Pain and depression in older people: comorbidity and patterns of help seeking

J Affect Disord. 2009 Oct;117(3):193-6. doi: 10.1016/j.jad.2009.01.012. Epub 2009 Feb 13.

Abstract

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antidepressive Agents / therapeutic use
  • Benzodiazepines / therapeutic use
  • Comorbidity
  • Cross-Sectional Studies
  • Depressive Disorder, Major / drug therapy
  • Depressive Disorder, Major / epidemiology*
  • Depressive Disorder, Major / psychology
  • Drug Utilization / statistics & numerical data
  • Europe
  • Female
  • Health Surveys
  • Humans
  • Male
  • Pain / drug therapy
  • Pain / epidemiology*
  • Pain / psychology
  • Patient Acceptance of Health Care / psychology
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Sex Factors

Substances

  • Antidepressive Agents
  • Benzodiazepines