What are some of the mental disorders which pain patients develop?
The comorbidity of mental disorders among pain populations is considered to be high, although precise prevalence rates vary by the pain condition and demographics of the populations (e.g., age, educational attainment, gender). Among the most common found are disorders of depression, anxiety (including posttraumatic stress disorder, panic, and generalized anxiety disorder), alcohol abuse/dependence, and somatization. Sleep and substance use disorders are also common. Despite the large body of evidence demonstrating the presence of mental disorders, they are not usually evaluated, identified, or treated. The difficulty detecting mental disorders, especially depression, in pain populations is complicated by overlap of psychiatric symptoms and pain symptoms. For example, sleep disturbance is often due to both medical and psychiatric factors, such as depression. Moreover, research has substantiated a relationship of reciprocity with psychiatric distress, the pain experience and pain outcomes, in part because they share many biological pathways. Psychiatric distress has been shown to worsen severity, frequency, and duration of pain. Conversely, as the severity of pain increases, so does the severity of psychiatric distress. Although the prevalence rates of mental disorders vary by pain condition, empirical evidence demonstrates high comorbidity. Depression appears to be the most prevalent mental disorder seen in pain populations.