Psychiatric disorders as assessed with SCID in chronic pain patients: the anxiety disorders precede the onset of pain
Abstract
Objective The aim of the study was to determine the prevalence of psychiatric disorders in patients referred to a tertiary pain clinic. The temporal relationship between the onset of pain and depression and anxiety and the association of psychiatric disorders with pain intensity were also analyzed.Method One hundred consecutive outpatients underwent a psychiatric assessment using the Structured Clinical Interview and Statistical Manual of Mental Disorders Axis I.Results The psychiatric disorders diagnosed for the past 12 months included major depressive (37%), anxiety (25%) and substance use disorder (12%). The prevalence of any lifetime psychiatric disorder was 75%. Most anxiety disorders (77%) had been present before pain onset, whereas 63% of the depressive disorders appeared after the onset of pain. Psychiatric morbidity was associated with increased pain intensity.Conclusions Chronic pain patients have a remarkable psychiatric morbidity. A structured diagnostic interview, covering a large range of psychiatric diagnoses, allows a more comprehensive approach to the assessment of the patient. This should improve the management of chronic pain. However, prospective studies are needed to show this.
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In most cases of co-occurrence, anxiety precedes the onset of chronic pain, unlike depression which usually occurs after the development of chronic pain.
“In fact, there is evidence that in most cases of co-occurrence, anxiety precedes the onset of CP, unlike depression which usually occurs after the development of CP.11”
From Psychological interventions for depression and anxiety: a systematic review and meta-analysis of Iranian chronic pain trials. (2020) · cites this paper as [11]
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- Authors
- Knaster, P., Karlsson, H., Estlander, A.-M., & Kalso, E.
- Affiliations
- Helsinki University Hospital (FI)
- Corresponding author
- Knaster, Peter
- Venue
- General Hospital Psychiatry
- Publisher
- Elsevier BV
- Published
- 2012-01
- Volume
- 34
- Issue
- 1
- Pages
- 46-52
- ISSN
- 0163-8343 (ISSN-L)
- OpenAlex
- W2005618492
- Cited by
- 136
- References
- 38
- Citations by year
- 2026: 3 · 2025: 11 · 2024: 7 · 2023: 7 · 2022: 8 · 2021: 9 · 2020: 13 · 2019: 10 · 2018: 9 · 2017: 11 · 2016: 11 · 2015: 11 · 2014: 12 · 2013: 12 · 2012: 1
- FWCI
- 6.09
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- General Hospital Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Keywords
- chronic pain, psychiatric comorbidity, anxiety disorders, depression, substance use disorders, pain onset, pain intensity, prevalence of mental disorders, pain clinic patients
- MeSH terms
- Adult, Aged, Anxiety Disorders, Mental Disorders, Female, Finland, Humans, Interview, Psychological, Male, Middle Aged, Regression Analysis, Comorbidity, Chronic Pain
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