Depression Prevalence in Neuropathic Pain and Its Impact on the Quality of Life

Abstract

Introduction. The management of neuropathic pain remains complex, generally because of the psychiatric comorbidity that is often underdiagnosed. The objectives of our work were to determine the link between depression and the characteristics of NP on the one hand and quality of life on the other hand, in a sample of subjects consulting for neuropathic pain (NP) regardless of etiology. Methods. We conducted a cross-sectional study involving 61 neuropathic pain consulting patients in whom we assessed five parameters, namely, neuropathic pain based on DN4, pain intensity using EVA, anxiety, and depression according to the HADS and quality of life. Results. The study population mean age was 52.71 ± 14.29 years while the sex ratio (m/f) was 0.52. The neuropathic pain’s most common etiologies were postherpetic pain, carpal tunnel syndrome, and diabetic neuropathy. Depression and anxiety prevailed by 65.6% and 73.7%, respectively. The quality of life was impaired with average SF-12 physical and mental scores of 33.76 ± 8.03 and 37.78 ± 11.52, respectively. The overall mean BPI score was 5.53 ± 1.76. Patients with high DN4 scores were significantly more depressed (p=0.025). A significantly positive association was found between the depression score and the pain intensity (p=0.001, r = 0.41). Depressed subjects had a poor quality of life according to SF-12 and BPI. Conclusion. Given the depressive comorbidity impact on the neuropathic pain components as well as the quality of life, screening for this comorbidity should be part of the baseline ND assessment.

Predicting the Quality of Life in Patients With Painful Diabetic Neuropathy (PDN) Based on Pain Severity, Pain Catastrophizing, Pain Acceptance, Depression, Anxiety, and Sleep Disturbance: Assessing the Prevalence of Psychiatric Symptoms in Iranian Patients With PDN.

“…These resultsare in line with previous studies in other countries. For example, in Tunisian patients with PDN, depression, and anxiety rates are 65.6% and 73.7% (18).Also, in the USA, the anxiety rate in PDN is reported to be 57% which is close to our results (38).Also, various researches in chronic pain found that sleep disturbances rate range between 50% to 80% (39,40). So, in Iranian patients with PDN, sleep disturbances are higher than in almost all countries.…”

“…In another study, painrelated factors reduced QoL in patients with diabetes (33).Furthermore, Cherif et al (2020) found that depression symptoms extensively reduced Qol in patients with PDN. Moreover, they found that depression was positively correlated with pain severity (18).Also, Pain Catastrophizing Is Independently Associated with Qol in medical contexts (34).…”

“…The minimum score in this test can be 0, and the maximum can be 63. The cut-off scores of BDI include minimal or nothing depression (0-13), mild depression (14)(15)(16)(17)(18)(19), moderate depression (20)(21)(22)(23)(24)(25)(26)(27)(28), and severe (above 29). In the BDI.II, the cut-off point for adulthood depression in the medical context is 14 (26).BDI is utilized for measuring depressed patients' signs and symptoms.…”

“…Researches have demonstrated that the Persian version of BAI has high-grade reliability (r=0.72), a suitable validity (r=0.83), and an excellent internal consistency (a=0.92) (29).According to the manual, the suggested cutoff for clinically signi cant anxiety on the BAI is 16. The BAI category includes no anxiety (0-16), moderate anxiety (17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35), and severe anxiety (36-63) (30,31).…”

“…However, various studies have targeted a number of these symptoms in various ways (6,8,11,14).Therefore, the contribution of each one in reducing these patients' Qol has not been determined. It has been associated with limitations such as meager sample size (less than 60 people) (18,19), failure to conduct individual interviews (9), and lack of examination in psychological variables (20). On the Qol, a better understanding of factors related to Qol is gained in this study.…”