cifically for neuropathic pain? Several case studies willhighlight patient and clinician experience of goingthrough a pain management programme.

doi:10.1016/j.ejpain.2007.03.115

102THE ROLE OF PSYCHOSOCIAL FACTORS AND

NEUROPATHIC PAINJ. Haythornthwaite

Department of Psychiatry and Behavioral Sciences,

Centre for Mind-Body Research, Johns Hopkins Univer-

sity School of Medicine, Baltimore, USA

The potential impact chronic pain can have on anindividual’s psychological, social and physical functionand thus quality of life is well documented. Such datain the neuropathic pain literature is less well developed.Evidence from clinical and experimental studies will bereviewed in order to examine the relationship betweenneuropathic pain and psychological functioning. Theimportance of assessing psychosocial factors whendetermining treatment options and evaluating outcomewill be addressed. Specifically, anxiety and depressionhave been established as risk factors for persistent painin general, and their role in persistent neuropathic painrequires consideration. The impact of these factors onvarious outcomes, including pain, pain-related disabil-ity, and treatment response will be discussed.

doi:10.1016/j.ejpain.2007.03.116

103ASSESSMENT OF PSYCHOSOCIAL FACTORS IN

NEUROPATHIC PAIN

H.M. Poole

Faculty of Science, Liverpool John Moores University,

Liverpool, UK

A large number of measures are available for theassessment of non-pain psychosocial variables inpatients with neuropathic pain. This presentation willdescribe and critically review the validity and reliabilityof these measures with particular emphasis on thosedesigned to assess anxiety, depression and/or qualityof life. The utility of assessment tools in helping to deter-mine treatment options will be considered and the extentto which generic rather than disease specific tools areuseful for evaluating treatment and outcome will be dis-cussed. The process and development of a quality of lifemeasure for neuropathic pain will be used as a vehicle toexplore the issue of patient reported outcomes and thefutility of measuring pain in isolation from these contex-tual factors. The question of whether psychosocial vari-ables, such as quality of life, should be considered asprimary rather than secondary outcome parameters intreatment trials will be raised using evidence from pub-lished studies to support this premise.

doi:10.1016/j.ejpain.2007.03.117

104TREATMENT FOR NEUROPATHIC PAIN FROMA PSYCHOSOCIAL PERSPECTIVE

P. Murphy

Department of Pain Management, The Walton Centre for

Neurology and Neurosurgery NHS Trust, Liverpool, UK

Invited Presentations / Workshop – Assessment And Diagnosis 5 / European Journal of Pain 11(S1) (2007) S1–S57 S41

The utility of non-pharmacological treatments,including pain management programmes based on cog-nitive behavioural principles, for specific neuropathicpain conditions will be explored and evidence for theirefficacy reviewed. In particular, to consider the extentthat generic pain management programmes can meetthe needs of the patient with neuropathic pain. Inaddition, to describe and evaluate the role of the multi-disciplinary team in the assessing the suitability of apain patient for either a pain management programmeor spinal cord stimulation, or possibly a combinationof both. Several case studies will be used to illustratethe experience of both neuropathic pain patients and cli-nicians on various treatment pathways.

doi:10.1016/j.ejpain.2007.03.118

Workshop – Epidemiology And Health Care Systems 5:

EPIDEMIOLOGY OF DIABETIC NEUROPATHY

– LATIN AMERICAN EXPERIENCE

105EPIDEMIOLOGY OF DIABETIC NEUROPATHYIN MEXICO

M. Genis Rondero

AMETD, Mexico City, Mexico

Pain is a multidimensional sensory experience that isintrinsically unpleasant and associated with hurting andsoreness. It may vary in intensity, quality, duration, andreferral. Although it is essentially a sensation, pain hasstrong cognitive and emotional components; it is linkedto, or described in terms of suffering. It is also associatedwith avoidance motor reflexes and alterations in auto-nomic output. All of these traits are inextricably linkedto the experience of pain.

Diabetes Mellitus: In Mexico, among all Mexicanstates reported the prevalence of diabetes. In Mexicois 10.8% from one hundred five million peopleinhabitants.

Although neuropathy has long been recognized as acomplication of diabetes, the impact of this conditionhas not been properly adequately established. The prev-alence of diabetic neuropathy is virtually unknown.

Diabetes is commonly associated with a peripheralneuropathy that often results in significant pain.

Actually in the Latin American Federation chaptersof pain (FEDELAT), an investigation of prevalence ofpain in Latin America is being carried out, and theseconclusions will be presented on May 2007.

Our aim is to study and demonstrate that in Mexicoand the rest of Latin America, the incidence, prevalenceand social impact of neuropathic pain is consequence ofdiabetes condition.

I am certain that the results of this effort willcontribute to a better understanding and treatment ofpain due to diabetic neuropathy in Mexico and LatinAmerica.

doi:10.1016/j.ejpain.2007.03.119

106EPIDEMIOLOGY OF PAINFUL DIABETIC NEU-

ROPATHY IN CENTRAL AMERICA AND THE

CARIBBEAN

E. Ibarra

Pain Clinic, Albonito, Puerto Rico

Diabetic neuropathy and its related pain is a worldwide complication of the primary disease that affectsmillions of human beings around the world. It is aperipheral nerve disorder in which the symptoms maynot be prominent at first but then gradually appear inthe form of pain, numbness, tingling in the feet, legs orboth and after time weakness in the muscles of the feetmay appear. On occasions the neuropathy appears sud-denly and affects specific nerves so the affected individualwill develop double vision, drooping eyelids or weaknessand atrophy of the thigh muscles. After years of sufferingthe condition, the patients may also develop problemswith the digestive and sexual systems which may causeindigestion, diarrhea or constipation, dizziness, bladderinfections and impotence. The loss of sensation in thefeet may cause injuries in the foot to go unnoticedand so develop lesions that may later become infectedulcers.

The Latin-American Federation of IASP chapters(FEDELAT) is conducting a survey in the 20 countriesof the American Continent twenty known as ‘‘LatinAmerica’’ in which the epidemiology of chronic pain willbe shown. The aim of our presentation is to show theincidence and prevalence of painful diabetic neuropathyin Central America and the Caribbean and let the audi-ence known what is being done to properly diagnose andtreat the condition throughout the region.

doi:10.1016/j.ejpain.2007.03.120

107EPIDEMIOLOGY OF DIABETES NEUROPATHY

IN SOUTH AMERICA

M.J. Gutfrajnd

Chief Pain Management Department, CEMES, La Paz,

Bolivia

Diabetes is the most common cause of neuropathy inthe world and of course also in Latin America.

S42 Invited Presentations / Workshop – Epidemiology And Health Care Systems 5 / European Journal of Pain 11(S1) (2007) S1–S57