Chronic pain: Overlap and specificity in multimorbidity management.

BACKGROUND: Chronic non-cancer pain (CNCP) frequently co-occurs with other chronic conditions, resulting in multimorbidity. OBJECTIVE: The aim of this article is to summarise current approaches to CNCP management and explore areas of specificity and overlap with chronic conditions in general. DISCUSSION: The biomedical component of the management of chronic conditions may be condition-specific. However, mind-body, connection, activity and nutrition components entail significant overlap and are helpful across conditions. Effective practice avoids overemphasis on medical treatments at the expense of evidence-based, multidimensional lifestyle approaches. CNCP management illustrates the case for reconceptualising chronic condition management using a generic lifestyle-based approach. This capitalises on overlapping treatments, creates system efficiency and allows patients with multimorbidity to be treated more effectively in primary care, with only a small subgroup referred to condition-specific tertiary services.

Aggression and trauma experiences among carer-relatives of people with psychosis.

BACKGROUND: Exposure to aggression and associated psychological outcomes are poorly characterised among carer-relatives of people with psychosis. METHOD: Carer-relatives (N = 106) completed questionnaires assessing socio-demographics and perceived prevalence of aggression in their caring role in the last 12 months. Carers exposed to moderate-severe levels of aggression were re-approached to assess PTSD and coping strategies. RESULTS: Most respondents (77.4%) reported experiencing moderate-severe levels of aggression. Increased contact with (M = 15.12 vs. M = 6.71 days per month), and significantly higher ratings of affective, antisocial, negative and psychotic symptomology in affected relatives were associated with experiences of moderate-severe aggression. Approximately half of the moderate-severe respondents reported potentially significant levels of PTSD (52%, N = 34), which was associated with greater exposure to verbal aggression and increased usage of coping strategies. CONCLUSIONS: Comparable ratios of physical to non-physical aggression to those reported by professional carers working in acute psychiatric treatment settings were reported. Carer-relatives require greater levels of information and support to assist them in their community caring roles.