Dissociation and Pain-Catastrophizing: Absorptive Detachment as a Higher-Order Factor in Control of Pain-Related Fearful Anticipations Prior to Total Knee Arthroplasty (TKA).

Total Knee Arthroplasty (TKA) is the ultima-ratio therapy for knee-osteoarthritis (OA), which is a paradigmatic condition of chronic pain. A hierarchical organization may explain the reported covariation of pain-catastrophizing (PC) and dissociation, which is a trauma-related psychopathology. This study tests the hypotheses of an overlap and hierarchical organization of the two constructs, PC and dissociation, respectively, using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the Childhood Trauma Screener (CTS), a shortened version of the Dissociative Experiences Scale (FDS-20), the Brief Symptom Inventory (BSI-18), the Pain-Catastrophizing Scale (PCS), and the Tampa Scale of Kinesiophobia (TSK) in 93 participants with knee-OA and TKA.

[Cognitive dysfunction as a hidden multiple sclerosis related symptom relevant for an expert appraisal].

We report on a patient with multiple sclerosis (MS), who had severe cognitive dysfunction despite only mild changes in cerebral magnetic resonance imaging (cMRI). The severe MS-related cognitive deficits were disclosed only in a comprehensive neuropsychological evaluation. A previous appraiser was not able to detect these neuropsychological deficits as he did not conduct an appropriate neuropsychological assessment.