Original Research ARTICLE
Depression according to ICD-10 clinical interview vs. depression according to the Epidemiologic Studies Depression Scale to predict pain therapy outcomes
- 1Danube University Krems, Austria
- 2Freiburg University Medical Center, Germany
Purpose: Pain and depression have been shown to have a bidirectional interaction. Although several outcome studies have been conducted, it is still unclear if and how depression influences pain outcome. The current study aims to further clarify this relationship by comparing the predicting value of an interview- and a questionnaire-based assessment of depression.
Patients and methods: This retrospective study analyzed data of N=496 chronic pain patients who received a multimodal pain management program. Multilevel models were performed with depression as predictor, pain measures as dependent variables, and the respective pain score at baseline as covariate. Depression was measured at baseline with (1) a semi-structured psychiatric interview corresponding to the ICD 10 and (2) the Center for Epidemiologic Studies Depression Scale (CES-D). Pain outcomes were pain intensity assessed with the Numeric Rating Scale (NRS), pain disability measured with the Pain Disability Index (PDI), and affective as well as sensory pain perception assessed with the Pain Perception Scale (PPS-A / PPS-S).
Results: At post-treatment, pain intensity (NRS) was higher in patients with depression. This result emerged for interview- (ICD-10) and questionnaire- (CES-D) based depression. These results were significant after correction for multiple testing as well. Moreover, affective pain perception (PSS-A) at post-treatment was higher in patients with depression. Again, this result emerged for interview- (ICD-10) and questionnaire- (CES-D) based depression but it was not significant anymore after correction for multiple testing. Furthermore, pain disability (PDI) was higher at post-treatment in patients with depression according to the CES-D than in those without CES-D depression and this difference in the PDI did not emerge for interview-based depression. Yet, this difference on the PDI between the CES-D depression group and the CES-D no depression group was not significant anymore after correction for multiple testing.
Conclusion: The hypothesis that how depression is assessed – interview-based corresponding to the ICD 10 or with the CES-D – contributes to the association between depression and pain treatment outcome could not be confirmed. Future research should use more than one interview and questionnaire to assess depression, since our results are limited to the clinical ICD-10 interview and the CES-D.
Keywords: Mood disorder, Self-Assessment, Evaluation, Disability, Interdisciplinary treatment
Received: 16 May 2019;
Accepted: 29 Jul 2019.
Edited by:Gabriella Martino, University of Messina, Italy
Reviewed by:Oriana Mosca, Roma Tre University, Italy
M.A. Salehienjad, International Graduate School of Neuroscience, Ruhr University Bochum, Germany
Copyright: © 2019 Fiegl, Lahmann, O'Rourke, Probst and Pieh. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Mx. Sabine Fiegl, Danube University Krems, Krems an der Donau, Austria, email@example.com