Predicting treatment response in depressed and non-depressed chronic pain patients

Dworkin, Robert H.; Richlin, David M.; Handlin, David S.; Brand, Leonard

doi:10.1016/0304-3959(86)90120-x

Cited by 72 publications

(30 citation statements)

References 43 publications

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“…121,122 Although most studies (Table 3) support the finding that patients with pain and depression have poorer overall response to treatment than pain patients without depression, a few did not report such a relationship. 55,121,129,130 …”

Section: Does the Presence Of Depression Affect Clinical Outcomes In mentioning

confidence: 99%

Depression and Pain Comorbidity

Bair¹,

Robinson²,

Katon³

et al. 2003

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Because depression and painful symptoms commonly occur together, we conducted a literature review to determine the prevalence of both conditions and the effects of comorbidity on diagnosis, clinical outcomes, and treatment. The prevalences of pain in depressed cohorts and depression in pain cohorts are higher than when these conditions are individually examined. The presence of pain negatively affects the recognition and treatment of depression. When pain is moderate to severe, impairs function, and/or is refractory to treatment, it is associated with more depressive symptoms and worse depression outcomes (eg, lower quality of life, decreased work function, and increased health care utilization). Similarly, depression in patients with pain is associated with more pain complaints and greater impairment. Depression and pain share biological pathways and neurotransmitters, which has implications for the treatment of both concurrently. A model that incorporates assessment and treatment of depression and pain simultaneously is necessary for improved outcomes.

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Section: Does the Presence Of Depression Affect Clinical Outcomes In mentioning

confidence: 99%

Depression and Pain Comorbidity

Bair¹,

Robinson²,

Katon³

et al. 2003

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“…It is also suggested thatactivity and active involvement in treatment are particularly important with chronic pain patients who are depressed (Dworkin et al, 1986).…”

Section: Effect Of Depressive State On Treatmentmentioning

confidence: 99%

The Effect of Depressive Emotional State on the Efficacy of Physical Therapy in Patients with Low Back Pain

Mayalı¹,

Oz²,

Gülpek³

et al. 2016

Mid. Black Sea J of Health Sci.

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Objective: The aim was to investigate the effect of depressive emotional state on the efficacy of physical therapy in patients with chronic mechanical low back pain (LBP). Methods: Sixty patients with chronic LBP were included in the study. The patients were evaluated by a psychiatrist according to the Hamilton Depression Rating Scale (HAM-D) and separated into 2 groups regarding the cut off score. Group 1 consisted of 31 patients without depressive emotion while group 2 included 29 patients with depressive emotion. An exercise program consisting of lumbar dynamic stabilization exercises was instructed to all of the patients for 8 weeks. Infrared, ultrasound and TENS were applied to both groups for 15 seance. The pain was evaluated by visual analog scale (VAS), disability and quality of life was evaluated by Oswestry disability index and the Short-Form 36(SF-36) at baseline and 3rd and 8th weeks. Results: İmprovement at pain severity during ADL, rest and sitting position was found to be significantly higher in group 2 compared to group 1 patients at the 8th week (p<0.05). Oswestry scores and some subscale of SF-36; physical functioning, general health perception, vitality, mental health scores of group 2 were significantly higher compared to group 1 at baseline and the 8th week (p<0.05). Improvement of Oswestry scores between groups was not significantly different at 8th week (p>0.05), but improvement of some SF-36 subscale scores (pain, emotional role functioning, mental health) of groups significantly lower in group 2 compared to group 1 at the 8th weeks (p<0.05). Conclusions: Patients with chronic LBP and a depressive emotional state are inclined to have more disability and poorer quality of life, while physical therapy and exercises yield to less improvement in scores of pain and some subscales of the SF-36 in these patients than those without depressive affect.

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“…The data may justify treatment of these patients with antidepressant drugs. Finally, it is worth noting that the presence of depression in chronic-pain patients has been shown to affect the patient's treatment response [2]. If antidepressant medication is indicated, tricyclic antidepressants such as amitryptilin (75-150 mg daily) or doxepin (75-150 mg daily) are common [13].…”

Section: Psychodynamic Interpretation Of the Gd Symptomsmentioning

confidence: 99%

Glossodynia as an Expression of a Somatoform Disorder – a Hard-to-Grasp Psychodiagnostic Disease? With Presentation of a Single Case from a Psychodynamic Point of View

Niemeier¹,

Kupfer²,

Brosig³

et al. 2001

Dermatol Psychosom

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Background: Glossodynia (GD) patients are frequently ‘difficult’ patients. They usually have low emotional self-reference, are focused on their physical complaints and make the doctor-patient relationship difficult with their petulant-demanding behavior. Even when organic causes of physical complaints have been ruled out, these patients seldom receive adequate psychosomatic therapy. Case Report: The process of psychotherapeutic treatment of a female patient with GD of several years’ duration is reported. This patient found access to psychodynamic psychotherapy (PT) through the psychosomatic liaison service. The results of the test inventory used for diagnostic and therapy evaluation of the individual case (CSD (Coping with Skin Disease Questionnaire), SCL-90R (Symptom Check-List), TAS-26 (Toronto Alexithymia Scale)) are critically discussed. The patient showed very low values in all CSD scales compared to other patients in a psychosomatic liaison service. In the TAS-26, very high values were reported which indicate alexithymia. Conclusion: A meaningful treatment possibility is described using the example of successfully combined antidepressive drug therapy and psychodynamic PT of a glossodynia patient.

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Predicting treatment response in depressed and non-depressed chronic pain patients

Cited by 72 publications

References 43 publications

Depression and Pain Comorbidity

Depression and Pain Comorbidity

The Effect of Depressive Emotional State on the Efficacy of Physical Therapy in Patients with Low Back Pain

Glossodynia as an Expression of a Somatoform Disorder – a Hard-to-Grasp Psychodiagnostic Disease? With Presentation of a Single Case from a Psychodynamic Point of View

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