Progress in Neuro-Psychopharmacology and Biological Psychiatry
Epidemiology of pain and relation to psychiatric disorders
Introduction
Chronic pain is a significant health problem. It is common and it affects quality of life, sleep, work, decreases socialization, and increases health care use and costs, as well as mortality (Elliott et al., 1999, Henschke et al., 2015, Smith et al., 2014). Epidemiological studies have also demonstrated that some psychiatric disorders are common in the general population. There is increasing evidence that chronic pain and psychiatric disorders are not only common comorbidities, but psychiatric disorders may modify the risk of chronic pain, as well as pain may contribute to psychiatric disorders (Portenoy et al., 2004, Gureje et al., 1998, de Heer et al., 2014, Bruffaerts et al., 2015). This chapter first provides an overview of the distribution of chronic pain and psychiatric disorders, and then it describes the relationship between psychiatric conditions and chronic pain. This overview is selective, rather than comprehensive. A review of each study assessing the association between a psychiatric disorder and pain would prove infeasible for a single article. Therefore, we have committed this overview to specific psychiatric disorders such as anxiety, depression, substance use disorder, suicide, schizophrenia and dementia.
Section snippets
Overview of epidemiology of chronic pain
The annual incidence rates of chronic pain range from 2% to 8% (Eriksen et al., 2004, Elliott et al., 2002, Reitsma et al., 2012). Table 1 lists a few prevalence estimates of chronic pain around the world, ranging from below 1% to 76%, and some details of the study methods (Andersson, 1994, Arnow et al., 2006, Bhattarai et al., 2007, Blay et al., 2007, Demyttenaere et al., 2007, Elliott et al., 1999, Fayaz et al., 2016, Gureje et al., 1998, Jakobsson, 2010, Moulin et al., 2002, Naidoo et al.,
Overview of psychological disorders associated with chronic pain
Similarly, to chronic pain, some psychiatric disorders, such as anxiety and depression, are also common. A meta-analysis including 174 surveys across 63 countries estimated the 12-month period and lifetime prevalence estimates of a set of common mental disorders (i.e., anxiety, depression and substance use disorders) as 18% and 29%, respectively (Steel et al., 2014).
Chronic pain is frequently accompanied by psychological disorders; anxiety and depression. Gureje et al. found that individuals
Discussion
This overview found many studies showing that some psychiatric disorders are not only more common among persons with chronic pain (e.g., headache, back pain), but they are also possible contributors to a higher incidence of chronic pain. These results are valid, since the methodology used in most of these studies appropriately ascertains that the significant association was not a consequence of bias and confounding.
Although current evidence suggests that psychiatric disorders are associated
Conclusion
The present chapter adds to a growing knowledge of prevalence of chronic pain, and the relation between chronic pain and psychiatric disorders. We have used the best available data to demonstrate that, for some types of chronic pain and psychiatric conditions, they are common comorbidities. Moreover, either condition modifies the risk of the other.
It is therefore essential that health professionals identify psychiatric disorders comorbidities in patients with any kind of chronic pain early on,
Acknowledgements
The authors declare no conflict of interest.
References (135)
- et al.
Risk factors for onset of chronic oro-facial pain–results of the North Cheshire oro-facial pain prospective population study
Pain
(2010) - et al.
Fibromyalgia syndrome and depressive symptoms: comorbidity and clinical correlates
J. Affect. Disord.
(2011) - et al.
Clinical characteristics and economic costs of patients with painful neuropathic disorders
J. Pain
(2004) - et al.
Pain conditions among veterans with schizophrenia or bipolar disorder
Gen. Hosp. Psychiatry
(2013) - et al.
Chronic pain in Australia: a prevalence study
Pain
(2001) - et al.
Prevalence of irritable bowel syndrome (IBS) and variability of diagnostic criteria
Gastroenterol. Clin. Biol.
(2004) - et al.
The associations between preexisting mental disorders and subsequent onset of chronic headaches: a worldwide epidemiologic perspective
J. Pain
(2015) Prevalence of chronic pain in psychiatric patients
Pain
(1987)- et al.
Mental health diagnoses in patients with interstitial cystitis/painful bladder syndrome and chronic prostatitis/chronic pelvic pain syndrome: a case/control study
J. Urol.
(2008) - et al.
Prevalence of prostatitis-like symptoms in a managed care population
J. Urol.
(2006)
Functional abdominal pain syndrome
Gastroenterology
Mental disorders among persons with chronic back or neck pain: results from the World Mental Health Surveys
Pain
The course of chronic pain in the community: results of a 4-year follow-up study
Pain
The epidemiology of chronic pain in the community
Lancet
Clinical pain in schizophrenia: a systematic review
J. Pain
Development of and recovery from long-term pain. A 6-year follow-up study of a cross-section of the adult Danish population
Pain
Psychological factors associated with development of TMD: the OPPERA prospective cohort study
J. Pain
Potential psychosocial risk factors for chronic TMD: descriptive data and empirically identified domains from the OPPERA case-control study
J. Pain
Male and female chronic pain patients categorized by DSM-III psychiatric diagnostic criteria
Pain
A meta-analysis investigating the prevalence and moderators of migraines among people with bipolar disorder
J. Affect. Disord.
Prevalence of dementia subtypes in United States Medicare fee-for-service beneficiaries, 2011–2013
Alzheimers Dement.
Clinical characteristics and pain management among patients with painful peripheral neuropathic disorders in general practice settings
Eur. J. Pain
Chronic pelvic pain in New Zealand: prevalence, pain severity, diagnoses and use of the health services
Aust. N. Z. J. Public Health
The epidemiology and economic consequences of pain
Mayo Clin. Proc.
The prevalence of prostatitis-like symptoms in China
J. Urol.
Chronic pelvic pain: prevalence, health-related quality of life, and economic correlates
Obstet. Gynecol.
Depression and anxiety associated with three pain conditions: results from a nationally representative sample
Pain
Systematic review of dementia prevalence and incidence in United States race/ethnic populations
Alzheimers Dement.
Depression, chronic diseases, and decrements in health: results from the World Health Surveys
Lancet
Co-morbidity does not reflect complexity in internal medicine patients
Eur. J. Intern. Med.
Prevalence of prostatitis-like symptoms in a population based study using the National Institutes of Health chronic prostatitis symptom index
J. Urol.
How does subjective experience of pain relate to psychopathology among psychiatric patients?
Gen. Hosp. Psychiatry
Population-based survey of pain in the United States: differences among white, African American, and Hispanic subjects
J. Pain
Hypoalgesia in schizophrenia is independent of antipsychotic drugs: a systematic quantitative review of experimental studies
Pain
Barriers to postoperative pain management in hip fracture patients with dementia as evaluated by nursing staff
Pain Manag. Nurs.
Psychiatric comorbidities in a community sample of women with fibromyalgia
Pain
Prevalence of psychiatric disorders in sick listed chronic low back pain patients
Eur. J. Pain
Assessing psychological factors, social aspects and psychiatric co-morbidity associated with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) in men – a systematic review
J. Psychosom. Res.
Prevalence and characteristics of chronic pain in the general Norwegian population
Eur. J. Pain
Addiction severity index in a chronic pain sample receiving opioid therapy
J. Subst. Abus. Treat.
Pain management in patients with dementia
Clin. Interv. Aging
The epidemiology of chronic syndromes that are frequently unexplained: do they have common associated factors?
Int. J. Epidemiol.
The epidemiology of chronic pain in a Swedish rural area
Qual. Life Res.
Comorbidity of fibromyalgia and psychiatric disorders
J. Clin. Psychiatry
Comorbid depression, chronic pain, and disability in primary care
Psychosom. Med.
Epidemiology of anxiety disorders in the 21st century
Dialogues Clin. Neurosci.
Prevalence of doctor-diagnosed arthritis at state and county levels - United States, 2014
MMWR Morb. Mortal. Wkly Rep.
Mood and anxiety disorders in chronic headache
Headache
Clinical characteristics and patterns of healthcare utilization in patients with painful neuropathic disorders in UK general practice: a retrospective cohort study
BMC Neurol.
Prevalence of suicidal ideation, depression, and anxiety in chronic temporomandibular disorder patients
J. Oral. Facial Pain Headache
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