Pain as a symptom of depression: prevalence and clinical correlates in patients attending psychiatric clinics.
BACKGROUND
The need to assess the prevalence and characteristics of painful symptoms among depressed patients attended by psychiatrists in their regular clinical practice.


METHODS
A multi-centre, cross-sectional study was carried out in a large sample (n=3566) of patients attending out-patient psychiatric facilities in Spain. All types of DSM-IV-TR depressive disorders were included. Data on the diagnosis, specific symptoms, intensity of depression and antidepressant and analgesic drug treatments were collected. The presence and characteristics of significant pain (visual analogue scale score>40) at the time of the study were also recorded.


RESULTS
The prevalence of pain in depressed patients was 59.1% (CI 95%: 57.7%; 60.7%). Factors associated independently with the existence of significant pain were: being female, presence of loss of energy and the diagnosis of dysthymia or depression induced by physical disorders. In addition, age and the intensity of depression were two risk factors, where each year of age and each point in the Hamilton scale increased the risk of having pain by 2% and 8% respectively. The presence of anhedonia and the diagnosis of depression induced by illegal drugs were factors inversely related to pain.


CONCLUSIONS
The cross-sectional naturalistic characteristics of the study.


CONCLUSIONS
Our data show a high prevalence of pain among depressive patients attending psychiatric clinics. Painful symptoms are modulated differently depending on the type of depression and the presence of specific symptoms, such as loss of energy or anhedonia. Psychiatrists should ask their depressive patients for the presence of pain on a regular basis.
Psychiatry Department, University Hospital 12 de Octubre, Complutense University, Madrid & Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.
L
L
Agüera-Ortiz
I
I
Failde
J A
JA
Mico
J
J
Cervilla
J J
JJ
López-Ibor
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000503:physiopathology / Q000523:psychology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010146:Pain / Q000453:epidemiology / Q000209:etiology / Q000523:psychology*; D010147:Pain Measurement; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D012737:Sex Factors; D018709:Statistics, Nonparametric