Psychiatric disorders as assessed with SCID in chronic pain patients: the anxiety disorders precede the onset of pain

Gen Hosp Psychiatry. Jan-Feb 2012;34(1):46-52. doi: 10.1016/j.genhosppsych.2011.09.004. Epub 2011 Oct 15.

Abstract

Objective: The aim of the study was to determine the prevalence of psychiatric disorders in patients referred to a tertiary pain clinic. The temporal relationship between the onset of pain and depression and anxiety and the association of psychiatric disorders with pain intensity were also analyzed.

Method: One hundred consecutive outpatients underwent a psychiatric assessment using the Structured Clinical Interview and Statistical Manual of Mental Disorders Axis I.

Results: The psychiatric disorders diagnosed for the past 12 months included major depressive (37%), anxiety (25%) and substance use disorder (12%). The prevalence of any lifetime psychiatric disorder was 75%. Most anxiety disorders (77%) had been present before pain onset, whereas 63% of the depressive disorders appeared after the onset of pain. Psychiatric morbidity was associated with increased pain intensity.

Conclusions: Chronic pain patients have a remarkable psychiatric morbidity. A structured diagnostic interview, covering a large range of psychiatric diagnoses, allows a more comprehensive approach to the assessment of the patient. This should improve the management of chronic pain. However, prospective studies are needed to show this.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Anxiety Disorders / epidemiology*
  • Chronic Pain / epidemiology*
  • Comorbidity
  • Female
  • Finland / epidemiology
  • Humans
  • Interview, Psychological / methods*
  • Male
  • Mental Disorders / diagnosis
  • Mental Disorders / epidemiology*
  • Middle Aged
  • Regression Analysis