Scott, Jenny;
(2021)
Can compassion-based interventions (CBIs) improve depressive symptoms in patients with chronic pain? A systematic review and the acute and long-term effects of sub-anaesthetic ketamine on pain, mood and cognitive functioning in chronic pain patients.
Doctoral thesis (D.Clin.Psy), UCL (University College London).
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Abstract
Part one of this thesis is a systematic review examining the evidence for compassion-based interventions in reducing depressive symptoms in chronic pain patients. Eleven studies were included in the review, of which ten reported improvements in depression symptoms after the completion of a compassion-based intervention. However, there was considerable variation in the quality of the reviewed literature. Part two of this thesis presents an empirical study comparing the acute and long-term effects of sub-anaesthetic ketamine infusions (compared to lidocaine) on pain, mood and cognitive functioning in chronic pain patients. Long-term follow-up data was collected and compared with baseline, mid-infusion, post-infusion and one-week follow-up data. Although ketamine produced superior analgesic effects over lidocaine during the acute phase, this difference between the two groups was no longer present at one-week follow-up or long-term follow-up. Ketamine did not show any specific antidepressant effects in a chronic pain population, either acutely or over the longer-term. Ketamine acutely impaired performance on tasks of episodic memory, verbal fluency and working memory and concentration which was hypothesised to be due to a practice-blocking effect. However, these impairments were no longer observed at long-term follow-up. Part three of this thesis presents a critical appraisal of this research. It reflects on various aspects of the research process, including the impact of COVID-19 and my experiences of conducting research in a clinical setting. This thesis is a joint project with Laura Marks, who completed qualitative analyses of interviews with ketamine patients. Additionally, this is a continuation of a previous project by past UCL DClinPsy trainees: Georgia Halls (2020), Joe Kibble (2020), Matt Knox (2018) and Catherine Trotman (2018).
| Type: | Thesis (Doctoral) |
|---|---|
| Qualification: | D.Clin.Psy |
| Title: | Can compassion-based interventions (CBIs) improve depressive symptoms in patients with chronic pain? A systematic review and the acute and long-term effects of sub-anaesthetic ketamine on pain, mood and cognitive functioning in chronic pain patients |
| Event: | UCL (University College London) |
| Open access status: | An open access version is available from UCL Discovery |
| Language: | English |
| Additional information: | Copyright © The Author 2021. Original content in this thesis is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) Licence (https://creativecommons.org/licenses/by-nc/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request. |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10134800 |
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