Verger P, Clavaud H, Bidaud S, Paraponaris A, Sauze L. Les prescriptions d'antalgiques, d'anti-inflammatoires ou le nombre d'actes radiologiques sont des facteurs prédictifs d'un traitement par antidépresseur.
Presse Med 2007;
36:50-6. [PMID:
17261448 DOI:
10.1016/j.lpm.2006.07.004]
[Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2006] [Accepted: 07/06/2006] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVES
Physicians frequently fail to detect mental health disorders in patients consulting them. This study tests the hypothesis that patients repeatedly prescribed analgesics or antiinflammatory drugs or X-ray examinations for unexplained somatic symptoms are at higher risk of antidepressant treatment, independent of physical comorbidity.
METHODS
This case-control study is based on health reimbursement data for self-employed artisans and shopkeepers. Cases were subjects who first began antidepressant treatment between January and March 2003. Controls, matched for age, sex, and urban or rural residence, had not been reimbursed for any psychotropic drug in the 18 months before and 6 months after this quarter. Reimbursement data for analgesic and antiinflammatory drugs, and X-rays, temporary disability payments and their reasons, chronic diseases, and hospitalizations over the 18-month period before inclusion were compared for cases and controls with simple and multiple logistic regressions.
RESULTS
The study included 988 cases (36.5% of whom were reimbursed only once for an antidepressant) and 1976 controls. The multiple logistic regressions adjusted for history of psychiatric morbidity and somatic comorbidity showed significant linear associations between starting antidepressant treatment and reimbursements for analgesic and anti-inflammatory drugs or X-rays.
DISCUSSION
Severe somatic diseases can induce psychological distress. At the same time, mental disorders may be manifested as unexplained chronic pain, without the individual recognizing the link between them.
CONCLUSION
These results confirm the initial hypothesis and suggest signs that may alert physicians to possible undetected psychological distress or mental disorders.
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