Tıp Fakültesi Öğrencilerinde Santral Sensitizasyonun Değerlendirilmesi: Kesitsel Bir Çalışma

Nihan Erdinç Gündüz; Yıldırım Hakan Bayazit; Rojin Bozarslan; Orhun Serhat Baskal; Ahmet Borikır; İbrahim Emir Bayram; Mustafa Samet Başdemir; Ercan Beyaztaş; Hülya Ellidokuz; Elif Akalın

doi:10.18614/deutip.1275720

Araştırma Makalesi

Tıp Fakültesi Öğrencilerinde Santral Sensitizasyonun Değerlendirilmesi: Kesitsel Bir Çalışma

Yıl 2023, Cilt: 37 Sayı: 2, 141 - 151, 06.09.2023

Nihan Erdinç Gündüz Yıldırım Hakan Bayazit Rojin Bozarslan Orhun Serhat Baskal Ahmet Borikır İbrahim Emir Bayram Mustafa Samet Başdemir Ercan Beyaztaş Hülya Ellidokuz Elif Akalın

https://doi.org/10.18614/deutip.1275720

Öz

ÖZ
Amaç: Bu çalışmanın amacı, tıp öğrencilerinde santral sensitizasyon ve ilişkili faktörleri değerlendirmektir.
Gereç ve yöntemler: Bu kesitsel çalışma, 18-25 yaşları arasındaki tüm sınıflardan tıp öğrencilerini içermektedir. Santral sensitizasyon, Santral Sensitizasyon Envanteri'ne göre, Bölüm A'dan 40 veya daha yüksek puan alınmasına göre belirlendi. İlişkili faktörler olarak öğrencilere yaş, cinsiyet, vücut kitle indeksi, eğitim durumu, tanı almış kronik hastalık varlığı, düzenli ilaç kullanımı ve birinci derece akrabalarda herhangi bir santral sensitizasyon sendromu varlığı sorgulandı.
Bulgular: Ortanca yaşı 21 (aralık: 18–25) olan 332 öğrenci dahil edildi. Santral sensitizasyon prevalansı %25.9 olarak saptandı ve kadın katılımcılarda erkeklerden önemli ölçüde daha yaygındı (P=0.008). Santral Sensitizasyon Envanteri Bölüm B bulguları, en sık görülen santral sensitizasyonu sendromunun %9,0 oranıyla depresyon olduğunu ortaya koydu. Santral sensitizasyonu olan ve olmayanlar arasında yaş ve vücut kitle indeksi açısından anlamlı fark yoktu (P>0,05). Santral sensitizasyon, sürekli ilaç kullanan öğrencilerde kullanmayanlara göre istatistiksel olarak anlamlı derecede yüksekti (P=0.021) ve ailesinde kronik yorgunluk sendromu, migren ve huzursuz bacak sendromu öyküsü olan öğrencilerde olmayanlara göre istatistiksel olarak anlamlı derecede daha yüksekti (sırasıyla 0.001, P<0.001 ve P<0.001). Son olarak, santral sensitizasyon sendromu, aile öyküsü olanlarda istatistiksel olarak anlamlı derecede daha yaygındı.
Sonuç: Santral sensitizasyon prevalansının tıp öğrencilerinde yüksek olduğu ve cinsiyet, aile öyküsü ve sürekli ilaç kullanımı ile ilişkili olduğu saptanmıştır.

Anahtar Kelimeler

Santral Sensitizasyon, Santral Sensitizasyon Envanteri, Tıp Fakültesi Öğrencileri

Destekleyen Kurum

yok

Proje Numarası

yok

Teşekkür

yok

Kaynakça

1. Neblett R, Cohen H, Choi Y, Hartzell MM, Williams M, Mayer TG, et al. The Central Sensitization Inventory (CSI): establishing clinically significant values for identifying central sensitivity syndromes in an outpatient chronic pain sample. J Pain 2013;14(5):438-45
2. Nijs J, Apeldoorn A, Hallegraeff H, Clark J, Smeets R, Malfliet A et al. Low back pain: guidelines for the clinical classification of predominant neuropathic, nociceptive, or central sensitization pain. Pain Phys 2015; 18(3):E333–E346
3. Nijs J, Van Houdenhove B, Oostendorp RA.Recognition of central sensitization in patients with musculoskeletal pain: application of pain neurophysiology in manual therapy practice. Man Ther 2010;15(2):135–141
4. Staud R, Craggs JG, Robinson ME, Perlstein WM, Price DD. Brain activity related to temporal summation of C-fiber evoked pain. Pain 2007;129(1-2):130–142
5. L. Arendt-Nielsen, B. Morlion, S. Perrot et al., “Assessment and manifestation of central sensitisation across different chronic pain conditions,” European Journal of Pain, vol. 22, no. 2, pp. 216–241, 2018
6. Nijs J, Leysen L, Vanlauwe J, et al. Treatment of central sensitization in patients with chronic pain: time for change? Expert Opin Pharmacother. 2019;20(16):1961-1970.
7. Yunus M. Central sensitivity syndromes: a unified concept for fibromyalgia and other similar maladies. J Indian Rheum Assoc 2000;8(1):27-33).
8. Yunus MB. Fibromyalgia and overlapping disorders: the unifying concept of central sensitivity syndromes. Semin Arthritis Rheum. 2007;36(6):339-356.
9. Woolf CJ. Central sensitization: implications for the diagnosis and treatment of pain. Pain. 2011 Mar; 152(3 Suppl): S2-15. PubMed PMID: 20961685. Pubmed Central PMCID: 3268359.
10. Ravindran M, Zheng Y, Timbol C, Merck S, Baraniuk J. Migraine headaches in chronic fatigue syndrom (CFS): comparison of two prospective cross-sectional studies. BMC Neurol. 2011; 11:30.
11. Ang D, Chakr R, France C, et al. Association of nociceptive responsivity with clinical and the moderating effect of depression. J Pain. 2011; 12:384–389.
12. Fernandez-de-Las-Penas C, Ortega-Santiago R, Cuadrado M, Lopez-de-Silanes C, Pareja A. Bilateral widespread mechanical pain hypersensitivity as sign of central sensitization in patients with cluster headache. Headache. 2011;51: 384–391.
13. Bezov D, Ashina S, Jensen R, Bendtsen L. Pain perception studies in tension-type headache. Headache. 2011; 51:262–271.
14. Van Houdenhove B, Luyten P. Central sensitivity syndromes: stress system failure may explain the whole picture. Semin Arthritis Rheum. 2009; 39:218–219.
15. Yunus MB. Role of central sensitization in symptoms beyond muscle pain, and the evaluation of a patient with widespread pain. Best Pract Res Clin Rheumatol. 2007;21: 481–491.
16. Sohail N. Stress and academic performance among medical students. J Coll Physicians Surg Pak 2013;23:67-71
17. Sharifirad G, Marjani A, Abdolrahman C, Mostafa Q, Hossein S. Stress among Isfahan medical sciences students. J Res Med Sci 2012;17:402-6
18. Yusoff MS, Yaacob MJ, Naing NN, Esa AR. Psychometric properties of the Medical Student Well-Being Index among medical students in a Malaysian medical school. Asian J Psychiatr 2013;6:60-5.
19. Rosal MC, Ockene IS, Ockene JK, et al. A longitudinal study of students' depression at one medical school. Academic Medicine : Journal of the Association of American Medical Colleges. 1997 Jun;72(6):542-546. DOI: 10.1097/00001888-199706000-00022. PMID: 9200590.
20. Shapiro, Shauna L. MA; Shapiro, Daniel E. PhD; Schwartz, Gary E. R. PhD. Stress Management in Medical EducationTable 1. A Review of the Literature on Stress Management in Medical Education, 1969 to 1998Table 1. Continued.Table 1. Continued.Table 1. Continued.Table 1. Continued.Table 1. Continued.: A Review of the Literature. Academic Medicine: July 2000 - Volume 75 - Issue 7 - p 748-759
21. Professor P.M. Niemi & P.T. Vainiomäki. Medical students’ distress – quality, continuity and gender differences during a six-year medical programme, Medical Teacher, 2006; 28:2, 136-141, DOI: 10.1080/01421590600607088
22. Mayer, T.G., Neblett, R., Cohen, H., Howard, K.J., Choi, Y.H., Williams, M.J., Perez, Y. and Gatchel, R.J. The Development and Psychometric Validation of the Central Sensitization Inventory. Pain Practice, 2012; 12: 276-285. https://doi.org/10.1111/j.1533-2500.2011.00493.x24.
23. Düzce Keleş E, Birtane M, Ekuklu G, Kılınçer C, Çalıyurt O, Taştekin N, et al. Validity and reliability of the Turkish version of the central sensitization inventory. Arch Rheumatol 2021;36(4):518-526.
24. Neblett R, Hartzell MM, Mayer TG, Cohen H, Gatchel RJ. Establishing clinically relevant severity levels for the central sensitization inventory. Pain Pract. 2017;17(2):166–75.
25. Haruyama, Y., Sairenchi, T., Uchiyama, K. et al. A large-scale population-based epidemiological study on the prevalence of central sensitization syndromes in Japan. Sci Rep 11, 23299 (2021). https://doi.org/10.1038/s41598-021-02678-1)
26. Wang XJ, Ebbert JO, Gilman EA, Rosedahl JK, Ramar P, Philpot LM. Central Sensitization Symptom Severity and Patient-Provider Relationships in a Community Setting. Journal of Primary Care & Community Health. 2021;12. doi:10.1177/21501327211031767
27. Ibrahim ME, Hefny MA. Central sensitization and adult attention deficit hyperactivity disorder in medical students with chronic back pain: a cross-sectional study. Egypt Rheumatol Rehabil. (2022) 49:24. 10.1186/s43166-022-00124-2
28. Mirza AA, Baig M, Beyari GM, Halawani MA, Mirza AA. Depression and Anxiety Among Medical Students: A Brief Overview. Adv Med Educ Pract. 2021 Apr 21;12:393-398. doi: 10.2147/AMEP.S302897. PMID: 33911913; PMCID: PMC8071692.
29. Rotenstein LS, Ramos MA, Torre M, et al. Prevalence of depression, depressive symptoms, and suicidal ideation among medical students a systematic review and meta-analysis. JAMA. 2016;316(21):2214– 2236. Doi:10.1001/jama.2016.17324.
30. Prinz P, Hertrich K, Hirschfelder U, de Zwaan M. Burnout, depression and depersonalisation–psychological factors and coping gies in dental and medical students. GMS Z Med Ausbild. 2012;29(1). doi:10.3205/zma000780
31. Smart KM, Blake C, Staines A, Doody C. The Discriminative validity of “nociceptive,” “peripheral neuropathic,” and “central sensitization” as mechanisms-based classifications of musculoskeletal pain. The Clinical Journal of Pain. 2011 Oct; 27(8): 655-63. PubMed PMID: 21471812.
32. Kötter T, Pohontsch NJ, oltmer E. Stressors and starting points for health-promoting interventions in medical school from the students’ perspective: a qualitative study. Perspect Med Educ. 2015; 4(3):128-35.
33. Niemi PM, ainioma ki PT. Medical students’ distress: quality, continuity and gender differences during a six-year medical programme. Med Teach. 2006; 28:136-141.
34. Cristina Roldán-Jiménez, PhD, David Pérez-Cruzado, PhD, Randy Neblett, MA, LPC, BCB, Robert Gatchel, PhD, Antonio Cuesta-Vargas, PhD, Central Sensitization in Chronic Musculoskeletal Pain Disorders in Different Populations: A Cross-Sectional Study, Pain Medicine, Volume 21, Issue 11, November 2020, Pages 2958–2963, https://doi.org/10.1093/pm/pnaa069.
35. Racine M, Tousignant-Laflamme Y, Kloda LA, Dion D, Dupuis G, Choinie`re M. A systematic literature review of 10 years of research on sex/gender and pain perception - part 2: Do biopsychosocial factors alter pain sensitivity differently in women and men? Pain 2012;153(3):619–35.
36. Bartley EJ, Fillingim RB. Sex differences in pain: A brief review of clinical and experimental findings. Br J Anaesth 2013;111 (1):52–8
37. Schug SA, Bruce J. Risk stratification for the development of chronic postsurgical pain. Pain Rep 2017;2(6): e 627.
38. Arnold, L. M., Hudson, J. I., Hess, E. V., Ware, A. E., Fritz, D. A., Auchenbach, M. B., Keck Jr, P. E. (2004). Family study of fibromyalgia. Arthritis and Rheumatism, 50(3), 944–952. https://doi.org/10.1002/art.20042
39. Kato, K., Sullivan, P. F., Evengard, B., & Pedersen, N. L. (2009). A population-based twin study of functional somatic syndromes. Psychological Medicine, 39(3), 497–505. https://doi.org/10.1017/S0033291708003784.
40. Harte, S., Harris, R., & Clauw, D. (2018). The neurobiology of central sensitization. Journal of Applied Biobehavioral Research, 23(2), e12137.
41. Yunus MB. Central sensitivity syndromes: a new paradigm and group nosology for fibromyalgia and overlapping conditions, and the related issue of disease versus illness. Semin Arthritis Rheum. 2008; 37:339–352.
42. Phillips, K., & Clauw, D. J. (2011). Central pain mechanisms in chronic pain states – Maybe it is all in their head. Best Practice & Research Clinical Rheumatology, 25(2), 141–154. https://doi.org/10.1016/j.berh.2011.02.005
43. Kindler, L. L., Bennett, R. M., & Jones, K. D. (2011). Central sensitivity syndromes: Mounting pathophysiologic evidence to link fibromyalgia with other common chronic pain disorders. Pain Management Nursing, 12(1), 15–24. https://doi. org/10.1016/j.pmn.2009.10.003

AN EVALUATION OF CENTRAL SENSITIZATION IN MEDICAL STUDENTS: A CROSS‑SECTIONAL STUDY

Yıl 2023, Cilt: 37 Sayı: 2, 141 - 151, 06.09.2023

Nihan Erdinç Gündüz Yıldırım Hakan Bayazit Rojin Bozarslan Orhun Serhat Baskal Ahmet Borikır İbrahim Emir Bayram Mustafa Samet Başdemir Ercan Beyaztaş Hülya Ellidokuz Elif Akalın

https://doi.org/10.18614/deutip.1275720

Öz

ABSTRACT:
Background/aim: The objective of this study is to evaluate central sensitization and associated factors in medical students.
Materials and methods: This cross-sectional study included medical students from all grades, aged 18–25 years. Central sensitization was determined based on the Central Sensitization Inventory, based on a Central Sensitization Inventory Part A score of 40 or higher. As associated factors, students were questioned about age, sex, body mass index, education grade, presence of diagnosed chronic disease, regular drug use and the presence of any central sensitization syndrome in first-degree relatives.
Results: 332 students were included with a median age of 21 (range: 18–25) years. A prevalence of central sensitization of 25.9% was identified and was significantly more common in the female respondents than the males (P=0.008). The findings of the Central Sensitization Inventory Part B revealed the most common central sensitization syndrome to be depression, with a rate of 9.0%. There was no significant difference between those with and without central sensitization in terms of age or body mass index (P>0.05). Central sensitization was statistically significantly higher in students who used drugs continuously than those who did not (P=0.021), and was statistically significantly higher in students with a family history of chronic fatigue syndrome, migraine and restless leg syndrome than those without (P=0.001, P<0.001 and P<0.001, respectively). Finally, central sensitization syndrome was statistically significantly more common in those with a family history of the condition.
Conclusion: The prevalence of central sensitization was found to be high in medical students and was associated with sex, family history and continuous drug use.

Anahtar Kelimeler

Central sensitization, Central Sensitization Inventory, Medical students

Proje Numarası

yok

Kaynakça

1. Neblett R, Cohen H, Choi Y, Hartzell MM, Williams M, Mayer TG, et al. The Central Sensitization Inventory (CSI): establishing clinically significant values for identifying central sensitivity syndromes in an outpatient chronic pain sample. J Pain 2013;14(5):438-45
2. Nijs J, Apeldoorn A, Hallegraeff H, Clark J, Smeets R, Malfliet A et al. Low back pain: guidelines for the clinical classification of predominant neuropathic, nociceptive, or central sensitization pain. Pain Phys 2015; 18(3):E333–E346
3. Nijs J, Van Houdenhove B, Oostendorp RA.Recognition of central sensitization in patients with musculoskeletal pain: application of pain neurophysiology in manual therapy practice. Man Ther 2010;15(2):135–141
4. Staud R, Craggs JG, Robinson ME, Perlstein WM, Price DD. Brain activity related to temporal summation of C-fiber evoked pain. Pain 2007;129(1-2):130–142
5. L. Arendt-Nielsen, B. Morlion, S. Perrot et al., “Assessment and manifestation of central sensitisation across different chronic pain conditions,” European Journal of Pain, vol. 22, no. 2, pp. 216–241, 2018
6. Nijs J, Leysen L, Vanlauwe J, et al. Treatment of central sensitization in patients with chronic pain: time for change? Expert Opin Pharmacother. 2019;20(16):1961-1970.
7. Yunus M. Central sensitivity syndromes: a unified concept for fibromyalgia and other similar maladies. J Indian Rheum Assoc 2000;8(1):27-33).
8. Yunus MB. Fibromyalgia and overlapping disorders: the unifying concept of central sensitivity syndromes. Semin Arthritis Rheum. 2007;36(6):339-356.
9. Woolf CJ. Central sensitization: implications for the diagnosis and treatment of pain. Pain. 2011 Mar; 152(3 Suppl): S2-15. PubMed PMID: 20961685. Pubmed Central PMCID: 3268359.
10. Ravindran M, Zheng Y, Timbol C, Merck S, Baraniuk J. Migraine headaches in chronic fatigue syndrom (CFS): comparison of two prospective cross-sectional studies. BMC Neurol. 2011; 11:30.
11. Ang D, Chakr R, France C, et al. Association of nociceptive responsivity with clinical and the moderating effect of depression. J Pain. 2011; 12:384–389.
12. Fernandez-de-Las-Penas C, Ortega-Santiago R, Cuadrado M, Lopez-de-Silanes C, Pareja A. Bilateral widespread mechanical pain hypersensitivity as sign of central sensitization in patients with cluster headache. Headache. 2011;51: 384–391.
13. Bezov D, Ashina S, Jensen R, Bendtsen L. Pain perception studies in tension-type headache. Headache. 2011; 51:262–271.
14. Van Houdenhove B, Luyten P. Central sensitivity syndromes: stress system failure may explain the whole picture. Semin Arthritis Rheum. 2009; 39:218–219.
15. Yunus MB. Role of central sensitization in symptoms beyond muscle pain, and the evaluation of a patient with widespread pain. Best Pract Res Clin Rheumatol. 2007;21: 481–491.
16. Sohail N. Stress and academic performance among medical students. J Coll Physicians Surg Pak 2013;23:67-71
17. Sharifirad G, Marjani A, Abdolrahman C, Mostafa Q, Hossein S. Stress among Isfahan medical sciences students. J Res Med Sci 2012;17:402-6
18. Yusoff MS, Yaacob MJ, Naing NN, Esa AR. Psychometric properties of the Medical Student Well-Being Index among medical students in a Malaysian medical school. Asian J Psychiatr 2013;6:60-5.
19. Rosal MC, Ockene IS, Ockene JK, et al. A longitudinal study of students' depression at one medical school. Academic Medicine : Journal of the Association of American Medical Colleges. 1997 Jun;72(6):542-546. DOI: 10.1097/00001888-199706000-00022. PMID: 9200590.
20. Shapiro, Shauna L. MA; Shapiro, Daniel E. PhD; Schwartz, Gary E. R. PhD. Stress Management in Medical EducationTable 1. A Review of the Literature on Stress Management in Medical Education, 1969 to 1998Table 1. Continued.Table 1. Continued.Table 1. Continued.Table 1. Continued.Table 1. Continued.: A Review of the Literature. Academic Medicine: July 2000 - Volume 75 - Issue 7 - p 748-759
21. Professor P.M. Niemi & P.T. Vainiomäki. Medical students’ distress – quality, continuity and gender differences during a six-year medical programme, Medical Teacher, 2006; 28:2, 136-141, DOI: 10.1080/01421590600607088
22. Mayer, T.G., Neblett, R., Cohen, H., Howard, K.J., Choi, Y.H., Williams, M.J., Perez, Y. and Gatchel, R.J. The Development and Psychometric Validation of the Central Sensitization Inventory. Pain Practice, 2012; 12: 276-285. https://doi.org/10.1111/j.1533-2500.2011.00493.x24.
23. Düzce Keleş E, Birtane M, Ekuklu G, Kılınçer C, Çalıyurt O, Taştekin N, et al. Validity and reliability of the Turkish version of the central sensitization inventory. Arch Rheumatol 2021;36(4):518-526.
24. Neblett R, Hartzell MM, Mayer TG, Cohen H, Gatchel RJ. Establishing clinically relevant severity levels for the central sensitization inventory. Pain Pract. 2017;17(2):166–75.
25. Haruyama, Y., Sairenchi, T., Uchiyama, K. et al. A large-scale population-based epidemiological study on the prevalence of central sensitization syndromes in Japan. Sci Rep 11, 23299 (2021). https://doi.org/10.1038/s41598-021-02678-1)
26. Wang XJ, Ebbert JO, Gilman EA, Rosedahl JK, Ramar P, Philpot LM. Central Sensitization Symptom Severity and Patient-Provider Relationships in a Community Setting. Journal of Primary Care & Community Health. 2021;12. doi:10.1177/21501327211031767
27. Ibrahim ME, Hefny MA. Central sensitization and adult attention deficit hyperactivity disorder in medical students with chronic back pain: a cross-sectional study. Egypt Rheumatol Rehabil. (2022) 49:24. 10.1186/s43166-022-00124-2
28. Mirza AA, Baig M, Beyari GM, Halawani MA, Mirza AA. Depression and Anxiety Among Medical Students: A Brief Overview. Adv Med Educ Pract. 2021 Apr 21;12:393-398. doi: 10.2147/AMEP.S302897. PMID: 33911913; PMCID: PMC8071692.
29. Rotenstein LS, Ramos MA, Torre M, et al. Prevalence of depression, depressive symptoms, and suicidal ideation among medical students a systematic review and meta-analysis. JAMA. 2016;316(21):2214– 2236. Doi:10.1001/jama.2016.17324.
30. Prinz P, Hertrich K, Hirschfelder U, de Zwaan M. Burnout, depression and depersonalisation–psychological factors and coping gies in dental and medical students. GMS Z Med Ausbild. 2012;29(1). doi:10.3205/zma000780
31. Smart KM, Blake C, Staines A, Doody C. The Discriminative validity of “nociceptive,” “peripheral neuropathic,” and “central sensitization” as mechanisms-based classifications of musculoskeletal pain. The Clinical Journal of Pain. 2011 Oct; 27(8): 655-63. PubMed PMID: 21471812.
32. Kötter T, Pohontsch NJ, oltmer E. Stressors and starting points for health-promoting interventions in medical school from the students’ perspective: a qualitative study. Perspect Med Educ. 2015; 4(3):128-35.
33. Niemi PM, ainioma ki PT. Medical students’ distress: quality, continuity and gender differences during a six-year medical programme. Med Teach. 2006; 28:136-141.
34. Cristina Roldán-Jiménez, PhD, David Pérez-Cruzado, PhD, Randy Neblett, MA, LPC, BCB, Robert Gatchel, PhD, Antonio Cuesta-Vargas, PhD, Central Sensitization in Chronic Musculoskeletal Pain Disorders in Different Populations: A Cross-Sectional Study, Pain Medicine, Volume 21, Issue 11, November 2020, Pages 2958–2963, https://doi.org/10.1093/pm/pnaa069.
35. Racine M, Tousignant-Laflamme Y, Kloda LA, Dion D, Dupuis G, Choinie`re M. A systematic literature review of 10 years of research on sex/gender and pain perception - part 2: Do biopsychosocial factors alter pain sensitivity differently in women and men? Pain 2012;153(3):619–35.
36. Bartley EJ, Fillingim RB. Sex differences in pain: A brief review of clinical and experimental findings. Br J Anaesth 2013;111 (1):52–8
37. Schug SA, Bruce J. Risk stratification for the development of chronic postsurgical pain. Pain Rep 2017;2(6): e 627.
38. Arnold, L. M., Hudson, J. I., Hess, E. V., Ware, A. E., Fritz, D. A., Auchenbach, M. B., Keck Jr, P. E. (2004). Family study of fibromyalgia. Arthritis and Rheumatism, 50(3), 944–952. https://doi.org/10.1002/art.20042
39. Kato, K., Sullivan, P. F., Evengard, B., & Pedersen, N. L. (2009). A population-based twin study of functional somatic syndromes. Psychological Medicine, 39(3), 497–505. https://doi.org/10.1017/S0033291708003784.
40. Harte, S., Harris, R., & Clauw, D. (2018). The neurobiology of central sensitization. Journal of Applied Biobehavioral Research, 23(2), e12137.
41. Yunus MB. Central sensitivity syndromes: a new paradigm and group nosology for fibromyalgia and overlapping conditions, and the related issue of disease versus illness. Semin Arthritis Rheum. 2008; 37:339–352.
42. Phillips, K., & Clauw, D. J. (2011). Central pain mechanisms in chronic pain states – Maybe it is all in their head. Best Practice & Research Clinical Rheumatology, 25(2), 141–154. https://doi.org/10.1016/j.berh.2011.02.005
43. Kindler, L. L., Bennett, R. M., & Jones, K. D. (2011). Central sensitivity syndromes: Mounting pathophysiologic evidence to link fibromyalgia with other common chronic pain disorders. Pain Management Nursing, 12(1), 15–24. https://doi. org/10.1016/j.pmn.2009.10.003

Toplam 43 adet kaynakça vardır.

Ayrıntılar

Birincil Dil	Türkçe
Konular	Klinik Tıp Bilimleri
Bölüm	Araştırma Makaleleri
Yazarlar	Nihan Erdinç Gündüz 0000-0002-0371-328X Yıldırım Hakan Bayazit 0009-0002-1201-0022 Rojin Bozarslan 0009-0002-8933-5757 Orhun Serhat Baskal 0009-0009-3695-1637 Ahmet Borikır 0009-0005-5011-7287 İbrahim Emir Bayram 0009-0007-1918-7839 Mustafa Samet Başdemir 0009-0000-4715-5374 Ercan Beyaztaş 0009-0005-8066-090X Hülya Ellidokuz 0000-0001-8503-061X Elif Akalın 0009-0008-4489-8349
Proje Numarası	yok
Yayımlanma Tarihi	6 Eylül 2023
Gönderilme Tarihi	3 Nisan 2023
Yayımlandığı Sayı	Yıl 2023 Cilt: 37 Sayı: 2

Kaynak Göster

Vancouver	Erdinç Gündüz N, Bayazit YH, Bozarslan R, Baskal OS, Borikır A, Bayram İE, Başdemir MS, Beyaztaş E, Ellidokuz H, Akalın E. Tıp Fakültesi Öğrencilerinde Santral Sensitizasyonun Değerlendirilmesi: Kesitsel Bir Çalışma. DEU Tıp Derg. 2023;37(2):141-5.

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