The medical community is increasingly finding that mental and physical health are closely intertwined. Screenings for multiple areas of mental health are important when treating physical health concerns because many physical health conditions, and particularly those of a chronic nature, are connected with mental health issues. A new study provides evidence that anxiety is closely linked to chronic pain. In research led by Kurt Kroenke, M.D., a professor of medicine at IndianaUniversity in Indianapolis, findings show that individuals being treated for chronic pain often exhibit symptoms of anxiety. The study, published in a recent issue of the journal General Hospital Psychiatry, indicates that while patients are often checked for depression associated with an ongoing pain problem, there may be reason to screen for anxiety as well. The study authors enrolled 250 patients who were in treatment for pain at a Midwestern medical center. The patients each exhibited moderate to severe chronic pain in joints or in the back that had been present for at least three months, regardless of treatment with pain medication. The patients were screened for several common anxiety conditions: generalized anxiety (persistent worry), panic, social anxiety, post-traumatic stress disorder and obsessive-compulsive disorder. In addition, the patients were screened for several quality of life aspects, such as sleep habits, fatigue and productivity at work. The results of the screening indicated that 45 percent of those being treated for chronic pain also exhibited symptoms for at least one of the common types of anxiety disorders. In addition, those who had an anxiety disorder indicated significantly higher levels of pain and a lower health-related quality of life when compared to those patients who did not meet criteria for an anxiety disorder. Kroenke notes that while many of the patients exhibited symptoms of an anxiety disorder, some of those patients would not meet criteria for a full diagnosis of an anxiety disorder if they were evaluated through a full psychiatric diagnosis process. Many of the patients, says Kroenke, may just have symptoms of anxiety and would not require specific intervention. However, about one in five patients being treated for chronic pain met criteria for some type of anxiety disorder and would benefit from treatment. The findings of the analysis also showed that it was common for the symptoms of one anxiety disorder to be accompanied by symptoms of an additional anxiety disorder, as well as the patients displaying the symptoms in combination with those of depression. Experts note that patients being treated for chronic pain conditions may benefit from the incorporation of cognitive behavioral therapy to help them cope with the ongoing pain and the possibility of related anxiety symptoms. Treating a pain problem with pain medication only may not address a significant contributor to the pain.
