Sleep, Pain and Depression in Primary Care
Close to half of all patients coming to primary care are experiencing sleep problems, but not necessarily presenting it. Increased experienced intensity of sleep problems are associated with significant increases of both average pain intensity and risk of Major Depressive Disorder. DoloTest provide an easy way to find and evaluate this coexistence. This is the conclusion of data I am presenting today at a poster.
I am in Warszawa, Poland to participate in the WONCA Europe 2011 Scientific congress. WONCA is the international scientific organization for primary care. Today, Thursday 9th of September, am I going to present both a poster and also give a presentation at a seminar. The presentation is about “Bridging the Communication Gap between Pain Patients and Healthcare Professionals using DoloTest” – and I will come back to that later here on the Picture of Pain blog.
This post is about the poster with the title “Correlation between Sleep, Pain and Depression in Primary Care Patients using DoloTest®” 
The findings are important for primary care but also for everyone else in professional contact with patients suffering from pain, sleep or depression – and indeed for those affected by these conditions.
Based on data from the “Pain and Depression Profiles in General Practice Study: using DoloTest®”, the aim was to find frequency and intensity of sleep problems among all patients seeking primary care, and to detect how this correlate with experienced pain intensity and risk of Major Depression Disorder (MDD). In the study 1044 patients coming to primary care, no matter the reason for their visit, were asked to complete a DoloTest, a Major Depression Index (MDI) and to answer a few questions. 715 patients completed the questionnaires. 47.1%, almost half of all the patients, reported sleep problems wit a score on 20 or more on a 0 to 100 scale. As intensity of sleep problems increased, so did the average pain intensity and the frequency of MDD, since there were direct positive correlations between pain, sleep problems and frequency of MDD. For sleep scores in the highest segment, that is 80 to 100, the frequency of MDD was 73.2% and the average pain score in that segment was 59.3.
We do know that pain, sleep and depression are closely linked and that they share some neurobiological pathways along the serotonin-noradrenalin pathway, and recently neuro-imaging studies have revealed a close relationship between brain areas implicated in the integration of the sensorial and emotional aspects of pain and areas modulated by depression . However this study shows us clearly, how frequent and how closely related these problems are in an average population of patients coming to primary care.
The consequences for pain management in primary care and everywhere else is clear: It does not make sense to treat either pain, sleep problems or MDD without considering the other factors !!!
The patients completed the tests in the waiting room while waiting, so the study also demonstrates, that DoloTest provide an easy way to assess and demonstrate these problems.
You can see the poster here under the poster section, and I would love to hear your comments below.
- Kristiansen K, Correlation between Sleep, Pain and Depression in Primary Care Patients using DoloTest®. Poster presented at WONCA EUROPE; Warsaw, Sept. 9. 2011
- Ehnvall, A., Mitchell, P.B., Hadzi-Pavlovic, D., Malhi, G.S., Parker, G., 2009. Pain during depression and relationship to rejection sensitivity. Acta Psychiatr. Scand. 119, 375-382
Kim Kristiansen, M.D. (2011). Sleep, Pain and Depression in Primary Care Picture of Pain Blog : hhttp://blog.dolotest.com/2011/09/09/sleep-pain-and-depression-in-primary-care/