Joel Katz

• PhD CPsych FCAHS
• Distinguished Research Professor at York University

Past research has indicated that individuals with Ehlers-Danlos Syndromes (EDS) and Generalized Hypermobililty Spectrum Disorder (G-HSD) report psychological and psychiatric symptoms, particularly anxiety disorders and depressive symptoms, at much greater rates than the general population. However, these studies have been primarily conducted in sma...

Chronic postsurgical pain (CPSP) is a prevalent yet unintended consequence of surgery with substantial burdens to the individual and their family, the healthcare system, and society at large. The present article briefly reviews the evidence for transitional pain services (TPSs) that have arisen in an effort to prevent and mange CPSP and persistent...

Evidence-based treatment of chronic pain requires a multidisciplinary approach grounded in the biopsychosocial model. Implementing this approach within health systems relies on its acceptance by both healthcare providers and patients. While pioneering multidisciplinary pain clinics can serve as a model for implementation, a systematic effort is nee...

Background Negative perceptions of psilocybin and challenges of participant enrollment may represent barriers to conducting a randomized controlled trial examining psilocybin for chronic neuropathic pain. Aim Prior to trial initiation, we aimed to examine patient attitudes toward the trial via a prospective preference assessment. Methods Twenty-s...

Background The clinical landscape of limb loss rehabilitation across Canada is poorly delineated, lacks standard rehabilitation guidelines, and is without a shared clinical database. Objective To address these gaps, the objective of the present study was to undertake an environmental scan of the rehabilitation centers across Canada that provide in...

Purpose Risk factors for the development of chronic postsurgical pain (CPSP) have been reported in primary studies and an increasing number of reviews. The objective of this umbrella review was to compile and understand the published presurgical risk factors associated with the development of CPSP for various surgery types. Methods Six databases w...

Introduction The Transitional Pain Service (TPS) is an innovative, personalized approach to postsurgical opioid consumption and pain management. The objectives of this study were to identify trajectories of opioid consumption and pain intensity within 12 months after initiating treatment through the TPS, identify biopsychosocial factors associated...

Anxiety sensitivity and hopelessness are two traits that have been previously linked to increased gaming problems. Research in the early stages of the COVID-19 pandemic showed that emotionally vulnerable individuals were turning to video games as a means of coping with their distress. However, more research is needed on the long-term and enduring p...

BACKGROUND Adherence to medication regimens is critical to effectively manage chronic diseases, prevent their complications, and reduce costs. Text messaging interventions, are a potentially cost-effective way to support chronic disease management in developing nations, owing to the increasing availability of mobile phones. OBJECTIVE To systematic...

Background There has been a recent and, for many within the chronic pain space, long-overdue increase in literature that focuses on equity, diversity, inclusion, and decolonization (EDI-D) to understand chronic pain among people who are historically and structurally marginalized. Aims In light of this growing attention in chronic pain research, we...

Introduction Clinical hypnosis has been proposed for post-surgical pain management for its potential vagal-mediated anti-inflammatory properties. Evidence is needed to understand its effectiveness for post-surgical recovery. Iin this secondary outcome study, it was hypothesized that surgical oncology patients randomized to receive perioperative cli...

BACKGROUND Understanding the association of acute pain intensity and opioid consumption after cardiac surgery with chronic postsurgical pain (CPSP) can facilitate implementation of personalized prevention measures to improve outcomes. The objectives were to (1) examine acute pain intensity and daily mg morphine equivalent dose (MME/day) trajectorie...

Background: Sensitivity to pain traumatization is defined as the propensity to develop cognitive, affective, and behavioral responses to pain that resemble a traumatic stress reaction. To date, sensitivity to pain traumatization has been assessed in adults (Sensitivity to Pain Traumatization Scale [SPTS-12]) and parents of youth with chronic pain...

Clinical hypnosis is an effective strategy for managing acute pain in the surgical setting. However, the opioid sparing effects of clinical hypnosis are not as well understood. This pre-registered (NCT03730350) randomized, controlled trial (RCT) examined the impact of clinical hypnosis, pre- and post-surgery, on opioid consumption during hospitaliz...

Background Internet-based cognitive behavioral therapy (CBT) and stand-alone mindfulness meditation interventions are gaining empirical support for a wide variety of mental health conditions. In this study, we test the efficacy of web-based therapist-guided mindfulness-based cognitive behavioral therapy (CBT-M) for body dysmorphic disorder (BDD), a...

BACKGROUND Internet-based cognitive behavioral therapy (CBT) and stand-alone mindfulness meditation interventions are gaining empirical support for a wide variety of mental health conditions. In this study, we test the efficacy of web-based therapist-guided mindfulness-based cognitive behavioral therapy (CBT-M) for body dysmorphic disorder (BDD), a...

Introduction It has been well described that a small but significant proportion of patients continue to use opioids months after surgical discharge. We sought to evaluate postdischarge opioid use of patients who were seen by a Transitional Pain Service compared with controls. Methods We conducted a retrospective cohort study using administrative d...

BACKGROUND Background: Chronic pain affects ~8 million Canadians (~20%), impacting their physical and mental health while burdening the healthcare system with costs of upwards of 60 billion dollars a year. Indeed, patients are often trialed on numerous medications over several years without reductions to their symptoms. Therefore, there is an urgen...

Background Chronic pain affects approximately 8 million Canadians (~20%), impacting their physical and mental health while burdening the health care system with costs of upwards of US $60 billion a year. Indeed, patients are often trialed on numerous medications over several years without reductions to their symptoms. Therefore, there is an urgent...

Purpose: To examine feasibility and acceptability of providing stepped collaborative care case management targeting posttraumatic stress disorder (PTSD) and pain symptoms after major traumatic injury. Materials and methods: Participants were major trauma survivors in Victoria, Australia, at risk of persistent pain or PTSD with high baseline symp...

Objectives Chronic pain (CP) is a poorly recognised and frequently inadequately treated condition affecting one in five adults. Reflecting on sociodemographic disparities as barriers to CP care in Canada was recently established as a federal priority. The objective of this study was to assess sex and gender differences in healthcare utilisation tra...

Early in the COVID-19 pandemic, social interactions were constrained by physical distancing guidelines. Consequently, some individuals may have turned to video games to cope with isolation and negative emotions. Previous studies have shown that people who struggle with anxiety and depression are at particular risk for developing problem gaming beha...

Background: Chronic post-surgical pain is a common complication of surgery. The role of psychological risk factors like depression and anxiety is substantially understudied in cardiac surgery. This study sought to identify perioperative factors associated with chronic pain at 3, 6, and 12 months after cardiac surgery. We hypothesize that baseline...

Background Current evidence supports physical activity (PA) as an adjunctive treatment for major depressive disorder (MDD). Few studies, however, have examined the relationship between objectively measured PA and MDD treatment outcomes using prospective data. Objective This study is a secondary analysis of data from a 24-week internet-based, mindf...

BACKGROUND Current evidence supports physical activity (PA) as an adjunctive treatment for major depressive disorder (MDD). Few studies, however, have examined the relationship between objectively measured PA and MDD treatment outcomes using prospective data. OBJECTIVE This study is a secondary analysis of data from a 24-week internet-based, mindf...

Tonya M Palermo,1 Karen Deborah Davis,2 Didier Bouhassira,3 Robert W Hurley,4 Joel D Katz,5 Francis J Keefe,6 Michael E Schatman,7,8 Dennis C Turk,1 David Yarnitsky9 1Department of Anesthesiology & Pain Medicine, University of Washington, Seattle, Washington, USA; 2Department of Surgery and Institute of Medical Science, Krembil Brain Institute, Uni...

Background: With >700 transplant surgeries performed each year, Toronto General Hospital (TGH) is currently one of the largest adult transplant centers in North America. There is a lack of literature regarding both the identification and management of chronic postsurgical pain (CPSP) after organ transplantation. Since 2014, the TGH Transitional Pa...

Science and medicine have a long and troubling history of reinforcing racist, antiethnic, and sexist attitudes and beliefs, as well as ignoring and mistreating marginalized people. In their editorial in Nature,1 titled “Science Must Overcome Its Racist Legacy,” Nobles and colleagues described how the scientific enterprise has reinforced racist beli...

There have been several recent calls to “re-think chronic pain” in response to the growing awareness of social inequities that impact the prevalence of chronic pain and its management. This in turn has resulted in new explorations of suffering as it relates to pain. While laudable, many of these clinically oriented accounts are abstract and often f...

LAY SUMMARY Canadian Armed Forces (CAF) servicemembers and Veterans with chronic pain and posttraumatic stress disorder (PTSD) symptoms were surveyed. Participants with a high number of PTSD symptoms had a higher vulnerability to becoming psychologically traumatized by their chronic pain than participants with a low number of PTSD symptoms. In turn...

Currently, ketamine is used in treating multiple pain, mental health, and substance abuse disorders due to rapid-acting analgesic and antidepressant effects. Its limited short-term durability has motivated research into the potential synergistic actions between ketamine and psychotherapy to sustain benefits. This systematic review on ketamine-assis...

Phantom limb pain (PLP) impacts the majority of individuals who undergo limb amputation. The PLP experience is highly heterogenous in its quality, intensity, frequency and severity. This heterogeneity, combined with the low prevalence of amputation in the general population, has made it difficult to accumulate reliable data on PLP. Consequently, we...

[This corrects the article DOI: 10.2196/29726.].

UNSTRUCTURED This is a corrigendum.

The bidirectional relationship between anxiety and chronic pain in youth is well-known, but how anxiety contributes to the maintenance of pediatric chronic pain needs to be elucidated. Sensitivity to pain traumatization (SPT), an individual’s propensity to develop responses to pain that resemble a traumatic stress response, may contribute to the mu...

Recent cross-sectional studies have identified differences in autobiographical memory (AM) among individuals with chronic pain, but temporal relationship between the two is unknown. Moreover, AM has yet to be studied in patients undergoing major surgery. The present study addressed these gaps by conducting a prospective, longitudinal study of memor...

Background: Three to 22% of youth undergoing surgery develop chronic postsurgical pain (CPSP). Negative biases in pain memories (i.e., recalling higher levels of pain as compared to initial reports) are a risk factor for CPSP development. Children's memories for pain are modifiable. Existing memory-reframing interventions reduced negatively biased...

Memory biases for previous pain experiences are known to be strong predictors of postsurgical pain outcomes in children. Until recently, much research on the subject in youth has assessed the sensory and affective components of recall using single-item, self-report pain ratings. However, a newly emerging focus in the field has been on the episodic...

A growing number of studies have identified high rates of pediatric chronic postsurgical pain (CPSP) after major surgery. Pediatric CPSP is associated with pain-related distress and co-morbid mental health outcomes, such as anxiety and depression. From a biopsychosocial perspective, youth factors, such as genetics, epigenetics, sex, pre-surgical pa...

Background: Posttraumatic stress disorder (PTSD) is a debilitating, undertreated condition. The web-based delivery of cognitive behavioral therapy supplemented with mindfulness meditation and yoga is a viable treatment that emphasizes self-directed daily practice. Objective: This study aims to examine the effectiveness of a web-based cognitive beh...

In this chapter, the authors focus on the transition of acute to chronic pain after surgery. They provide a selective overview of chronic postsurgical pain (CPSP). The authors review the basic epidemiology of CPSP according to surgery type; define the concept of a risk factor and the requirements for determining causality; and describe the surgical...

Insulin-like growth factors (IGFs) have diverse functions in skeletal muscles by acting through multiple signaling pathways, including growth regulation and differentiation, anti-inflammation and anti-oxidation. IGFs have anti-inflammatory effects and also play roles in nociceptive pathways, determining pain sensitivity, in addition to their protec...

Purpose The Sensitivity to Pain Traumatization Scale (SPTS-12) was developed to assess the propensity to develop a traumatic stress response to pain. The SPTS-12 is a reliable and valid scale with a one-factor structure. The aim of the present study is to further examine the psychometric properties of the SPTS-12 by evaluating its criterion validit...

Introduction: The Ehlers-Danlos Syndromes (EDS) and Generalized Hypermobility Spectrum Disorders (G-HSD) comprise a heterogeneous group of genetic disorders of abnormal synthesis and/or maturation of collagen and other matricellular proteins. EDS is commonly characterized by manifestations such as multi joint hypermobility that can lead to musculos...

Objective: The present systematic review aimed to evaluate the association between childhood maltreatment and chronic pain, with specific attention to the temporal nature of the relationship and putative moderators, including, the nature (type), timing of occurrence, and magnitude of maltreatment; whether physical harm or injury occurred; and whet...

Purpose Limb loss occurs for various reasons (trauma, infection, vascular diseases, tumors, congenital absence). Limb loss is known to result in several types of pain. Little is known about pain in residents with missing limbs admitted to complex chronic care (CCC) facilities. This study examined the presence of pain and its intensity in CCC reside...

Hypertension-related hypoalgesia, defined as lower pain sensitivity in individuals with high blood pressure, has yet to be examined in a large-scale study of complex care residents. Here, the Continuing Care Reporting System database, which contains health information on residents of Canadian complex chronic care facilities, was used for assessment...

Ehlers-Danlos Syndrome (EDS) are a heterogeneous group of genetic connective tissue disorders, and typically manifests as weak joints that subluxate/dislocate, stretchy and/or fragile skin, organ/systems dysfunction, and significant widespread pain. Historically, this syndrome has been poorly understood and often overlooked. As a result, people liv...

This chapter explores the efficacy of psychotherapeutic interventions for patients with type 2 diabetes mellitus (T2DM). This condition can lead to serious adverse health outcomes (e.g., cardiovascular disease, blindness, loss of limbs, etc.). Medical interventions alone are often not sufficient to manage the disease. Psychotherapy can promote beha...

BACKGROUND: Posttraumatic Stress Disorder (PTSD) is a debilitating condition that remains undertreated. Online delivery of cognitive behavioural therapy supplemented with mindfulness meditation and yoga can be a viable treatment that emphasizes self-directed practice. OBJECTIVE: This study examined the effectiveness of an online cognitive behaviou...

Sensitivity to pain traumatization (SPT) is defined as the propensity to develop responses to pain that resemble a traumatic stress reaction. To date, SPT has been assessed in adults with a self-report measure (Sensitivity to Pain Traumatization Scale (SPTS-12)). SPT may also be relevant in the context of parenting a child with chronic pain, as man...

Objective This systematic review synthesized evidence about the relationship between childhood bullying victimization and chronic pain, with a focus on the temporal nature of the relationship and moderating factors, such as the type and intensity of victimization. Method We included prospective cohort studies that examined the relationship between...

Understanding the predisposing factors that confer a greater or lesser risk of developing chronic, or persistent, pain is an essential step in chronic pain prevention and management. This chapter focuses on current theoretical models that can inform prevention of pediatric pain and disability. We review the literature on known risk/protective facto...

PurposeChronic post-surgical pain (CPSP) is a highly prevalent complication following thoracic surgery. This is a prospective cohort study that aims to describe the pain trajectories of patients undergoing thoracic surgery beginning preoperatively and up to 1 year after surgery Methods Two hundred and seventy nine patients undergoing elective thora...

Chronic postsurgical pain (CPSP) and disability after cardiothoracic surgery are highly prevalent and difficult to treat. Researchers have explored a variety of presurgical risk factors for CPSP and disability after cardiothoracic surgery, including one study that examined distress from bodily sensations. The current prospective, longitudinal study...

Background: Approximately 70% of mental health disorders appear prior to 25 years of age and can become chronic when ineffectively treated. Individuals between 18 and 25 years old are significantly more likely to experience mental health disorders, substance dependencies, and suicidality. Treatment progress, capitalizing on the tendencies of youth...

Pediatric chronic post-surgical pain is a surgical complication associated with various levels of functional limitation. Two commonly used measures of functional limitations in youth are the Functional Disability Inventory (FDI) and the PROMIS Pediatric Pain Interference Scale (PPIS), where the former is general, and the latter, pain specific. The...

Background: The incidence of mental health disorders in Canada is increasing with costs of CAD $51 billion (US $40 billion) per year. Depression is the most prevalent cause of disability while cognitive behavioral therapy (CBT) is the best validated behavioral depression treatment. CBT, when combined with mindfulness meditation (CBT-M), has strong...

BACKGROUND The incidence of mental health disorders in Canada is increasing with costs of CAD $51 billion (US $40 billion) per year. Depression is the most prevalent cause of disability while cognitive behavioral therapy (CBT) is the best validated behavioral depression treatment. CBT, when combined with mindfulness meditation (CBT-M), has strong e...

Background: Chronic pain imposes a large burden on individuals and society. A patient-centric digital chronic pain management app called Manage My Pain (MMP) can be used to enhance communication between providers and patients and promote self-management. Objective: The purpose of this study was to evaluate the real-world engagement of patients i...

Higher meaning in life (MIL) consistently predicts better health, but the physiological processes underlying this relationship are not well understood. This study examined the relationship between MIL and vagally-mediated heart rate variability (VmHRV) under resting (N = 77), stressor (n = 73), and mindfulness intervention (n = 72) conditions. Regr...

Objective: To evaluate the feasibility and safety of hyperbaric oxygen therapy (HBOT) in patients with fibromyalgia (FM). Design: A cohort study with a delayed treatment arm used as a comparator. Setting: Hyperbaric Medicine Unit, Toronto General Hospital, Ontario, Canada. Subjects: Eighteen patients diagnosed with FM according to the Americ...

Although certain risk factors can identify individuals who are most likely to develop chronic pain, few interventions to prevent chronic pain have been identified. To facilitate the identification of preventive interventions, an IMMPACT meeting was convened to discuss research design considerations for clinical trials investigating the prevention o...

Objectives: The appropriateness and relevance of somatic symptom disorder and conversion disorder ( American Psychiatric Association, 2013 ) diagnoses are in question as they relate to pediatric chronic pain. This survey-based study on pediatric chronic pain explores how these psychiatric diagnoses are made and perceived and how treatment of patien...

BACKGROUND Chronic pain imposes a large burden on individuals and society. A patient-centric digital chronic pain management app called Manage My Pain (MMP) can be used to enhance communication between providers and patients and promote self-management. OBJECTIVE The purpose of this study was to evaluate the real-world engagement of patients in ur...

Background: Posttraumatic stress disorder (PTSD) is a debilitating, undertreated condition. The web-based delivery of cognitive behavioral therapy supplemented with mindfulness meditation and yoga is a viable treatment that emphasizes self-directed daily practice. Objective: This study aims to examine the effectiveness of a web-based cognitive b...

BACKGROUND Posttraumatic stress disorder (PTSD) is a debilitating, undertreated condition. The web-based delivery of cognitive behavioral therapy supplemented with mindfulness meditation and yoga is a viable treatment that emphasizes self-directed daily practice. OBJECTIVE This study aims to examine the effectiveness of a web-based cognitive behav...

Purpose Disease multimorbidity and pain is a complex, yet common, problem for the aging population, and a significant burden on the health-care systems around the world. Despite this, disease comorbidity and the association with pain in a complex chronic care population is not well understood. This study examined the most prevalent disease combinat...

Trajectory modelling techniques have been developed to determine subgroups within a given population and are increasingly used to better understand intra- and inter-individual variability in health outcome patterns over time. The objectives of this narrative review are to explore various trajectory modelling approaches useful to epidemiological res...

Objective Mobile health platforms have become an important component of pain self-management programs and hundreds of mobile applications are commercially available for patients to monitor pain. However, few of these applications have been developed in collaboration with healthcare professionals or have been critically evaluated. Manage My Pain is...

Background: Insulin-like growth factor-1 (IGF-1) plays an important role in muscle maintenance and repair. The role of IGF-2 in the muscle is less clear. Objectives: To compare the levels of IGF-1 and IGF-2 in acute myofascial pain syndrome (MPS) versus healthy controls and to determine whether age, sex, body mass index (BMI), region of pain, an...

Background Approximately 70% of mental health disorders appear prior to 25 years of age and can become chronic when ineffectively treated. Individuals between 18 and 25 years old are significantly more likely to experience mental health disorders, substance dependencies, and suicidality. Treatment progress, capitalizing on the tendencies of youth t...

BACKGROUND Approximately 70% of mental health disorders appear prior to 25 years of age and can become chronic when ineffectively treated. Individuals between 18 and 25 years old are significantly more likely to experience mental health disorders, substance dependencies, and suicidality. Treatment progress, capitalizing on the tendencies of youth t...

Background The objective of this study was to evaluate the psychometric properties of the 17‐item Tampa Scale for Kinesiophobia (TSK) in youth. Methods Participants were 264 children and adolescents (58.7% female, M age=14.1 years, SD age=2.51) scheduled for major surgery who were assessed before surgery, while in hospital postoperatively, and at...

Many health care professions have reacted swiftly to the COVID-19 pandemic. In-person care has been ramped down and telemedicine/telehealth has been thrust to the forefront of clinical care. For people living with chronic pain and often concomitantly dealing with opioid-related issues, this is a time of great stress. With population-wide movements...

Differences in vagally mediated heart rate variability between a primary headache group and a control group.