Depression-sleep disturbance-chronic pain syndrome

• Main Authors: Mayank Gupta, Gautam Das, Priyanka, Anand G.S. Kumar
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2014-01-01
• Series: Indian Journal of Pain
• Subjects: Chronic pain; depression; PHQ-9; sleep disturbance
• Online Access: http://www.indianjpain.org/article.asp?issn=0970-5333;year=2014;volume=28;issue=3;spage=177;epage=183;aulast=Gupta

Context: Chronic pain, depression and poor sleep quality are the most prevalent cause of human suffering, often co-occurring in a mutually reinforcing relationship. However, the prevalence and the risk factors for development of depression and poor sleep quality in Indian patients suffering from chronic pain remains elusive. Aims: The purpose of the present study was to study the prevalence and severity of depression, self-reported sleep disturbance and their co-relation with various pain descriptors such as intensity and duration of pain in 471 Indian patients suffering from chronic pain (more than 3 months). Materials and Methods: The patients were assessed for depression and sleep disturbance by using preformed questionnaires. Depression was evaluated by ′Patient Health Questionnaire 9 (PHQ-9) depression scale′, a self-administered version of mental disorder assessing tool PRIME-MD. Self-reported descriptors like ′waking up refreshed′, ′waking up fatigued′, ′can′t find a comfortable position′ and ′toss and turn frequently′ were used to assess sleep quality and classify patients into those with good (waking up refreshed) or poor (waking up fatigued, cannot find a comfortable position and toss and turn frequently) sleep quality. Results: We found a high prevalence (87.6%) of depression among Indian patients suffering from chronic pain. Moderate-severe depression was found in 31.2% of patients and 68.8% of patients reportedly having poor sleep quality. Females outnumbered males in terms of suffering from chronic pain, moderate-severe depression and poor sleep quality with a female:male of 1:0.514, 1:0.43 and 1:0.6, respectively. Patients suffering from moderate-severe depression and poor sleep quality reported greater perceived intensity of pain, P = 0.005 and 0.012, respectively. Conclusion: Depression and pain frequently co-exist and evaluation and treatment of both are of paramount importance for optimal treatment. Female sex, intensity of pain and poor sleep quality act as risk factors for development of depression in Indian patients suffering from chronic pain.