Measurement of prevalence of ′major depressive syndrome′ among Indian patients attending pain clinic with chronic pain using PHQ-9 scale

Abstract

Background:Presence of major depressive syndrome (MDS) in chronic pain patients (CPPs) requires more attention from the clinicians because of its clinical nature, association of suicidal thoughts and their actual completion, and treatment difficulties. The prevalence of MDS among Indian CPPs is not well studied.Aim:To determine the prevalence of MDS among Indian CPPs visiting pain clinic.Materials and Methods:In this prospective study, 476 patients who attended a pain clinic in a metropolitan city of India for chronic pain (pain more than six months) were included. They were assessed by ‘PHQ-9 depression scale’ for presence of MDS. Intensity of pain was assessed by ‘Visual analogue scale’ (VAS). Patient details (viz. age, sex), duration and site of pain, and scores of PHQ-9 depression scale and VAS, were noted and statistically analyzed.Results:146 out of 476 CPPs (30.67%) were found to suffer from MDS. Women were more prone (F: M =3:2) to develop MDS while suffering from chronic pain. Among 146 CPPs who were suffering from MDS, 108 (73.97%) patients also had suicidal thought. The prevalence of suicidal thought among all CPPs was found to be 22.69%. The depression severity was found to be strongly associated with intensity of pain (P = 0.005 < 0.05) but not associated with the duration of pain (P = 0.159 > 0.05) and age of the patient (P = 0.24 > 0.05).Conclusion:We found a high prevalence of MDS among CPPs from India and majority of them also harbored suicidal thought. Therefore, for successful outcome in chronic pain management routine psychological assessment in CPPs should be done to exclude the presence of MDS and suicidal thought.