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Pain and Depression in a Cohort of Underserved, Community-Dwelling Primary Care Patients

Published on May 1, 2012in Journal of the American Board of Family Medicine2.511
· DOI :10.3122/jabfm.2012.03.080138
Janine E. Janosky54
Estimated H-index: 54
,
Jeannette E. South-Paul7
Estimated H-index: 7
,
Chyongchiou J. Lin14
Estimated H-index: 14
Abstract
Purpose: Almost 17% of the US population exhibits a major depressive disorder in their lifetimes. Prevalence data show that whites experience depression earlier than African Americans, and women have a higher prevalence than men. Less is known regarding depression among underserved minority populations. The goal of our study was to examine the relationship of depression and associated self-reported conditions in participants enrolled in a community-based research registry, a substantial number of whom were underrepresented minorities. Methods: This study used a research registry of community members who had expressed interest in participating in health education projects conducted by the Center for Primary Care Community-Based Research. The patients received care at 10 family health centers. Participants were surveyed regarding family history of depression/anxiety and associated symptoms. Descriptive analyses, univariate analyses, and logistic regressions were used. Results: The population (N 2421) included women (72.2%), African Americans (54.9%), and reported good or very good general health (68.9%). Comorbid pain was found, with headache as the predominant complaint. Compared with nonwhites, whites had a significantly higher prevalence of current depression (26.3% vs. 23.8%; P .01), current anxiety (25.5% vs. 16.6%), and current headache (14.2% vs. 11.2%). Whites also had a higher prevalence of a family history of depression (38.4% vs. 32.1%) and anxiety (8.9% vs. 7.7%) and of taking depression (22.4% vs. 14.8%) and anxiety (15.8% vs. 7.8%) medications. However, nonwhites had a higher prevalence of leg pain (18.8% vs. 14.9%) but a lower prevalence of headache (11.2% vs. 14.2%). Conclusions: Pain was common in patients with comorbid behavioral conditions. Headache was more common in whites, whereas leg pain was more common in nonwhites. Physicians should screen for depression and anxiety in patients with headache and other pain symptoms. (J Am Board Fam Med 2012;25:300‐307.)
  • References (37)
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References37
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(Headache 2011;51:789-795) Objective.— We describe a sample of patients receiving a diagnosis of headache attributed to psychiatric disorder (HSPD). Background.— The international literature to date provides only a few case reports of patients presenting with HSPD. Method.— A retrospective study of the medical records of all patients having received HSPD when consulting at a headache emergency center during 2009. Results.— Out of a total of 8479 patients seen during one year, 25 men and 62 women...
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Chronic daily headache (CDH), defined as a primary headache occurring at least 15 days per month, is a problem of worldwide scope, which is seen in 3% to 5% of the population. Though it has been recognized since ancient times, only recently have there been attempts to define and classify it. CDH usually consists of a mixture of migraine and tension-type headaches (TTH), with the more severe headaches having migraine features and the less severe headaches fitting the definition of TTH. Some patie...
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Migraine is an extremely common disorder. The underlying mechanisms of this chronic illness interspersed with acute symptoms appear to be increasingly complex. An important aspect of migraine heterogeneity is comorbidity with other neurological diseases, cardiovascular disorders, and psychiatric illnesses. Depressive disorders are among the leading causes of disability worldwide according to WHO estimation. In this review, we have mainly considered the findings from general population studies an...
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