Prevalence of psychiatric disorders in patients with chronic disabling occupational spinal disorders

Jeffrey Dersh, Robert J. Gatchel, Tom Mayer, Peter Polatin, Owen R. Temple

Research output: Contribution to journalArticle

108 Scopus citations

Abstract

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.

Original languageEnglish
Pages (from-to)1156-1162
Number of pages7
JournalSpine
Volume31
Issue number10
DOIs
StatePublished - 1 May 2006

Keywords

  • Biopsychosocial approach
  • Chronic pain
  • Disabling occupational spinal disorders
  • Epidemiology
  • Functional restoration
  • Psychiatric disorders
  • Psychopathology
  • Work-related injuries

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