Marc Vogel1,2, Anastasia Frank2, Fiona Choi2, Verena Strehlau2,3, Nooshin Nikoo2, Mohammadali Nikoo2, Stephen W Hwang4, Julian Somers5, Michael R Krausz2,3, Christian G Schütz2,3. 1. University of Basel, Department of Psychiatry, Basel, Switzerland. 2. Department of Psychiatry, Institute of Mental Health. 3. Centre for Health Evaluation and Outcome Sciences (CHEOS), The University of British Columbia, Vancouver, British Columbia, Canada. 4. Centre for Research on Inner City Health, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada. 5. Faculty of Health Sciences, Simon Fraser University, Vancouver, British Columbia, Canada.
Abstract
OBJECTIVE: Chronic pain is an important public health issue. However, characteristics and needs of marginalized populations have received limited attention. Studies on prevalence and correlates of chronic pain among homeless persons are lacking. We assessed chronic pain among homeless persons with mental illness in the At Home/Chez Soi study. DESIGN: Cross-sectional data from a randomized controlled trial on homelessness and mental health. SETTING: Data collected between 2009 and 2013 in three Canadian cities. SUBJECTS: One thousand two hundred eighty-seven homeless persons with mental illness. METHODS: Data on chronic pain and utilization of prescribed and nonprescribed interventions was assessed using a chronic pain screening instrument. Mental illness was diagnosed with the Mini-International Neuropsychiatric Interview. RESULTS: Forty-three percent reported moderate to severe chronic pain, interfering with general daily activities (80%), sleep (78%), and social interactions (61%). Multivariate analysis indicated that increasing age and diagnoses of major depressive disorder, mood disorder with psychotic features, panic disorder, and post-traumatic stress disorder (PTSD) were independent predictors of chronic pain. Chronic pain was further associated with increased suicidality. Among participants reporting chronic pain, 64% had sought medical treatment and 56% treated pain with prescribed drugs, while 38% used illicit drugs for pain relief. CONCLUSIONS: Chronic pain is very common among homeless persons with mental illness and affects activities of daily living. Clinicians treating this population should be aware of the common connections between chronic pain, depression, panic disorder, PTSD, and substance use. While the data indicate the contribution of chronic pain to complex treatment needs, they also indicate a clear treatment gap.
OBJECTIVE: Chronic pain is an important public health issue. However, characteristics and needs of marginalized populations have received limited attention. Studies on prevalence and correlates of chronic pain among homeless persons are lacking. We assessed chronic pain among homeless persons with mental illness in the At Home/Chez Soi study. DESIGN: Cross-sectional data from a randomized controlled trial on homelessness and mental health. SETTING: Data collected between 2009 and 2013 in three Canadian cities. SUBJECTS: One thousand two hundred eighty-seven homeless persons with mental illness. METHODS: Data on chronic pain and utilization of prescribed and nonprescribed interventions was assessed using a chronic pain screening instrument. Mental illness was diagnosed with the Mini-International Neuropsychiatric Interview. RESULTS: Forty-three percent reported moderate to severe chronic pain, interfering with general daily activities (80%), sleep (78%), and social interactions (61%). Multivariate analysis indicated that increasing age and diagnoses of major depressive disorder, mood disorder with psychotic features, panic disorder, and post-traumatic stress disorder (PTSD) were independent predictors of chronic pain. Chronic pain was further associated with increased suicidality. Among participants reporting chronic pain, 64% had sought medical treatment and 56% treated pain with prescribed drugs, while 38% used illicit drugs for pain relief. CONCLUSIONS: Chronic pain is very common among homeless persons with mental illness and affects activities of daily living. Clinicians treating this population should be aware of the common connections between chronic pain, depression, panic disorder, PTSD, and substance use. While the data indicate the contribution of chronic pain to complex treatment needs, they also indicate a clear treatment gap.
Authors: Marc Vogel; Fiona Choi; Jean N Westenberg; Maurice Cabanis; Nooshin Nikoo; Mohammadali Nikoo; Stephen W Hwang; Julian Somers; Christian G Schütz; Michael Krausz Journal: Int J Environ Res Public Health Date: 2021-12-21 Impact factor: 3.390
Authors: Karyn Kershaw; Lisa Martelly; Cassidy Stevens; D Keith McInnes; Allie Silverman; Thomas Byrne; Diana Aycinena; Lora L Sabin; Lynn A Garvin; Varsha G Vimalananda; Robert Hass Journal: Digit Health Date: 2022-10-09