Depression among chronic pain patients at Hospital Tengku Ampuan Rahimah, Klang

Introduction: Despite the high prevalence rates of depression amongst chronic pain patients reported globally, the condition is often under-recognised and under-treated. Depression frequently complicates the effective management of pain and is associated with poor quality of life. This study aimed to explore the incidence of depression and its’ associated factors in a sample of chronic pain patients in Malaysia. Materials and methods: This descriptive cross-sectional study was conducted amongst clinically diagnosed chronic pain patients from the pain management clinic of Hospital Tengku Ampuan Rahimah over a period of seven months. Socio-demographics and clinical data were obtained from patients’ interview and medical records. The validated Depression Anxiety Stress Scale-21 (DASS-21) was used for screening and Mini International Neuropsychiatric Interview (MINI) was used to establish the depression diagnoses among the patients. Numeric pain intensity scale was used to assess the severity of pain. Results: Eighty-three patients with a mean age of 50.4±12.50 years participated in this study. The majority of the patients were females (56.6%), married (85.5%) and being employed (49.4%). The percentage of depression was 37.4%. Depression was significantly associated with severity of pain (p<0.001) and the duration of pain (p <0.05). Conclusion: Almost one third of chronic pain patients in this study have depression. Depression was significantly associated with the severity and duration of pain. Depression should be regularly screened among patient with chronic pain.

Interventional management of chronic pain

Chronic non-cancer pain is a common clinical condition affecting a significant part of the population. This article aims to review the interventional options for non-cancer pain. Multiple searches using Medline were carried out and additional searches were made using reference lists of published papers and book chapters. The article discussed procedures ranging from selective nerve root or zygapophyseal (facet) joint block with local anaesthetics to irreversible neurodestruction with radiofrequency energy or neurolytic agents and neuromodulation with spinal cord stimulation. Other techniques include intraspinal delivery of analgesics. There is evidence that these interventional procedures are valuable both diagnostically and therapeutically.