Psychiatric Morbidity Among Patients with Chronic Pain Attending a Tertiary Care Centre: A Cross-Sectional Study

Abstract

Chronic pain is a multidimensional health problem involving biological, psychological, and social factors. Psychiatric disorders, particularly depression and anxiety, frequently coexist with chronic pain and may contribute to greater pain severity, functional impairment, disability, poor treatment response, and reduced quality of life. Early identification of psychiatric morbidity is therefore important for comprehensive pain management. Aim: To determine the prevalence and pattern of psychiatric morbidity among patients with chronic pain attending a tertiary care centre and to evaluate factors associated with psychiatric morbidity. Materials and Methods: A hospital-based cross-sectional observational study was conducted among 200 adult patients with chronic pain attending a tertiary care centre. Chronic pain was defined as pain persisting or recurring for more than three months. Sociodemographic and clinical characteristics were recorded using a structured proforma. Pain intensity was assessed using the Numerical Rating Scale (NRS). Psychiatric morbidity was assessed through clinical psychiatric evaluation supplemented by validated screening instruments for depression and anxiety. Diagnoses were categorized according to standard diagnostic criteria. Associations between psychiatric morbidity and demographic and pain-related variables were analyzed using appropriate statistical tests. Multivariable logistic regression was used to identify independent predictors. Results: Illustrative data: The mean age of participants was 46.8 ± 12.7 years, and 112 (56.0%) were female. Overall psychiatric morbidity was identified in 94 (47.0%) participants. Depressive disorders were the most frequent psychiatric morbidity (24.0%), followed by anxiety disorders (13.0%), mixed anxiety-depressive presentations (6.0%), and other psychiatric disorders (4.0%). Psychiatric morbidity was significantly associated with female sex, pain duration ≥2 years, severe pain, sleep disturbance, functional impairment, and unemployment. Multivariable analysis identified severe pain, prolonged pain duration, and sleep disturbance as significant independent correlates. Conclusion: Psychiatric morbidity is common among patients with chronic pain. Depression and anxiety constitute the major psychiatric comorbidities. Routine psychological assessment and integration of psychiatric services with multidisciplinary pain management may facilitate early detection and improve patient-centered outcomes.