Browse > Article
http://dx.doi.org/10.3344/kjp.2018.31.2.116

Prevalence of unrecognized depression in patients with chronic pain without a history of psychiatric diseases  

Lee, Ho-Jin (Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital)
Choi, Eun Joo (Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital)
Nahm, Francis Sahngun (Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital)
Yoon, In Young (Department of Neuropsychiatry, Seoul National University Bundang Hospital)
Lee, Pyung Bok (Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital)
Publication Information
The Korean Journal of Pain / v.31, no.2, 2018 , pp. 116-124 More about this Journal
Abstract
Background: We aimed to investigate the prevalence of unrecognized depression in patients with chronic pain, but with no history of psychiatric diseases. Methods: Patients with chronic pain who did not have a history of psychiatric disease were selected for this study. The Beck Depression Index (BDI) was used to evaluate depression. Participants' socio-demographic characteristics and pain-related characteristics were also recorded. Results: The study included 94 consecutive patients with chronic pain (28 men and 66 women). Based on the BDI scores, 33/94 (35.1%) patients with chronic pain had comorbid depression. The prevalence of depression was significantly higher in our cohort than it was in the general population (P < 0.001). The standardized incidence ratio, adjusted for age and sex, was 2.77 in men and 2.60 in women. Patients who were unmarried (odds ratio [OR] = 3.714, P = 0.044), and who had subjective sleep disturbance (OR = 8.885, P < 0.001), were more likely to have moderate to severe depression. Patients with high education levels (OR = 0.244, P = 0.016), and who were economically active (OR = 0.284, P = 0.023), were less likely to have moderate to severe depression. Conclusions: Our results indicate that unrecognized depression in patients with chronic pain is common. Therefore, pain physicians should actively seek to identify these problems rather than relying on the patient to volunteer such information.
Keywords
Age factors; Chronic pain; Delayed diagnosis; Depression; Marital status; Mental disorders; Outpatient clinics; Pain clinics;
Citations & Related Records
Times Cited By KSCI : 1  (Citation Analysis)
연도 인용수 순위
1 Pain terms: a list with definitions and notes on usage. Recommended by the IASP Subcommittee on Taxonomy. Pain 1979; 6: 249.
2 Keogh E, Cochrane M. Anxiety sensitivity, cognitive biases, and the experience of pain. J Pain 2002; 3: 320-9.   DOI
3 Gatchel RJ, Turk DC. Psychosocial factors in pain: critical perspectives. New York (NY), Guilford Press. 1999.
4 Gaskin ME, Greene AF, Robinson ME, Geisser ME. Negative affect and the experience of chronic pain. J Psychosom Res 1992; 36: 707-13.   DOI
5 Benjamin S, Morris S, McBeth J, Macfarlane GJ, Silman AJ. The association between chronic widespread pain and mental disorder: a population-based study. Arthritis Rheum 2000; 43: 561-7.   DOI
6 Gureje O, Simon GE, Von Korff M. A cross-national study of the course of persistent pain in primary care. Pain 2001; 92: 195-200.   DOI
7 Bair MJ, Robinson RL, Katon W, Kroenke K. Depression and pain comorbidity: a literature review. Arch Intern Med 2003; 163: 2433-45.   DOI
8 Kim AR, Seo BB, Kim JM, Bae JI, Jang YH, Lee YC, et al. Beck depression inventory score and associated factors in Korean patients with lumbar spinal stenosis. Korean J Pain 2007; 20: 138-42.   DOI
9 Boakye PA, Olechowski C, Rashiq S, Verrier MJ, Kerr B, Witmans M, et al. A critical review of neurobiological factors involved in the interactions between chronic pain, depression, and sleep disruption. Clin J Pain 2016; 32: 327-36.   DOI
10 Lamb SE, Guralnik JM, Buchner DM, Ferrucci LM, Hochberg MC, Simonsick EM, et al. Factors that modify the association between knee pain and mobility limitation in older women: the Women's Health and Aging Study. Ann Rheum Dis 2000; 59: 331-7.   DOI
11 Croft PR, Papageorgiou AC, Ferry S, Thomas E, Jayson MI, Silman AJ. Psychologic distress and low back pain. Evidence from a prospective study in the general population. Spine (Phila Pa 1976) 1995; 20: 2731-7.   DOI
12 Burton AK, Tillotson KM, Main CJ, Hollis S. Psychosocial predictors of outcome in acute and subchronic low back trouble. Spine (Phila Pa 1976) 1995; 20: 722-8.   DOI
13 Arnow BA, Hunkeler EM, Blasey CM, Lee J, Constantino MJ, Fireman B, et al. Comorbid depression, chronic pain, and disability in primary care. Psychosom Med 2006; 68: 262-8.   DOI
14 Cepoiu M, McCusker J, Cole MG, Sewitch M, Belzile E, Ciampi A. Recognition of depression by non-psychiatric physicians: a systematic literature review and meta-analysis. J Gen Intern Med 2008; 23: 25-36.   DOI
15 Wancata J, Windhaber J, Bach M, Meise U. Recognition of psychiatric disorders in nonpsychiatric hospital wards. J Psychosom Res 2000; 48: 149-55.   DOI
16 Rhee M, Lee Y, Park S, Shon C, Jeong Y, Hong S, et al. A standardization study of beck depression inventory I-Korean version (K-BDI): reliability and factor analysis. Korean J Psychopathol 1995; 4: 77-95.
17 Kohli C, Kishore J, Agarwal P, Singh SV. Prevalence of unrecognised depression among outpatient department attendees of a rural hospital in delhi, India. J Clin Diagn Res 2013; 7: 1921-5.
18 Barney LJ, Griffiths KM, Jorm AF, Christensen H. Stigma about depression and its impact on help-seeking intentions. Aust N Z J Psychiatry 2006; 40: 51-4.   DOI
19 Roeloffs C, Sherbourne C, Unutzer J, Fink A, Tang L, Wells KB. Stigma and depression among primary care patients. Gen Hosp Psychiatry 2003; 25: 311-5.   DOI
20 Love AW. Depression in chronic low back pain patients: diagnostic efficiency of three self-report questionnaires. J Clin Psychol 1987; 43: 84-9.
21 Geisser ME, Roth RS, Robinson ME. Assessing depression among persons with chronic pain using the Center for Epidemiological Studies-Depression Scale and the Beck Depression Inventory: a comparative analysis. Clin J Pain 1997; 13: 163-70.   DOI
22 Aragon T, Fay M, Wollschlaeger D. EpiTools: R package for epidemiologic data and graphics. Vienna, Comprehensive R Archive Network. 2010.
23 Jang Y, Kim G, Hansen L, Chiriboga DA. Attitudes of older Korean Americans toward mental health services. J Am Geriatr Soc 2007; 55: 616-20.   DOI
24 Ministry of Health and Welfare, Korea Centers for Disease Control and Prevention. Korea Health Statistics 2013: Korea National Health and Nutrition Examination Survey (KNHANES VI-1). Cheongju, Korea Centers for Disease Control and Prevention. 2014.
25 Cho M, Sung S, Shin S, Kim J, Jeon S, Kim M. The epidemiological survey of mental disorders in Korea. Seoul, Ministry of Health and Welfare. 2011.
26 Goldman LS, Nielsen NH, Champion HC. Awareness, diagnosis, and treatment of depression. J Gen Intern Med 1999; 14: 569-80.   DOI
27 O'Connor DW, Rosewarne R, Bruce A. Depression in primary care. 1: elderly patients' disclosure of depressive symptoms to their doctors. Int Psychogeriatr 2001; 13: 359-65.   DOI
28 Cho SJ, Lee JY, Hong JP, Lee HB, Cho MJ, Hahm BJ. Mental health service use in a nationwide sample of Korean adults. Soc Psychiatry Psychiatr Epidemiol 2009; 44: 943-51.   DOI
29 Menchetti M, Belvederi Murri M, Bertakis K, Bortolotti B, Berardi D. Recognition and treatment of depression in primary care: effect of patients' presentation and frequency of consultation. J Psychosom Res 2009; 66: 335-41.   DOI
30 Bertakis KD, Azari R, Callahan EJ. Patient pain: its influence on primary care physician-patient interaction. Fam Med 2003; 35: 119-23.
31 Whooley MA. Screening for depression--A tale of two questions. JAMA Intern Med 2016; 176: 436-8.   DOI
32 Whooley MA, Avins AL, Miranda J, Browner WS. Case-finding instruments for depression. Two questions are as good as many. J Gen Intern Med 1997; 12: 439-45.   DOI
33 Fishbain DA, Cutler R, Rosomoff HL, Rosomoff RS. Chronic pain-associated depression: antecedent or consequence of chronic pain? A review. Clin J Pain 1997; 13: 116-37.   DOI
34 Hahm BJ, Kim JK, Cho MJ. Prevalence, incidence, and risk factors of dementia and depressive disorders of the elderly residing in the community: a two stage one-year follow-up study. J Korean Geriatr Psychiatry 1999; 3: 140-8.
35 Wilson KG, Eriksson MY, D'Eon JL, Mikail SF, Emery PC. Major depression and insomnia in chronic pain. Clin J Pain 2002; 18: 77-83.
36 Gerrits MM, van Oppen P, van Marwijk HW, Penninx BW, van der Horst HE. Pain and the onset of depressive and anxiety disorders. Pain 2014; 155: 53-9.   DOI
37 Nicassio PM, Wallston KA. Longitudinal relationships among pain, sleep problems, and depression in rheumatoid arthritis. J Abnorm Psychol 1992; 101: 514-20.   DOI