Kollara Sukumaran Jyothi, Thoppil Purushothaman Sumesh
BACKGROUND Severe persistent pain is a significant stressful experience and it possibly causes psychiatric morbidities. Most of doctors working in chronic pain management apart from psychiatrist believes that worries and distress of patients with chronic pain can be consider as normal response to a chronic stress. This study aims to measure the prevalence of psychiatric co morbidities in patients with chronic pain, its relation with severity of pain and to compare the common screening questionnaires to valid diagnostic interview. MATERIALS AND METHODS Patients with chronic pain were recruited from pain clinic of Christian Medical College, Vellore after an informed consent. Data such as socio demographic information, two screening questionnaires GHQ and HADS, and a Clinical Interview Schedule-Revised (CIS-R) were collected. Pain severity was assessed by VAS (Visual Analogue Scale). RESULTS 62 Patients were included in the study. As a screening tool, we found that General Health Questionnaire (GHQ) is more useful than Hamilton Anxiety Depression Scale (HADS). CIS-R (clinical interview schedule revised) detected 51.6% of sample as cases of psychiatric morbidity. No correlation between severity of pain and psychiatric co morbidity was seen in this study. CONCLUSION Around fifty percent of pain patients are detected to have possible psychiatric disorders. Labelling all these as psychiatric disorders is too inclusive. Some of these can consider as normal response to a chronic distress. Referring them to a psychiatrist is an option. As a screening tool GHQ is simple, less confusing and time consuming than HADS, with more specificity and sensitivity.
