MIAMI — Athletic patients with significant musculoskeletal pain should be screened for comorbid depression and panic disorder, according to study findings presented at the annual meeting of the American Medical Society for Sports Medicine.
In a study of 148 consecutively-treated athletic patients who presented to a sports medicine clinic with musculoskeletal complaints, the overall prevalence of a major depressive disorder was 6%; 7% had another form of depression. Dr. William W. Dexter and his associates at the Maine Medical Center sports medicine program in Portland surveyed participants using the Primary Care Evaluation of Mental Disorders (PRIME-MD) patient questionnaire.
Although these overall prevalence rates are similar to those in a general primary care practice, the prevalence of mood disorders was even higher among those patients who presented with pain severity scores of 6 or higher on a scale of 0–10, Dr. Dexter noted in an interview.
Overall, the prevalence of panic disorder was 17%.
Although the association between mood disorders and musculoskeletal pain has been documented in the literature, there are no data on the prevalence of mental health disorders in a primary care sports medicine population. “In our clinic, we felt we were seeing a lot of musculoskeletal complaints in patients who had an undiagnosed or underdiagnosed mood disorder,” Dr. Dexter said.
If comorbid depression and/or panic disorder are not addressed, significant improvements in musculoskeletal pain are unlikely, he added.
Moreover, there was a “strong and significant” association between depression and/or panic attacks in patients with a history of pain lasting more than 6 weeks. “Many of the subjects in the study did not have a prior diagnosis of mood disorder,” Dr. Dexter said.