In Tunisia, the breast cancer is the most frequently diagnosed neoplasm in women.

- Highlight the health-related QOL of Tunisian women after the treatment of breast cancer compared with the general population.

- assess the functional scales that predict the global quality of life (GQOL) scale of the QLQ - C30.

We recruited 50 patients who were in remission for at least 3 months after initial treatment of breast cancer, and 50 women with no history of cancer.

Those patients were previously referred to the Department of Gynecology in Sfax University Hospital for breast surgery, and then they had all received adjuvant therapy.

QOL was evaluated using the Arabic version of the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 questionnaire.

The mean scores for QLQ - C30 indicated that the patients had poor to average functioning (GQOL, 56.7; and five functional scales, 55.6%–67.3%).

Those scores showed a significant deterioration in the sample of breast cancer survivors relative to general population.

Among the symptoms scales, only the financial difficulties were significantly greater in patients (p = 9.10-7).

Deterioration of the GQOL was induced by the worsening of the emotional (p = 0.005) and social (p = 0.008) functioning but it was independent of symptoms scales.

The findings indicated that, despite many treatment advances, Tunisian women had significantly poorer GQOL and functional scales scores in comparison with the general population. It seems also that improving the emotional and social functioning contribute to a better GQOL.

Evaluate a population of individuals with cancer referred to a first psychiatric appointment.

Descriptive and correlation analysis of first assessments of patients during three months.

A significant amount of patients were referred due to prior psychiatric pathology and for being under psychopharmacotherapy. Requests demanding an evaluation under the new disease status were fewer than it would have been expected in this population. Most patients were sent with objective symptoms or high cancer stages. The most frequent diagnosis was adjustment disorder with anxiety or depression, and also depressive disorder.

Distress levels in oncological patients demand a focused approach towards the psychological well-being.

Drug abuse during pregnancy is a growing problem in all developed countries of the world. Maternal drug abuse affects the developing system and its long-term effects can persist till adulthood so it can decreases the rate of their maturation. Since endogenous opioid induced analgesia, and morphine can interact with it, Thus the present study was designed to determine whether the exposure to the morphine during gestation permanently alter pain response.

To determine the effects of prenatal morphine exposure on pain response

12 Pregnant rats were divided to morphine and control groups.

Morphine was administrated (S.C) to female rats twice a day (08 h and 20 h) on gestational days 11–18, (5 mg/kg morphine for 3 days and 10 mg/kg for 5 days). Analgesic response of pups (P90, n = 6) were tested by formaline test.

The results of our experiment demonstrated that prenatal morphine exposure rats exhibited significantly lower pain thersholds.

Prenatal morphine exposure impair pain sensitivity

The association between pain and neuroticism varies from higher neuroticism values in patients with chronic pain compared to healthy subjects and lower neuroticism values in psychiatric patients with pain compared to psychiatric patients without pain (Bond, 1971; Merksey, 1972). Raselli & Broderick (2007) showed a possible influence of time (actual state and recall) and neuroticism on reporting pain in patients with chronic pain (Raselli & Broderick, 2007). Data from experimental studies are missing.

The goal was to test whether differences in neuroticism, measured with the Freiburg Personality Inventory N Scale (FPI-R N), effects the correlation between the reported subjective maximal pain threshold (SMPT) before and after an experimental pain study.

20 healthy subjects divided into a non neuroticism group (NNG with FPI-R N value < 5, N = 10) and a neuroticism group (NG with FPI-R N value > 5, N = 10) were exposed to aversive electric stimuli in different conditions in an experimental pain study. Before and after the experimental procedure SMPT was recorded (milliamperes/mA).

SMPT before and after the experimental procedure correlated significantly in both groups, but with higher a correlation in the NNG (R2 = 96%) in contrast to the NG (R2 = 88%). The NG showed lower SMPTs (mean 4.5 ± 2.9 mA) than in the NNG (mean 6.6 ± 3.3 mA).

According to Raselli & Broderick (2007) the correlation between pre and post SMPTs in an experimental setup varies between subjects with high or low neuroticism values. Deductions and Limitations of the study are discussed.

Studies regarding chronic pain have demonstrated that there is a high prevalence of this condition in 65 years of age and older population.

Our study objectives was to assess the prevalence of chronic pain in a sample of older subjects without known or diagnosticated pathology, and without analgesic routine use. It was a preliminary step in assessing the effects of aerobic exercise on this condition (as part of a research project supported by The National Council of the Higher Education’s Scientific Research - CNCSIS).

A complete anamnesis and routine laboratory was performed for each subject. Subjective tools (Faces Scale and the Visual Analog Scale) was used for assessment of pain, and two self-report measures of anxiety (Beck Anxiety Inventory, and Visual Analogue Scale) was used for assessment of anxiety.

Of 136 subjects enrolled (Av. Age 64 ± 4) 39 subjects (28.67%) presented chronic pain. In bivariate analyses pain was associated with anxiety, negative life events, loneliness, sedentary life.

Despite the apparent health of the subjects involved in this study the prevalence of unexplained chronic pain complaints was high. It seems necessary to explore more this condition in general practice in older to highlight any specific cases, in order to reach diagnoses and to select the treatment or, considering the subjective nature of this entity and the associated features of aging in absence of any identifiable pathology, to select an appropriate intervention to improve the quality of life for this people.

Migraine is a common headache and sometimes it's nocturnal attack awake patients while dreaming. Some dream contents accelerate migraine attacks. In this study the relationship between dream contents and migrainous headaches was evaluated.

The study was done in 185 patients with migraine in a period of 2 years. Diagnosis of migraine had done according to IHS criteria. Dreams had been analyzed by Hall Van de castle test. Data were analyzed by Spss V.17 software.

One hundred and thirty three patients out of 185 patients were female. The average number of attacks per month was higher in group with nocturnal migraine (P = 0.006). 231 dreams were noted from 130 patients. Patients with nocturnal migraine remember and noted more dreams (P = 0.02). Aggression in dreams contents have no significant relationship with nocturnal migraine and post dreaming headaches. Dreams with contents of friendliness, Sexual and misfortune was more prevalent in patients with nocturnal migraine (P = 0.001). Contents of sadness, misfortune, confusion and sexual materials (P = 0.001) and failure (P = 0.039) accelerated the migraine attacks.

Positive and negative Emotions lead to increasing the headache attacks. Studying dream contents in different migrenous patients with different cultures is a matter of concern and may help to understand patient's psychopathology.

Recent clinical reports show a sharp rise in the cesarean section rate, particularly in the private hospitals that might be affected by the cognitive variables.

This research was to compare fear of pain, pain catastrophizing, catastrophic cognition and also childbirth attitude in private and public hospitals.

The main aim of this research was to compare fear of pain, pain catastrophizing, catastrophic cognition and also childbirth attitude in private and public hospitals.

Participants were (n = 150) pregnant women from private hospitals who were selected using available sampling method as well as (n = 150) pregnant women from public hospitals who were counter balanced on the basis of the age, education, previous number of deliveries, previous number of cesarean and type of hospital variables. Three questionnaires of fear of pain (FPQ) and catastrophic cognition (CCQ) and childbirth attitude (CAQ) as well as scale of pain catastrophizing (PCS) were administrated.

Multivariate analyses of variance were shown significantly differences for two cognitive variables of “fear of pain” and “catastrophic cognition”, while no significant difference were observed for other variables.

These results suggested fear of pain and catastrophic cognition as important cognitive factors in the increase rate of cesarean labor in private hospitals.

Prevalence of the cesarean labor in Iran has reported 41percent in recent studies which is really higher than expected rate compare to other countries.

Our purpose in this research was to examine the role of “fear of pain” and related cognitive variables such as pain catastrophizing, catastrophic cognition and also childbirth attitude in prediction of the cesarean labor.

In this research was to examine the role of “fear of pain” and related cognitive variables in prediction of the cesarean labor.

Participants were 300 pregnant women from two private (n = 150) and public (n = 150) hospitals who were selected using available sampling method. After informed consent provided from all participate, variables such as age, level of education, month of pregnancy, previous number of deliveries, previous number of cesarean, tendency to cesarean and type of hospital were control for using counter balancing method. Three questionnaires of fear of pain (FPQ) and catastrophic cognition (CCQ) and childbirth attitude (CAQ) as well as scale of pain catastrophizing (PCS) were administrated.

A Regression Binary Logistic was revealed that month of pregnancy, previous number of cesareans and also the type of hospital could predict the tendency to cesarean. Further, a significant predictive value were also found for cognitive variables of pain catastrophizing, catastrophic cognition and childbirth attitude.

These results showed that increase in the month of pregnancy, pain catastrophizing, catastrophic cognition and childbirth attitude and also decrease in the previous number of cesareans and selection of private hospital, predict the cesarean delivery among women.

High levels of alexithymia as well as low scores on assertiveness have been described in patients with chronic pain and headache.

To determine alexithymia and assertiveness scores and to explore their association with headache impact, in primary chronic headache patients.

This study aims to advance knowledge of the emotional expressiveness in headache impact.

In a sample of 62 outpatients, we used the Toronto Alexithymia Scale (TAS-20), the Rathus Assertiveness Scale and the Headache Impact Test (HIT-6) and applied the Pearson correlation index.

77.4% of women, 36.3 years mean age. The most prevalent diagnoses are migraine combined with tension type headache (33.9%), migraine alone (32.3%) and tension-type headache alone (22.6%). Most of the patients have not any psychiatric comorbidity (77.8%). We observe a direct linear relationship and statistically significant difference, between the total impact of headache and the total score of alexithymia (r = 0.27 p = 0.03) and there is an inverse correlation between the impact of headache and the total score of the scale of assertiveness, not statistically significant (r = −0.004 p = 0.97).

Discriminated by diagnostic groups, we found that the association between assertiveness and headache impact remains only in patients with migraine alone, while that between alexithymia and headache impact is preserved in all subgroups.

Two indirect measures of the difficulties in emotional expressiveness such as alexithymia and assertiveness, show the expected association with headache impact. The sample size can influence some of the correlations not statistically significant.

Cognitive strategies have received considerable attention in the field of pain management, together with more traditional approaches based on physical interventions and behavior modification. Distraction is a technique that lately has been often studied.

Distraction is based on an individual's limited attention capacity; it diminishes attention aimed to a painful stimulus with a subsequent pain reduction (Wismeijer & Vingerhoets, 2005).

To study the effect of VR as a distraction technique in an experimental pain task.

37 healthy participants were induced pain through two consecutive immersions using the cold-pressor test. All participants went through two experimental conditions: VR and black screen. The order of conditions was counterbalanced and a design of repetitive measures was used.

A virtual environment “Surreal World” was developed based on distraction techniques designed to surprise participants. The effect of VR as a distraction technique was evaluated using objective measures of pain (threshold, tolerance, pain intensity and time estimation) and other cognitive measures (self-efficacy and catastrophic thinking in vivo).

VR significantly decreased tolerance and pain intensity, influenced participants to underestimate the length of immersion. A higher self-efficacy in VR and a lower rumination and helplessness were registered in the pain experience. Thus, VR may help improve the efficacy of cognitive strategies.

The study shows the relevance of VR as an adjunctive method in the treatment of acute pain and allows studying its efficacy in patients with chronic pain.

Psychological factors are predictive of long term disability for many pain syndromes as well as for pain severity emotional distress and treatment seeking. It is known that fear of pain leads to avoidance of pain-related experiences and contributes to disability.

To determine if there is a significant relationship between optimism/ pessimism, HRQOL and pain in a group of musculoskeletal patients referred to a rehabilitation center, because of chronic pain and mobility difficulties when controlling for fear of pain and pain reduction coping strategies.

The sample consisted of 96 patients. The questionnaires that were used are the Short Form health questionnaire (12 questions; SF12), the Pain Anxiety Symptoms Scale (PASS), the life orientation test-revised (LOT-R) and a VAS scale for pain measurement. Two separate linear regression analyses were conducted to examine the effects of optimism on each of the two main domains of SF12 with optimism entered in the last step of each model.

According to the regression analysis performed, dispositional optimism (β = ,284) is an independent factor affecting the mental composite score in patients with musculoskeletal problems, even after controlling for the effect of pain intensity. Pain -related escape and avoidance is the only factor affecting both physical (β = −,300) and mental health (β = −,192).

The consistent indications that fear is associated with the suffering and disability that often accompany pessimistic patients with chronic musculoskeletal pain, suggests that clinicians working with these individuals should conduct a careful assessment of fear and avoidance, both pain-related and otherwise.

The McGill Illnes Narrative (MINI) is a semiestructured, qualitative interview schedule, which is useful to explore individuals’ illnes narratives in sociocultural context. It has been used in first- time postmyocardial infarction patients and also in patients with hyperemesis gravidarum, but it has not yet been used in fibromyalgia.

A study was conducted using McGill Illness Narratives (MINI) with 20 patients who were recruited from a referral Rheumatology Service during 2009 and 2010, and met criteria of the American Association of Rheumatology for fibromyalgia syndrome (FMS) trying to explore:

• Narrative of illness experience

• Salient prototypes related to current health problem

• Explanatory models

• Help seeking and service utilization

• Impact of illness

The interviews were carried out and audiorecorded and the narratives were analyzed according to their structure and content.

The physical cause was the most common causal attribution. Most of them had been treated for different specialists, and reported problems in seeking diagnosis and help from professionals. Some patients were diagnosed by rheumatologists with celiac disease, lactose intolerance and undifferentiated spondylitis, termed “False Fibromyalgia”. Like previous research, negative emotional states were correlated with worsening pain. Many changes were related in their way of life.

Qualitative studies are essential to complement quantitative research methods and are imprescindible to understand FMS. The exploration of the explanatory models may stimulate exchange between disciplines and may give access to a popular cultural construct related to somatic conditions not yet documented in the literature.

Pain is a personal experience influenced by many factors such as cultural experiences and impressions, the educational and family situations and psychological problems are numerous and complex perceptual field above factors than the concept of individual forms of pain. Process

This study aimed to compare strategies to deal with pain and addiction introspective extraversion is being left.

This study is a comparison of Ali in the analysis of statistical methods MANOVA findings will be made and the strategies for coping with pain (the revocation, reinterpretation of pain, talk to your ignore pain, tragedy and pray for Entrepreneurship - Hope) and a behavioral strategy (increasing behavioral activity) classified in two groups of addicts introspective (15) and extraversion (15 cases) were compared for leaving.

Total average component methods to deal with the pain of eccentric left at addicts are left are more introverted. This suggests that addicts are left eccentric methods to deal with pain more than the poor addicts are left introverted enjoyed.

Deal with pain component) the revocation, reinterpretation of pain, talk to your ignore pain, disaster, playing, praying and hope (the personality types of introverts and extroverts have enjoyed significant difference. So therefore rejected and be accepted with maximum reliability.

Pain is a complex and multifacial phenomenon, which interferes in almost every person's life, while in case it turns into chronic, can cause a significant disturbance in individual's physical, psychological and social sphere. That means the intense communication and interaction between ache biome, living conditions and state of health. Cognitive factors play a significant role on the recurrent dysphoria levels, while cognitive functions participate actively in pain intensity, sense of disability and medicine response.

Estimate the possible significance between pain anxiety and pain intensity.

Eighty six elders suffering from various types of chronic pain were examined by the Pass-20 (Pain Anxiety Symptoms Scale) scale, and GPM (Geriatric Pain Measure), while the results were assessed by SPSS 14 and specifically the Linear Regression method.

It was found statistical significance between the four sub-scales and the presence and existence of chronic pain among participants. Specifically the first subcale (avoidance of pain) was linked with the intensity of pain (p = ,00), the second scale (fearfull thinking) was associated with the prevalence of pain and the gender (p = ,014), the third scale (cognitive anxiety) showed a statistic significance with GPM results and education levels (p = ,00) and the forth scale (psychological responses) was found to affect the pain sense, while it was depended by gender (p = ,0015).

Among elders pain anxiety can deteriorate the pain sense affecting the general well-being. For that reason non-pharmacological interventions can be very helpful both for the patient and clinician.