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)