Treatment Modalities for Chronic Pain in Elderly Patients With Depression

Pakniyat-Jahromi, Soroush; Amazan, Ralph; Garrels, Eric; Zamiri, Azadeh; Galo, Alejandra Ruiz; Gunturu, Sasidhar

doi:10.4088/pcc.21r03097

Cited by 3 publications

(3 citation statements)

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“…As supported by a recent systematic review from 2022 focusing on elderly patients with depression, it is imperative to acknowledge the importance of adopting a comprehensive approach that includes both pharmacological and non-pharmacological interventions (such as physical therapy and physiatry procedures) for patients enduring chronic pain [33]. This strategy ensures a more nuanced and effective therapeutic response, aligning with evolving medical perspectives and best practices.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with depression in patients undergoing rehabilitation for chronic pain: a cross-sectional analytical study at a referral hospital in Peru

De la Cerna-Luna,

Fernandez-Guzman,

Machicado-Chipana

et al. 2024

International Journal of Rehabilitation Research

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Despite the well-known impact of depression on patients with chronic pain and its association, few studies have evaluated its related factors in Physical Medicine and Rehabilitation settings. The objective of the present study was to assess the factors associated with depression in adult patients undergoing rehabilitation for chronic pain at Hospital Rebagliati (HNERM) in Peru. A cross-sectional analytical study was conducted between June and August 2023, involving 212 adult patients with chronic pain undergoing rehabilitation at HNERM. Data were collected through a survey, including sociodemographic information, pain characteristics, and depression assessment using the Patient Health Questionnaire-9 (PHQ-9). Statistical analysis included descriptive statistics and generalized linear models to identify factors associated with depression. Among 212 participants, 17.9% had a depression diagnosis based on the PHQ-9 (cutoff score: 10 points). Factors associated with a higher frequency of depression included a time since pain diagnosis of 3–6 months [adjusted prevalence ratios (aPR): 1.15, 95% confidence interval (CI): 1.04–1.27], severe pain (aPR: 1.17, 95% CI: 1.04–1.32), comorbidities (for 1: aPR: 1.21, 95% CI: 1.08–1.35; for 2: aPR: 1.17, 95% CI: 1.06–1.29; for ≥3: aPR: 1.27, 95% CI: 1.10–1.47), use of ≥2 medications for pain management (aPR: 1.27, 95% CI: 1.13–1.42), and receipt of psychological therapy (aPR: 1.26, 95% CI: 1.09–1.46). Nonpharmacological interventions did not show an association with an increased prevalence of depression. These findings underscore the significance of adopting a comprehensive approach to chronic pain management, including the screening, assessment, and treatment of associated depression.

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Section: Discussionmentioning

confidence: 99%

Factors associated with depression in patients undergoing rehabilitation for chronic pain: a cross-sectional analytical study at a referral hospital in Peru

De la Cerna-Luna,

Fernandez-Guzman,

Machicado-Chipana

et al. 2024

International Journal of Rehabilitation Research

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“…In a review of 37 articles on older adults (greater than 65 years old) with chronic pain and depression, several different therapies were reported [3]. These included dog-assisted therapy, medical marijuana, transcutaneous magnetic stimulation, cognitive behavior therapy, anti-depressants and daloxetine.…”

Section: Chengmentioning

confidence: 99%

“…In contrast to the data on adolescents, in patients older than 65, the prevalence of chronic pain appears to be lower. For example, in a review of 37 studies the authors reported that the prevalence of comorbid chronic pain and depression was only 13% [3].…”

mentioning

confidence: 99%

Chronic Pain and Comorbid Depression: A Narrative Review

Field

2024

J Clin Psychol Neurol

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This narrative review of research includes summaries of 44 papers on the comorbid conditions of chronic pain and depression that were published during the years 2022 and 2023. The publications of this period are primarily randomized controlled trials and systematic reviews/ meta-analyses of randomized controlled trials. Many of these are focused on the prevalence of chronic pain and depression which ranged from 7% to 25% in different age groups and in different countries. Many of the studies addressed the bidirectionality of chronic pain and depression and predictors including stress and inactivity. Ketamine was the most frequent intervention in this literature. And, the most frequent underlying mechanism was involvement of the amygdala. Surprisingly, very few studies focused on youth and on long-term effects of the comorbidity of chronic pain and depression. Methodological problems relate to the variability in the assessments of chronic pain and depression, the selfreport measures and the cross-sectional data that are not definitive about directionality of the chronic pain and depression relationship.

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