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High Level of Psychiatric Disorders Found in Individuals with Chronic Pain

December 16, 2019
Depression, anxiety, and other emotional distress are common in this population.

A PPM Brief

Psychiatric problems significantly affect somatic disorders, which can make treatment difficult and affect prognosis negatively. In some studies, rates of psychiatric disorders in patients with chronic pain have been shown to be higher than the general population.1 One recent study2 evaluated comorbid psychiatric disorders in patients with chronic pain to examine the effects of sociodemographic details and the level of somatic sense perception on disease severity.

What is the relationship between somatic sense perception levels and comorbid psychiatric diseases in chronic pain patients? (Image: iStockPhoto)

Approximately 51 chronic pain patients (72.5% female, mean age 41.1 ± 11.4; 27.5% male, mean age 38.2 ± 10.3) were admitted and evaluated to the pain outpatient clinic at the Cukurova University School of Medicine in Adana, Turkey, between August 2013 and March 2014. Patients had reported complaints of chronic pain and met with a psychiatrist for possible psychiatric comorbidities. Sociodemographic characteristics of the patients (age, gender, education level, and marital status) were recorded, and their chronic pain was classified as idiopathic or secondary to organic etiology. The Symptom Checklist-90, Somatosensory Amplification Scale (SSAS), Hamilton Depression Rating Scale, and the Hamilton Anxiety Scale (HAM-A) were used, resulting in the following findings:

  • A 74.5% incidence of psychiatric disorders was present in the patient sample
  • At 37.3%, somatoform disorders were the most frequently diagnosed
  • The rate of depressive and anxiety disorders was 29.4% and 23.5%, respectively
  • Comorbid anxiety scores (P = 0.019) and SSAS scores (P = 0.046) were significantly higher in chronic pain patients with a somatoform disorder
  • HAM-A scores were found to be significantly higher in patients with depression (P = 0.004)
  • A positive and linear relationship was determined between the SSAS score and depression, anxiety, and the severity of mental symptoms.

The high prevalence of psychiatric disorders in chronic pain patients found in this study aligns with similar study findings,3-5 as depression, anxiety and emotional distress are among the most frequently assessed negative psychological factors in patients with chronic pain. In terms of practical application, the research team urged in their paper that psychiatric evaluations be offered in pain clinics, and that pain physicians be cautious about patients who have been diagnosed with chronic pain for more than 1 year as they may have developed a psychiatric comorbid disorder.

“Although the mechanisms of the relationship between chronic pain and psychiatric disorders are not fully understood, effective management of both pain intensity and comorbid psychiatric conditions is necessary for the quality of life of patients,” they concluded.

Last updated on: December 16, 2019
Continue Reading:
Chronic Pain and Psychopathology in the Veteran and Disadvantaged Populations
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