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Pain and depression in older people: comorbidity and patterns of help seeking
A Bonnewyn1, C Katona, R Bruffaerts
1University Psychiatric Center KuLeuven, Campus Gasthuisberg, Leuven, Belgium. anke.bonnewyn@uz.kuleuven.ac.be
Background:
Chronic pain and mood disorders are common in older people. Their relationship however remains unclear. Only a few studies have investigated the role of pain in mental health service use and received psychopharmacological treatment.
Methods:
Cross-sectional study of the 65+ subsample from the European Study on the Epidemiology of Mental Disorders (ESEMeD). 4401 non-institutionalized individuals were interviewed using the third version of the Composite International Diagnostic Interview (CIDI-3.0).
Results:
Painful physical symptoms (PPS) were more likely in people with a 12-month major depressive episode (MDE) than in those without (OR=2.0). Help seeking for emotional problems was uncommon, but PPS were a significant predictor of help-seeking (OR=1.7). Respondents with MDE more frequently used benzodiazepines than antidepressants. The presence of PPS in respondents without depression resulted in a significant increase in the use of psychotropic medication.
Conclusions:
PPS were strongly and independently associated with major depressive disorder. Their presence had an influence on help seeking behavior and use of psychotropic medication.
Limitations:
The cross-sectional nature of this study does not allow determination of direction of causality.
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