Prevalence and correlates of psychiatric comorbidity in chronic pain patients: A hospital-based study

Abstract

Background: There is a paucity of information on psychiatric comorbidity in chronic pain patients in developing countries like India. The present study was undertaken in this context. Aim: The aim of this study is to assess the psychiatric comorbidity in chronic pain patients. Materials and Methods: Fifty adult chronic pain patients without organic cause of more than 6 months duration attending outpatient departments were included in the study with their informed consent. Psychiatric comorbidity was assessed by the Schedules for Clinical Assessment in Neuropsychiatry. Results: Majority (80%) of patients was between 18 and 50 years of age, came from nuclear families (88%), and was married (82%). Majority (76%) of patients had pain <2 years; 56% had moderate pain severity and 54% had moderate functional impairment due to pain. In chronic pain patients, 78% had psychiatric comorbidity; the most common disorder was depression (36%) followed by generalized anxiety disorder (18%), somatoform disorder (16%), and panic disorder (8%) patients indicating that patients with chronic pain are more likely to have mood disorder than other psychiatric disorders. A significant association was seen between psychiatric comorbidity and pain severity but not with sociodemographic characteristics. Psychiatric comorbidity was associated with severity of pain. Head and neck and back pain patients reported high prevalence of depression (39.5% and 36%), while chest pain and limb pain patients had high prevalence of generalized anxiety disorder (45.5% and 33.3%). There was high prevalence of nonspecific symptoms such as localized tension pain (90%) and worry (82%) in chronic pain patients. Conclusion: The high prevalence of psychiatric comorbidity in patients suffering from chronic pain disorders emphasize the need to screen these patients for psychiatric disorders, particularly depression and anxiety. Diagnosis and treatment of comorbid psychiatric disorders will greatly improve the management of chronic pain patients.