Depression and chronic pain in the elderly: links and management challenges

Zis, Panagiotis; Daskalaki, Argyro; Bountouni, Ilia; Sykioti, Panagiota; Varrassi, Giustino; Paladini, Antonella

doi:10.2147/cia.s113576

Cited by 288 publications

(242 citation statements)

References 140 publications

(137 reference statements)

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“…As in all conditions causing chronic pain, CTS has a negative effect on mental health in patients (Zis et al, ). The presence of chronic pain in CTS may play a large role in the mental health difficulties seen in CTS patients.…”

Section: Introductionmentioning

confidence: 99%

Anxiety and depression in patients with suspected carpal tunnel syndrome – A case controlled study

et al. 2019

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Purpose Carpal tunnel syndrome (CTS) is a common entrapment neuropathy causing significant, and often disabling, pain. We aimed to establish the prevalence of anxiety and depressive symptoms in patients who were referred with suspected CTS and identify potential determinants. Methods All patients underwent nerve conduction studies (NCS) and were classified into mild, moderate, severe, and no CTS groups. Volunteers, without symptoms or signs of CTS, formed the control group. Anxiety and depressive symptoms were assessed via the Hospital Anxiety and Depression Scale. Results Ninety‐one patients and 41 controls were recruited. Following NCS the patients were classified as follows: mild CTS (n = 20), moderate CTS (n = 21), severe CTS (n = 11), and no CTS (n = 31). CTS patients had significantly higher depression scores compared to controls but not anxiety scores. Patients experiencing pain and itchiness had significantly higher anxiety scores compared to those who did not. Patients who reported symptoms suggestive of CTS but did not meet the electrodiagnostic criteria for a diagnosis had significantly higher anxiety and depression scores compared to CTS patients and controls. Conclusions Patients suffering with CTS may be at an increased risk of depression. Experiencing pain in CTS may further increase the likelihood of experiencing mental health difficulties. Poor mental health can give rise to functional symptoms, similar to those seen in CTS, demonstrating the need for electrophysiological testing before considering surgical intervention.

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Section: Introductionmentioning

confidence: 99%

Anxiety and depression in patients with suspected carpal tunnel syndrome – A case controlled study

et al. 2019

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“…Lu et al found that when compared with American participants, Chinese participants in Hong Kong are more likely to report somatic symptoms instead of depressed feelings. The somatic symptoms include fatigue, pain, loss of appetite, and sleep problems …”

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confidence: 99%

Health Service Use Among Chinese American Older Adults: Is There a Somatization Effect?

Jiang

Sun

Wei

et al. 2019

J American Geriatrics Society

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BACKGROUND/OBJECTIVES: Somatization of depressive symptoms among Chinese American older adults remains understudied. This study aimed to identify whether the relationship between depressive symptoms and use of health services (ie, doctor visits, hospital, and emergency department) could be due to pain and whether acculturation played a role in the relations among depressive symptoms, pain, and health service use. DESIGN AND PARTICIPANTS: Secondary data came from the Population Study of Chinese Elderly in Chicago that surveyed 3159 Chinese community-dwelling older adults in the greater Chicago area. The average age was 76.3 years (standard deviation = 8.4); 57.95% were female). Negative binominal models were used to identify the effects of depression and pain on each type of health service use, controlling for sociodemographics and healthrelated factors (eg, chronic illness). MEASUREMENTS: Depressive symptoms were assessed using the Patient Health Questionnaire-9; pain was assessed by self-reported pain severity. Participants were classified into low, moderate, and high acculturation groups based on acculturation scores. RESULTS: Depressive symptoms and pain were positively related to health service use on the bivariate level. For groups with both low and high acculturation levels, depression and pain each independently predicted more health service use, whereas for the group with a moderate acculturation level, the effect of somatization was substantialized. CONCLUSION: Depression largely influenced health service use independently and partially through pain for older Chinese Americans. The somatization tended to be only salient for the moderate acculturation group, calling for more research attention to the complicated effect of acculturation. J Am Geriatr Soc 67:S584-S589, 2019.

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“…Both pharmacological and alternative therapies should be utilized for this population, especially for individuals with comorbidities [87]. AAs who receive outpatient mental health care incur lower costs for inpatient and emergency medical care [88].…”

Section: Discussionmentioning

confidence: 99%

Depression Treatment Status of Economically Disadvantaged African American Older Adults

et al. 2020

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Background: It is known that depression remains largely untreated in underserved communities. Hence, it is desirable to gain more knowledge on the prevalence and correlates of untreated depression among African-American (AA) older adults in economically disadvantaged areas. This knowledge may have the public health benefit of improving detection of AA older adults with depression who are at high risk of not receiving treatment, thereby reducing this health disparity. Objective: To study health and social correlates of untreated depression among AA older adults in economically disadvantaged areas. Methods: Between 2015 and 2018, this cross-sectional survey was conducted in South Los Angeles. Overall, 740 AA older adults who were 55+ years old entered this study. Independent variables were age, gender, living arrangement, insurance type, educational attainment, financial strain, chronic medical conditions, and pain intensity. Untreated depression was the dependent variable. Logistic and polynomial regression models were used to analyze these data. Results: According to the polynomial regression model, factors such as number of chronic medical conditions and pain intensity were higher in individuals with depression, regardless of treatment status. As our binary logistic regression showed, age, education, and number of providers were predictive of receiving treatment for depression. Conclusion: Age, educational attainment, number of providers (as a proxy of access to and use of care) may be useful to detect AA older adults with depression who are at high risk of not receiving treatment. Future research may focus on decomposition of the role of individual-level characteristics and health system-level characteristics that operate as barriers and facilitators to AA older adults receiving treatment for depression.

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Depression and chronic pain in the elderly: links and management challenges

Cited by 288 publications

References 140 publications

Anxiety and depression in patients with suspected carpal tunnel syndrome – A case controlled study

Anxiety and depression in patients with suspected carpal tunnel syndrome – A case controlled study

Health Service Use Among Chinese American Older Adults: Is There a Somatization Effect?

Depression Treatment Status of Economically Disadvantaged African American Older Adults

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