A UCT study has found that patients with chronic pain are more likely to suffer from depression and the majority of them are women.
A total of 32% depression prevalence was reported in patients that had presented with chronic pain to the Chronic Pain Management Clinic (CPMC) at Groote Schuur Hospital.
This was established using the medical records of 665 patients which were reviewed from June 2010 to June 2017.
The figure was found to be three times higher than the described lifetime prevalence in South Africa of 9.7%.
The study found that out of all the patients with chronic pain and a history of depression, 77% were women and 23% were men.
Principal investigator of the study and anaesthetics registrar at GSH, Joseph van Vreede, said women have a higher risk of depression.
“This occurs particularly during puberty, before menstruation, during pregnancy and the post-partum period and at perimenopause,” he said.
“In South Africa, one in three women during or after childbirth, experience a mental health disorder, primarily depression. This figure is threefold higher than the World Health Organisation's worldwide prevalence,” he added.
Van Vreede said there were multiple factors which contributed to the overlap in depression and chronic pain prevalence in women.
“Aside from the physiological hormonal changes present in the peripartum periods, multiple life changes contribute to vulnerability to depression,” he said.
“The low levels of oestrogen during the transition to menopause, either biologically or abruptly after a hysterectomy, combined with acute sleep disruptions and inherited traits account for the increased prevalence of depression in this group of patients.
“In South Africa women may also be vulnerable to domestic abuse, both physical and emotional, and may be victims of sexual or racial discrimination on a social level, affecting their self-esteem and contributing to their vulnerability to depression.”
Co-principal investigator of the study and director of the pain management unit at UCT, Professor Romy Parker, said the study provided insight into the importance of psychiatric and psychological management.
“This is an integral part of an effective pain management strategy and the need for an interdisciplinary team approach in chronic pain management,” she said.
Van Vreede added: “Pain relief alone is insufficient. To ensure optimal rehabilitation and the management of depression, an interdisciplinary approach should be utilised to improve patient outcomes and overall well-being.”