Health service utilization in patients with major depression and co‐morbid pain

Abstract

Aims: Patients with depression often have co-morbid pain symptoms. However, rates of service utilization by psychiatric in-patients with co-morbid pain symptoms are unknown. The purpose of this study is to estimate whether patients with major depression and co-morbid pain access medical treatment for their pain as much as their counterparts with psychiatric diagnoses other than major depression.Methods: A total of 103 patients (62 female; 41 male) were assessed for a diagnosis of major depression applying a psychiatric clinical interview followed by a self-report pain questionnaire, which assessed physical pain in psychiatric patients. Results:Patients with major depression reported higher rates of pain symptoms in the past 6 and 12 months than their counterparts with a psychiatric diagnosis other than major depression. Analysis of variance showed that patients with depression were less likely to attend medical and specialist services for their pain symptoms than their counterparts. On the contrary, depressed patients with pain attended more frequently general in-patient services than nondepressed patients with pain. Conclusions:Patients with depression suffer high rates of pain symptoms, but are at higher risk of not accessing appropriate services suggesting inadequate service utilization. The results have implications for screening and health care delivery for psychiatric patients with pain.

The need for long-term surveillance of recovery of psychiatric patients with somatic complaints

“…A poor health status, bodily pains and psychosomatic symptoms were linked with depressive symptoms. The study subjects reported long-lasting physical pains paralleling to the study of Alvarenga et al [8] of patients with MDD and pain. Indeed, depression complicates the treatment of patients with pain, and vice versa [12,17].…”

“…One of the most common ailments of depressive patient in primary care is bodily pain. This association is bi-directional [8,9]. Also somatisation, distress [10] and anxiety have a role in pain complaints [11], but depression has been shown to be the most detrimental to quality of life, ability to function [12] and overall health among chronic physical diseases [13].…”

A longitudinal study to explain the pain‐depression link in older adults with osteoarthritis

“…Chronic pain conditions are associated with substantial disability and costs to the individual and to the health care system (1, 2), which is related in part to the high prevalence of concomitant depression (3–5). Comorbid depression has been associated with reduced adherence by patients to effective pain interventions (6, 7), as well as with reduced effectiveness of these therapies when used (8).…”

Internet Cognitive–Behavioral Therapy for Depression in Older Adults With Knee Osteoarthritis: A Randomized Controlled Trial

“…Results and effect sizes are reported in Table T2 2. There were significant group by time interactions for the primary outcome measures (PHQ-9: F [3,191.03] = 9.82, P < 0.001 and K-10: F [3,190.06] = 6.37, P < 0.001). Posttreatment scores were significantly lower in the iCBT group relative to TAU on the primary outcomes, with a large between-group effect size for PHQ-9 scores (Hedges g = 1.01, 95% confidence interval [95% CI] 0.47, 1.54) and a medium effect size for the K-10 (Hedges g = 0.75, 95% CI 0.23, 1.28).…”

“…Approximately 1 in 5 adults with OA experience depressed mood (3)(4)(5)(6). Due to increases in life expectancy, obesity, sedentary lifestyle, and an aging population, OA is the fastest growing major health condition worldwide (7)(8)(9).…”