Relationship Between Anxiety/Depression Mood Disorders and Insomnia in Patients with Pain Syndromes in Primary Health Care: A Cohort Study

Abstract

Introduction: Chronic pain and mental health disorders are common in the general population, prevalence of chronic pain ranges from 2% to 40%, and the prevalence of mental health disorders ranges from 17% to 29%. Chronic pain is associated with irritability, depression, anxiety and sleep problems such as insomnia. However, the appearance of anxiety and depression has been described as a consequence of chronic pain. Aims: To determine the sociodemographic characteristics and the association between pain syndromes and mood disorders in individuals treated in primary care. Materials and methods: A prospective cohort study was undertaken in a primary care medical center for four months with patients whose pain was the reason for consultation. Scales such as DN4, VAS, Beck's criteria, and DSM-V were applied, and the sociodemographic characteristics of these individuals were determined. Results: A total of 132 patients who met the inclusion criteria were recruited. Of these, 81.81% (108) were women, 18.18% were men (24). The mean age for both sexes was 37.9 and the mean duration in hours of each painful episode was 14.35 hours. The proportion of the disorders that was noted were as follows: insomnia in 0.303, anxiety 0.265, depression 0.090. Those who presented with anxiety or depression and another disorder was 0.053. Patients who did not develop any of the diseases of interest in this study 0.185. Discussion: The coexistence and overlap of mood disorders and insomnia in patients suffering from pain syndromes, which have little or no importance when assessing patients in primary health care centers, are under-diagnosed. However, broadening the clinical history, and correctly using diagnostic tools for mood disorders increases their diagnosis rate, ignoring the positive relationship that exists between these disorders. Conclusions: Pain disorders trigger neuropsychiatric complications. Depression, anxiety, and insomnia worsen episodes of pain. However, the correct diagnostic approach and the application of adequate management greatly reduce the complications of these types of disorders.