Depression and Anxiety Among Chronic Pain Patients

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Chronic pain is still considered to be an extreme issue among at least 8% of the residents of progressive countries. The introduction of the study describes the apparent link between pain and demoralization. Chronic pain is always accompanied by negative emotional experiences and blocks a person’s ability to receive joy and satisfaction from life. The research investigates the development of depression and anxiety among patients receiving pharmaceutical opioids and medical marijuana (MM) as severe painkillers. It compares the efficacy of prescriptions and examines the possibility of post-treatment depression.

There is currently a severe lack of information about the effects of opiates. They manage pain successfully, but the past few decades indicated the growing concern regarding opiate abuse in forms of overdose and addiction. A more manageable and safer alternative might be medical marijuana. However, the legal status and novelty of this drug do not allow finding a large number of studies on its effectiveness. Specifically, it concerns the emotional condition of patients experiencing chronic pain. This research paper aims to analyze levels of depression and anxiety among people receiving therapy by comparing the effects of pharmaceutical opioids and MM.

The study was conducted in the form of collection and analysis of statistical data. Participants were recruited for six months at two major pain relief centers in Israel. The researchers used The Depression Module of the Patient Health Questionnaire and the Generalized Anxiety Disorder Scale to interview participants, evaluate their answers, and conduct the study. To specifically evaluate and compare the probabilities of depression or anxiety among the diverse groups, the study used multiple logistic regression analysis and chose medical marijuana as the control group.

This type of study is the most revealing and inclusive, as it contains direct responses from a large number of participants. All tools in the form of questionnaires and scales have already been used and proved their efficacy for collecting analytical data. It helps to systematize and classify distinct kinds of information for subsequent uncomplicated services. Thus, researchers can compare the effects of medications on patients of diverse age groups, backgrounds, physical conditions, emotional states, and so on.

The analysis of any human reaction has a high potential of subjectiveness and bias, especially regarding people in severe pain and unstable emotional condition. Perhaps some patients tend to exaggerate their depressive state or vice versa, de-emphasize serious difficulties. Because the survey responses were thoroughly anonymous, the researchers were unable to carefully analyze each patient’s reaction and compare it to the actual states of condition. More accurate answers could be obtained by professional psychologists via personal communication and behavioral analysis. However, this method of research is way more resource-intensive and energy-consuming.

Participants were recruited for six months at two major pain relief centers in Israel. All patients experienced chronic pain for at least 3 months. The study included 890 participants, of which 474 (59%) were treated solely with opioids, 329 (41%) were treated with MM, and 77 (8.6%) acquired both (Feingold et al., 2017). The remaining ten participants who did not receive pharmaceutical opioids and medical marijuana were withdrawn from the analysis in the research. Therefore, it is not possible to comprehensively compare patients taking medications with those who do not.

The study conducted a correlation type of research with variable measures. It evaluated the interdependence of various factors that affected the physical and emotional condition of patients experiencing chronic pain. For example, the survey showed that the ratio of female patients was remarkably higher in the opiates group compared to the MM group. In turn, people on opiates were more likely to report major depressive disorders.

The questionnaires used different variable measures to collect information. For example, it included comprehensive socio-demographic data: gender, age, country, type of residence (urban/rural), years of education, and employment status. Patients were also asked about their medical history over the years and the current presence of any severe diseases such as heart failure, diabetes, arthritis, and so on. The third measure of the questionnaire was indicated by information on any twelve-month and lifetime drug and alcohol consumption. In addition, the record included a pain measurement scale from 0 to 10 to evaluate discomfort feelings during the last month.

Among all participants in the study, 42.2% suffered from depression, and 37% experienced excessive anxiety. The plurality of depressive disorders among patients in the opiates, medical marijuana, and mixed OPMM groups numbered 57.1%, 22.3%, and 51.4%, respectively. The plurality of anxiety contained 48.4% among OP patients, 21.5% among MM patients, and 38.7% among OPMM participants. Patients who took strong opiates were tended to place their pain on a scale of 9 to 10 (Feingold et al., 2017). They were also anguished emotionally and reacted radically negatively to almost all survey questions. Patients who took only MM or mixed medications course had a significantly more stable emotional state and coped with pain more manageable.

One of the major limitations is the insufficiently high response rate, 57% instead of 70% (Feingold et al., 2017). It can be fairly explained by the weak focus of respondents who have overcome severe pain sensations and depressive episodes. It is not clear how to use these statistics, as they still may be relevant for the overall analysis.

Reference

Feingold, D., Brill, S., Goor-Aryeh, I., Delayahu, Y., & Lev-Ran, S. (2017). Depression and anxiety among chronic pain patients receiving prescription opioids and medical marijuana. Journal of Affective Disorders, 2181-7. Web.

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