Abstract
Background and Objective: Frequently patients with chronic pain show depressive disorders. The co-morbidity of pain and depressive disorders has a negative impact on the patient’s outcome, with an increase of the costs relating to health expenses, a reduction of productivity and a reduction of a probable remission of depressive symptoms. Following the evidences till now examined and reported, the study group elaborated recommendations for the pain and depressive disorder treatment. Databases and Data Treatment: We searched all potentially relevant publications in Medline database from 1990 to 2014. A quality assessment was conducted categorizing following a power of evidence criteria. Results: Forty-six relevant publications were identified: 34 randomized and controlled studies (RCT), 11 metaanalyses or reviews of literature and 1 observational open-label. Conclusions: In a condition of co-morbidity of chronic pain and depressive disorder there is poor evidence for the tricyclic antidepressant efficacy. Among the inhibitors of the serotonin-noradrenalin reuptake, duloxetine proved to be efficient in the short-long term treatment of the pain and depressive disorder states. There is poor evidence for the inhibitor use of serotonin re-uptake in the co-morbidity states of arthritis pain and depressive disorder, against their higher efficacy in the irritable bowel syndrome
Highlights
RationaleFrequently patients with chronic pain show depressive disorders
There is poor evidence for the inhibitor use of serotonin re-uptake in the co-morbidity states of arthritis pain and depressive disorder, against their higher efficacy in the irritable bowel syndrome
From 199 record identified through database searching, 46 relevant publications were identified because the met the eligibility criteria:
Summary
Some epidemiological studies report a prevalence rate of depressive disorders in patients with a chronic pain at about 65% [1,2]. The co-morbidity of pain and depressive disorders has a negative impact on the patient’s outcome: there is an increase of the costs relating to health expenses, there is a reduction of productivity with an increase of absence from working days, and a reduction of a probable remission of depressive symptoms [3]. The co-morbidity of pain and depressive disorders has a negative impact on the patient’s outcome, with an increase of the costs relating to health expenses, a reduction of productivity and a reduction of a probable remission of depressive symptoms. Following the evidences till examined and reported, the study group elaborated recommendations for the pain and depressive disorder treatment. A quality assessment was conducted categorizing following a power of evidence criteria
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