Psychiatric disorders as assessed with SCID in chronic pain patients: the anxiety disorders precede the onset of pain

Objective: The aim of the study was to determine the prevalence of psychiatric disorders in patients referred to a tertiary pain clinic. The temporal relationship between the onset of pain and depression and anxiety and the association of psychiatric disorders with pain intensity were also analyzed. Method: One hundred consecutive outpatients underwent a psychiatric assessment using the Structured Clinical Interview and Statistical Manual of Mental Disorders Axis I. Results: The psychiatric disorders diagnosed for the past 12 months included major depressive (37%), anxiety (25%) and substance use disorder (12%). The prevalence of any lifetime psychiatric disorder was 75%. Most anxiety disorders (77%) had been present before pain onset, whereas 63% of the depressive disorders appeared after the onset of pain. Psychiatric morbidity was associated with increased pain intensity. Conclusions: Chronic pain patients have a remarkable psychiatric morbidity. A structured diagnostic interview, covering a large range of psychiatric diagnoses, allows a more comprehensive approach to the assessment of the patient. This should improve the management of chronic pain. However, prospective studies are needed to show this. (C) 2012 Elsevier Inc. All rights reserved.