TY - JOUR
T1 - Prevalence of psychiatric disorders in patients with chronic disabling occupational spinal disorders
AU - Dersh, Jeffrey
AU - Gatchel, Robert J.
AU - Mayer, Tom
AU - Polatin, Peter
AU - Temple, Owen R.
PY - 2006/5
Y1 - 2006/5
N2 - Study Design. A prevalence study. Objectives. To assess the prevalence of psychiatric disorders among a large group of patients with chronic disabling occupational spinal disorders (CDOSDs), using a reliable and valid diagnostic instrument. Summary of Background Data. Although unrecognized and untreated psychiatric disorders have been found to interfere with successful treatment of CDOSD patients, little data are currently available regarding the psychiatric characteristics of patients claiming work-related injuries that result in CDOSDs. Methods. Psychiatric disorders in a consecutive group of CDOSD patients (n = 1,323) attending a tertiary referral center for patients with CDOSD were diagnosed using the Diagnostic and Statistical Manual of Mental Disorders. Results. Overall prevalence of psychiatric disorders was found to be significantly elevated in CDOSD patients compared with base rates in the general population. A majority (65%) of patients were diagnosed with at least one current disorder (not including Pain Disorder, which is nearly universal in this population), compared with only 15% of the general population. Major Depressive Disorder (56%), Substance Use Disorders (14%), Anxiety Disorders (11%), and Axis II Personality Disorders (70%) were the most common diagnoses. Conclusions. Clinicians treating CDOSD patients must be aware of the high prevalence of psychiatric disorders in this population. They must also be prepared to use mental health professionals to assist them in identifying and stabilizing these patients. Failure to follow a biopsychosocial approach to treatment will likely contribute to prolonged disability in a substantial number of these chronic pain patients.
AB - Study Design. A prevalence study. Objectives. To assess the prevalence of psychiatric disorders among a large group of patients with chronic disabling occupational spinal disorders (CDOSDs), using a reliable and valid diagnostic instrument. Summary of Background Data. Although unrecognized and untreated psychiatric disorders have been found to interfere with successful treatment of CDOSD patients, little data are currently available regarding the psychiatric characteristics of patients claiming work-related injuries that result in CDOSDs. Methods. Psychiatric disorders in a consecutive group of CDOSD patients (n = 1,323) attending a tertiary referral center for patients with CDOSD were diagnosed using the Diagnostic and Statistical Manual of Mental Disorders. Results. Overall prevalence of psychiatric disorders was found to be significantly elevated in CDOSD patients compared with base rates in the general population. A majority (65%) of patients were diagnosed with at least one current disorder (not including Pain Disorder, which is nearly universal in this population), compared with only 15% of the general population. Major Depressive Disorder (56%), Substance Use Disorders (14%), Anxiety Disorders (11%), and Axis II Personality Disorders (70%) were the most common diagnoses. Conclusions. Clinicians treating CDOSD patients must be aware of the high prevalence of psychiatric disorders in this population. They must also be prepared to use mental health professionals to assist them in identifying and stabilizing these patients. Failure to follow a biopsychosocial approach to treatment will likely contribute to prolonged disability in a substantial number of these chronic pain patients.
KW - Biopsychosocial approach
KW - Chronic pain
KW - Disabling occupational spinal disorders
KW - Epidemiology
KW - Functional restoration
KW - Psychiatric disorders
KW - Psychopathology
KW - Work-related injuries
UR - http://www.scopus.com/inward/record.url?scp=33646541669&partnerID=8YFLogxK
U2 - 10.1097/01.brs.0000216441.83135.6f
DO - 10.1097/01.brs.0000216441.83135.6f
M3 - Article
C2 - 16648753
AN - SCOPUS:33646541669
SN - 0362-2436
VL - 31
SP - 1156
EP - 1162
JO - Spine
JF - Spine
IS - 10
ER -