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Physician speciality and pain reduction in patients with depressive symptoms under treatment with venlafaxine

Published online by Cambridge University Press:  16 April 2020

S. Begré ,
M. Traber ,
M. Gerber  and
R. von Känel
S. Begré*
Affiliation:
Department of General Internal Medicine, Division of Psychosomatic Medicine, University Hospital/Inselspital, 3010Bern, Switzerland
M. Traber
Affiliation:
Wyeth Pharmaceuticals AG, Grafenauweg 10, CH-6301Zug, Switzerland
M. Gerber
Affiliation:
GEM Clinical Research Consulting, Gewerbestrasse 6, CH-6314Unterägeri, ZG, Switzerland
R. von Känel
Affiliation:
Department of General Internal Medicine, Division of Psychosomatic Medicine, University Hospital/Inselspital, 3010Bern, Switzerland
*
*Corresponding author. Tel.: +41 31 632 20 19; fax: +41 31 382 11 84. E-mail address: stefan.begre@insel.ch (S. Begré).
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Abstract

Objectives

Excessive pain perception may lead to unnecessary diagnostic testing or invasive procedures resulting in iatrogenic complications and prolonged disability. Naturalistic studies on patients with chronic pain and depressive symptoms investigating the impact of medical speciality on treatment outcome in a primary care setting are lacking.

Methods

In this observational study, we examined whether the magnitude of pain reduction in 444 patients with depressive symptomatology under venlafaxine would relate differently to the medical speciality of the 122 treating physicians, namely psychiatrists (n = 110 patients), general practitioners (n = 236 patients), and internists (n = 98 patients).

Results

Independent of age, gender, patient's region of origin, comorbidity, severity and duration of pain, and depressive symptoms at study entry, patients seemed to benefit significantly less in terms of pain reduction (p < 0.001) and of reduction in severity of depressive symptomatology by psychiatrists as compared to general practitioners (p < 0.019) and internists (p < 0.002).

Conclusions

The findings suggest that patients referred to psychiatrists are more difficult to treat than those referred to general practitioners and internists, and might not have been adequately prepared for psychiatric interventions. A supporting cooperation and networking between psychiatrists and primary care physicians may contribute to an integrated treatment concept and therefore, may lead to a better outcome in this challenging patient group.

Keywords

PainUnipolar depressionAntidepressantsPrimary carePhysician specialityVenlafaxine
Type
Depression
Information
European Psychiatry , Volume 25 , Issue 8 , December 2010 , pp. 455 - 460
Copyright
Copyright © Elsevier Masson SAS 2010

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