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DOI: 10.1055/s-0034-1387563
Schmerzsymptome als Hinweis auf Depressionen und Angsterkrankungen bei PatientInnen an somatischen Krankenhausabteilungen
Pain Symptoms as Predictors of Depressive or Anxiety Disorders in Patients with Physical IllnessAuthors
Publication History
Publication Date:
17 April 2015 (online)
Zusammenfassung
Anliegen: Ziel war den Zusammenhang zwischen Schmerzen und Depressionen sowie Angststörungen bei somatisch Kranken zu untersuchen.
Methode: Schmerzen wurden bei 290 PatientInnen somatischer Krankenhausabteilungen mittels Fragebogen erfasst, die psychiatrischen Diagnosen mittels eines standardisierten Interviews durch PsychiaterInnen.
Ergebnisse: Somatisch Kranke mit einer komorbiden psychischen Krankheit leiden signifikant häufiger an Schmerzsymptomen.
Schlussfolgerung: Schmerzen können ein wichtiger Hinweis auf das Vorhandensein von affektiven oder Angsterkrankungen sein.
Abstract
Objective: The aim of this study was to investigate the frequency of pain symptoms reported by patients of non-psychiatric hospital departments and to explore their association with affective and anxiety disorders.
Methods: Patients of non-psychiatric hospital departments (n = 290) reported pain symptoms by filling in a self-rating questionnaire. Psychiatric examinations were performed by psychiatrists using a structured diagnostic interview. The sum-scores of self-reported pain symptoms were tested for their screening accuracy for anxiety and depression.
Results: Patients suffering from affective or anxiety disorders reported significantly more often three or more pain symptoms (63 % vs. 28 %). Using a cut-off value of ≥ 3 of self-reported pain symptoms yielded a sensitivity of 63.1 % and a specificity of 71.7 %.
Conclusions: These findings highlight the relevance of a higher number of pain symptoms as a possible indicator for affective and anxiety disorders. The use of pain symptoms as pre-screening for depression and anxiety might be a useful tool, but needs further research before it can be recommended.
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Literatur
 - 1 Leadley RM, Armstrong N, Lee YC et al. Chronic diseases in the European Union. The prevalence and health cost implications of chronic pain. J Pain Palliat Care Pharmacother 2012; 26: 310-325
 - 2 Klimont J, Kytir J, Leitner B. Österreichische Gesundheitsbefragung 2006/2007. Wien: Bundesanstalt Statistik Österreich; 2007
 - 3 Bruster S, Jarman B, Bosanquet N et al. National survey of hospital patients. BMJ 1994; 309: 1542-1546
 - 4 Dix P, Sandhar B, Murdoch J et al. Pain on medical wards in a district general hospital. Br J Anaesth 2004; 92: 235-237
 - 5 Rockett MP, Simpson G, Crossley R et al. Characteristics of pain in hospitalized medical patients, surgical patients and outpatients attending a pain management centre. Br J Anaesth 2013; 18: 1-7
 - 6 Scott KM, Oakley Browne MA, McGee MA et al. Mental-physical comorbidity in Te Rau Hinengaro: The New Zealand Mental Health Survey. Aust N Z J Psychiatry 2006; 40: 882-888
 - 7 Von Korff M, Dworkin SF, Le Resche L. An epidemiologic comparison of pain complaints. Pain 1988; 32: 173-183
 - 8 Saastamoinen P, Laaksonen M, Kääriä SM et al. Pain and disability retirement: A prospective cohort study. Pain 2012; 153: 526-531
 - 9 Kessler RC, Chiu WT, Demler O et al. Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 2005; 62: 617-627
 - 10 Katon WJ, Russo JE, Von Korff M et al. Long-term effects on medical costs of improving depression outcomes in patients with depression and diabetes. Diabetes Care 2008; 31: 1155-1159
 - 11 Hörtnagl CM, Oberheinricher S, Hofer A. Soziale Kognition bei PatientInnen mit affektiven Störungen: Teil I: Unipolar Depressive Störung. Neuropsychiatr 2014; 28: 74-83
 - 12 Baumeister H, Knecht A, Hutter N. Direct and indirect costs in persons with chronic back pain and comorbid mental disorders – A systematic review. J Psychosom Res 2012; 73: 79-85
 - 13 Salize H-J, Jacke C, Gallas C et al. Krankenkassengestütztes Case-Management verbessert kostenneutral die Behandlungsqualität bei affektiven Störungen. Psychiat Prax 2014; 41: 432-438
 - 14 Jacke C, Salize HJ. Kosteneffektivität eines krankenkassengestützten Case-Management-Programms für Patienten mit affektiven Störungen. Neuropsychiatr 2014; 28: 130-141
 - 15 Wancata J, Benda N, Bach M et al. Recognition of psychiatric disorders in nonpsychiatric hospital wards. J Psychosom Res 2000; 48: 149-155
 - 16 US Preventive Services Task Force. Screening for depression. Recommendations and rational. Ann Intern Med 2002; 136: 760-764
 - 17 Friedrich F, Alexandrowicz R, Benda N et al. The criterion validity of different versions of the General Health Questionnaire among non-psychiatric inpatients. Soc Psychiatry Psychiatr Epidemiol 2011; 46: 635-641
 - 18 Alexandrowicz R, Fritzsche S, Keller F. Die Anwendbarkeit des BDI-II in klinischen und nichtklinischen Populationen aus psychometrischer Sicht. Eine vergleichende Analyse mit dem Rasch-Modell. Neuropsychiatr 2014; 28: 63-73
 - 19 Arroll B, Khin N, Kerse N. Screening for depression in primary care with two verbally asked questions: cross sectional study. BMJ 2003; 327: 1144-1146
 - 20 White JE. A two stage design for the study of the relationship between a rare exposure and a rare disease. Am J Epidemiol 1982; 115: 119-128
 - 21 Alexandrowicz R, Weiss M, Marquart B et al. Zur Validität zweistufigen Screenings am Beispiel Depressionsscreening. Psychiat Prax 2008; 35: 294-301
 - 22 Monsch AU, Bondi MW, Butters N et al. Comparisons of verbal fluency tasks in the detection of dementia of Alzheimer type. Arch Neurol 1992; 49: 1253-1258
 - 23 Spitzer RL, Williams JB, Kroenke K et al. Utility of a new procedure for diagnosing mental disorders in primary care. The PRIME-MD 1000 study. JAMA 1994; 272: 1749-1756
 - 24 Spiegel W, Tönies H, Scherer M et al. Learning by doing: a novel approach to improving general practitioners’ diagnostic skills for common mental disorders. Wien Klin Wochenschr 2006; 118: 1-7
 - 25 Sibitz I, Berger P, Freidl M et al. ICD-10 or DSM-IV? Anhedonia, fatigue and depressed mood as screening symptoms for diagnosing a current depressive episode in physically ill patients in general hospital. J Affect Disord 2010; 126: 245-251
 - 26 Wittchen HU, Pfister H. DIA-X-Interviews. Manual für Screening-Verfahren und Interview. Frankfurt: Swets & Zeitlinger; 1997
 - 27 Knaster P, Karlsson H, Estlander AM et al. Psychiatric disorders as assessed with SCID in chronic pain patients: The anxiety disorders precede the onset of pain. Gen Hosp Psychiatry 2012; 34: 46-52
 - 28 Rief W, Martin A. How to use DSM-V somatic syndrome disorder diagnosis in research and practice: A critical evaluation and a proposal for modifications. Annu Rev Clin Psychol 2014; 10: 339-367
 - 29 Dworkin SF, Von Korff M, LeResche L. Multiple pains and psychiatric disturbance. An epidemiologic investigation. Arch Gen Psychiatry 1990; 47: 239-244
 - 30 Minsky S, Etz RS, Gara M. Service use among patients with serious mental illnesses who presented with physical symptoms at intake. Psychiatr Serv 2011; 62: 1146-1151
 - 31 Bair MJ, Robinson RL, Katon W et al. Depression and Pain Comorbidity: A Literature Review. Arch Intern Med 2003; 163: 2433-2445
 - 32 Burke WJ, Roccaforte WH, Wengel SP. The short form of the Geriatric Depression Scale: a comparison with the 30-item form. J Geriatr Psychiatry Neurol 1991; 4: 173-178
 - 33 Van Marwijk HW, Wallace P, De Bock GH et al. Evaluation of the feasibility, reliability and diagnostic value of shortened versions of the geriatric depression scale. Br J Gen Pract 1995; 45: 195-199
 - 34 Burke WJ, Rangwani S, Roccaforte WH et al. The reliability and validity of the collateral source version of the Geriatric Depression Rating Scale administered by telephone. Int J Geriatr Psychiatry 1997; 12: 288-294
 - 35 Rinaldi P, Mecocci P, Benedetti C et al. Validation of the five-item geriatric depression scale in elderly subjects in three different settings. J Am Geriatr Soc 2003; 51: 694-698
 - 36 Blank K, Gruman C, Robison JT. Case-finding for depression in elderly people: balancing ease of administration with validity in varied treatment settings. J Gerontol B Psychol Sci Soc Sci 2004; 59: 378-384
 - 37 Fritzsche K, Schindler C, Eichenlaub J et al. Der Einsatz von Pflegepersonal im Psychosomatischen Konsil- und Liaisondienst. Psychiat Prax 2013; 40: 356-357
 
    
      
    