AN INDEX OF DEPRESSION IN PATIENTS WITH CHRONIC NONSPECIFIC MUSCULOSKELETAL PAIN
AbstractBackground: The present study was undertaken to derive an index of depression in patients with chronic non-specific musculoskeletal pain and to determine correlation between these two parameters. Method: The study was carried out at the Shaikh Zayed Hospital Lahore from November 2001 to May 2002 and included 36 patients with pain for at least 4-24 weeks duration; an equal number of healthy people acted as controls. Depression was assessed among subjects by administering the General Health Questionnaire (GHQ) to patients and controls and obtaining their GHQ scores. Pain assessment was performed in patients by scoring the total number of pain sites on digital palpation to provide a Total Pain Score (TPS). Results: Patients differed significantly from controls in their GHQ scores (patients 20.47 ± 7.19, controls 3.11 ± 1.89 respectively, p<0.001). The GHQ score and the TPS score correlated significantly in patients (r=0.517, p=0.001). Conclusions: Patients with chronic non-specific musculoskeletal pain suffer from significant levels of depression, in direct correlation to their pain.Key Words: Depression, Chronic pain, Musculoskeletal pain
Reza H, Khan MM. Depressive disorder: diagnosis and management in general practice in Pakistan. J Pak Med Assoc 2003; 53(10):500-5.
Laederach-Hofmann K, Fisch HU. Diagnosis and therapy of depression in the heart disease patient Ther Umsch 2003; 60(11):703-7.
Patten SB, Beck CA, Williams JV, Barbui C, Metz LM. Major depression in multiple sclerosis: a population-based perspective. Neurology 2003; 61(11):1524-7.
Escalante A, del Rincon I, Mulrow CD. Symptoms of depression and psychological distress among Hispanics with rheumatoid arthritis. Arthritis Care Res 2000; 13(3):156-67.
Yucedal C, Olmez N, Gezen G, Celik F, Altindag A, Yilmaz ME, Kara IH. Depression in dialysis patients. EDTNA ERCA J 2003; 29(3):151-5.
Smith EM, Gomm SA, Dickens CM. Assessing the independent contribution to quality of life from anxiety and depression in patients with advanced cancer. Palliat Med 2003;17(6):509-13.
Wilson RS, Mendes De Leon CF, Bennett DA, Bienias JL, Evans DA. Depressive symptoms and cognitive decline in a community population of older persons. J Neurol Neurosurg Psychiatry 2004;75(1):126-9.
Wojnar M, Drozdz W, Araszkiewicz A, Szymanski W, Nawacka-Pawlaczyk D, Urbanski R. Prevalence of depressive disorders among perimenopausal women seeking gynecological services. Psychiatr Pol 2003; 37(5):811-24.
Fiske A, Gatz M, Pedersen NL. Depressive symptoms and aging: the effects of illness and non-health-related events. J Gerontol B Psychol Sci Soc Sci 2003; 58(6):P320-8.
Swallow BL, Lindow SW, Masson EA, Hay DM. Psychological health in early pregnancy: relationship with nausea and vomiting. J Obstet Gynaecol 2004; 24(1):28-32.
Nonacs R, Cohen LS. Assessment and treatment of depression during pregnancy: an update. Psychiatr Clin North Am 2003; 26(3):547-62.
Hofberg K, Ward MR. Fear of pregnancy and childbirth. Postgrad Med J 2003; 79(935):505-10.
Oates MR, Cox JL, Neema S, Asten P, Glangeaud-Freudenthal N, Figueiredo B, et al; TCS-PND Group. Postnatal depression across countries and cultures: a qualitative study. Br J Psychiatry (Suppl) 2004; 46:s10-6.
Lukasik A, Blaszczyk K, Wojcieszyn M, Belowska A. Characteristics of affective disorders of the first week of puerperium. Ginekol Pol 2003; 74(10):1194-9.
Berle JO, Aarre TF, Mykletun A, Dahl AA, Holsten F. Screening for postnatal depression. Validation of the Norwegian version of the Edinburgh Postnatal Depression Scale, and assessment of risk factors for postnatal depression. J Affect Disord 2003;76(1-3):151-6.
Carney RM, Blumenthal JA, Catellier D, Freedland KE, Berkman LF, Watkins LL, et al. Depression as a risk factor for mortality after acute myocardial infarction. Am J Cardiol 2003; 92(11):1277-81.
Stewart RA, North FM, West TM, Sharples KJ, Simes RJ, Colquhoun DM, et al. Long-Term Intervention With Pravastatin in Ischaemic Disease (LIPID) Study Investigators. Depression and cardiovascular morbidity and mortality: cause or consequence? Eur Heart J 2003;24(22):2027-37.
Blumenthal JA, Lett HS, Babyak MA, White W, Smith PK, Mark DB, et al. NORG Investigators. Depression as a risk factor for mortality after coronary artery bypass surgery. Lancet 2003; 362(9384):604-9.
Rosenthal MH. The challenge of comorbid disorders in patients with depression. J Am Osteopath Assoc 2003;103(8 Suppl 4):S10-5.
Schoevers RA, Beekman AT, Deeg DJ, Jonker C, van Tilburg W. Comorbidity and risk-patterns of depression, generalised anxiety disorder and mixed anxiety-depression in later life: results from the AMSTEL study. Int J Geriatr Psychiatry 2003;18(11):994-1001.
Iosifescu DV, Nierenberg AA, Alpert JE, Smith M, Bitran S, Dording C, et al. The impact of medical comorbidity on acute treatment in major depressive disorder. Am J Psychiatry 2003;160(12):2122-7.
Katon WJ, Lin E, Russo J, Unutzer J. Increased medical costs of a population-based sample of depressed elderly patients. Arch Gen Psychiatry 2003; 60(9):897-903.
Greenberg PE, Kessler RC, Birnbaum HG, Leong SA, Lowe SW, Berglund PA, et al. The economic burden of depression in the United States: how did it change between 1990 and 2000? J Clin Psychiatry 2003;64(12):1465-75.
Thomas CM, Morris S. Cost of depression among adults in England in 2000. Br J Psychiatry 2003;183:514-9.
Greenberg PE, Leong SA, Birnbaum HG, Robinson RL. The economic burden of depression with painful symptoms. J Clin Psychiatry 2003;64 Suppl 7:17-23.
Passamonti M, Pigni M, Fraticelli C, Calori G, Piccinelli M. Varese Group Study of Depression in General Practice. Somatic symptoms and depression in general practice in Italy. Eur J Gen Pract 2003;9(2):66-7.
Mittermaier C, Dejaco C, Waldhoer T, Oefferlbauer-Ernst A, Miehsler W, Beier M, etal. Impact of depressive mood on relapse in patients with inflammatory bowel disease: a prospective 18-month follow-up study. Psychosom Med 2004; 66(1):79-84.
Lampe IK, Hulshoff Pol HE, Janssen J, Schnack HG, Kahn RS, Heeren TJ. Association of depression duration with reduction of global cerebral gray matter volume in female patients with recurrent major depressive disorder. Am J Psychiatry 2003; 160(11):2052-4.
Spiegel D, Giese-Davis J. Depression and cancer: mechanisms and disease progression. Biol Psychiatry 2003; 54(3):269-82.
Bair MJ, Robinson RL, Katon W, Kroenke K. Depression and pain comorbidity: a literature review. Arch Intern Med 2003; 163(20):2433-45.
Ohayon MM, Schatzberg AF. Using chronic pain to predict depressive morbidity in the general population. Arch Gen Psychiatry 2003; 60(1):39-47.
Ong KS, Keng SB. The biological, social, and psychological relationship between depression and chronic pain. Cranio 2003; 21(4):286-94.
Ciccone DS, Natelson BH. Comorbid illness in women with chronic fatigue syndrome: a test of the single syndrome hypothesis. Psychosom Med 2003; 65(2):268-75.
Geisser ME, Robinson ME, Miller QL, Bade SM. Psychosocial factors and functional capacity evaluation among persons with chronic pain. J Occup Rehabil 2003; 13(4):259-76.
Campbell LC, Clauw DJ, Keefe FJ. Persistent pain and depression: a biopsychosocial perspective. Biol Psychiatry 2003; 54(3):399-409.
Brown ES, Varghese FP, McEwen BS. Association of depression with medical illness: does cortisol play a role? Biol Psychiatry 2004; 55(1):1-9.
Dubas-Slemp H, Marmurowska-Michalowska H, Szuster-Ciesielska A, Kaminska T, Kandefer-Szerszen M. The role of cytokines in depression. Psychiatr Pol 2003; 37(5):787-98.
Tuglu C, Kara SH, Caliyurt O, Vardar E, Abay E. Increased serum tumor necrosis factor-alpha levels and treatment response in major depressive disorder. Psychopharmacology (Berl) 2003; 170(4):429-33.
Hestad KA, Tonseth S, Stoen CD, Ueland T, Aukrust P. Raised plasma levels of tumor necrosis factor alpha in patients with depression: normalization during electroconvulsive therapy. J ECT 2003; 19(4):183-8.
Shepherd M, Cooper B, Brown AC. General Heath Questionnaire. In: Psychiatric Illness in General Practice 1981. Oxford University Press, New York.
Croft P, Scholum J, Silman A. Population study of tender points count and pain as evidence of fibromyalgia. BMJ 1994; 309 (6956): 696-9.
ISAP Subcommittee on Taxonomy. Classification of chronic pain. Pain (suppl 3) 1986; S25-S214.
Ciaramella A, Grosso S, Poli P, Gioia A, Inghirami S, Massimetti G, et al. When pain is not fully explained by organic lesion: a psychiatric perspective on chronic pain patients. Eur J Pain 2004; 8(1):13-22.
Rethelyi JM, Berghammer R, Ittzes A, Szumska I, Purebl G, Csoboth C. Comorbidity of pain problems and depressive symptoms in young women: results from a cross-sectional survey among women aged 15-24 in Hungary. Eur J Pain 2004; 8(1):63-9.
Edwards R, Augustson E, Fillingim R. Differential relationships between anxiety and treatment-associated pain reduction among male and female chronic pain patients. 25: Clin J Pain 2003; 19(4):208-16.
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