title: Psychiatric Disorders Among Patients Seeking Treatment for Co-Occurring Chronic Pain and Opioid Use Disorder.
abstract: OBJECTIVE
  Psychiatric comorbidities complicate treatment of patients with chronic pain and opioid use disorder, but the prevalence of specific comorbid psychiatric disorders in this population has not been systematically investigated.
  
  
  METHODS
  170 consecutive participants entering a treatment research program for co-occurring chronic pain and opioid use disorder between March 2009 and July 2013 were evaluated with the Structured Clinical Interview for DSM-IV-TR Axis I Disorders (SCID-I/P) and the Diagnostic Interview for DSM-IV Personality Disorders (DIPD-IV).
  
  
  RESULTS
  The prevalence of any lifetime (and current) comorbid Axis I disorder was 91% (75%); 52% met criteria for lifetime anxiety disorder (48% current), 57% for lifetime mood disorder (48% current), and 78% for lifetime nonopioid substance use disorder (34% current). Common current anxiety diagnoses were posttraumatic stress disorder (21%), generalized anxiety disorder (16%), and panic disorder without agoraphobia (16%). Common current mood diagnoses were major depressive disorder (40%) and dysthymia (11%). A majority of patients had a personality disorder (52%).
  
  
  CONCLUSIONS
  High rates and persistence of co-occurring psychiatric disorders, including anxiety or mood disorders, may explain in part the difficulty providers have treating patients with co-occurring opioid use disorder and chronic pain and suggest possible targets for improving treatment.
  
  
  BACKGROUND
  ClinicalTrials.gov identifiers: buprenorphine/naloxone treatment (NCT00634803), opioid treatment program-based methadone maintenance treatment (NCT00727675).
authors: Yale University School of Medicine, CMHC/SAC Room 220, 34 Park St, New Haven, CT 06519-1187. declan.barry@yale.edu.|Yale University School of Medicine, New Haven, Connecticut, USA.|The APT Foundation Pain Treatment Services, New Haven, Connecticut, USA.
authors: Declan T
authors: DT
authors: Barry
authors: Yale University School of Medicine, New Haven, Connecticut, USA.|The APT Foundation Pain Treatment Services, New Haven, Connecticut, USA.
authors: Christopher J
authors: CJ
authors: Cutter
authors: Yale University School of Medicine, New Haven, Connecticut, USA.|The APT Foundation Pain Treatment Services, New Haven, Connecticut, USA.
authors: Mark
authors: M
authors: Beitel
authors: Yale University School of Medicine, New Haven, Connecticut, USA.|VA Connecticut Healthcare System, West Haven, Connecticut, USA.
authors: Robert D
authors: RD
authors: Kerns
authors: The APT Foundation Pain Treatment Services, New Haven, Connecticut, USA.
authors: Christopher
authors: C
authors: Liong
authors: Yale University School of Medicine, New Haven, Connecticut, USA.
authors: Richard S
authors: RS
authors: Schottenfeld
mesh_terms: D000328:Adult; D002047:Buprenorphine / Q000627:therapeutic use; D059350:Chronic Pain / Q000188:drug therapy* / Q000453:epidemiology* / Q000523:psychology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D006679:HIV Seropositivity / Q000453:epidemiology / Q000523:psychology / Q000534:rehabilitation; D006556:Heroin Dependence / Q000453:epidemiology / Q000523:psychology / Q000534:rehabilitation; D006801:Humans; D013287:Illicit Drugs; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000523:psychology; D008691:Methadone / Q000627:therapeutic use; D008875:Middle Aged; D009270:Naloxone / Q000627:therapeutic use; D009293:Opioid-Related Disorders / Q000453:epidemiology* / Q000523:psychology / Q000534:rehabilitation; D010147:Pain Measurement / Q000523:psychology; D055553:Prescription Drugs; D055815:Young Adult
chemical_list: D013287:Illicit Drugs; D055553:Prescription Drugs; D009270:Naloxone; D002047:Buprenorphine; D008691:Methadone