Pain and depression in older people: comorbidity and patterns of help seeking.
BACKGROUND
Chronic pain and mood disorders are common in older people. Their relationship however remains unclear. Only a few studies have investigated the role of pain in mental health service use and received psychopharmacological treatment.


METHODS
Cross-sectional study of the 65+ subsample from the European Study on the Epidemiology of Mental Disorders (ESEMeD). 4401 non-institutionalized individuals were interviewed using the third version of the Composite International Diagnostic Interview (CIDI-3.0).


RESULTS
Painful physical symptoms (PPS) were more likely in people with a 12-month major depressive episode (MDE) than in those without (OR=2.0). Help seeking for emotional problems was uncommon, but PPS were a significant predictor of help-seeking (OR=1.7). Respondents with MDE more frequently used benzodiazepines than antidepressants. The presence of PPS in respondents without depression resulted in a significant increase in the use of psychotropic medication.


CONCLUSIONS
PPS were strongly and independently associated with major depressive disorder. Their presence had an influence on help seeking behavior and use of psychotropic medication.


CONCLUSIONS
The cross-sectional nature of this study does not allow determination of direction of causality.
Bonnewyn
A
A
University Psychiatric Center KuLeuven, Campus Gasthuisberg, Leuven, Belgium. anke.bonnewyn@uz.kuleuven.ac.be
Katona
C
C
Bruffaerts
R
R
Haro
J M
JM
de Graaf
R
R
Alonso
J
J
Demyttenaere
K
K
D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000627:therapeutic use; D001569:Benzodiazepines / Q000627:therapeutic use; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000188:drug therapy / Q000453:epidemiology* / Q000523:psychology; D004363:Drug Utilization / Q000706:statistics & numerical data; D005060:Europe; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D010146:Pain / Q000188:drug therapy / Q000453:epidemiology* / Q000523:psychology; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data*; D012737:Sex Factors
D000928:Antidepressive Agents; D001569:Benzodiazepines