a Department of Psychology , University of Texas at Arlington - Center of Excellence for the Study of Health and Chronic Illnesses , Arlington , TX , USA.
Expert Rev Clin Pharmacol. 2017 Sep;10(9):957-963. doi: 10.1080/17512433.2017.1339602. Epub 2017 Jun 14.
A recent literature review concluded that the comorbidity of chronic pain and depression in adults is approximately 50%-65%. Physical and cognitive declines, concurrent multiple health conditions, and complex medication regimens add to the unique and complex challenges of effectively treating pain in particularly geriatric populations. Interdisciplinary medical intervention and monitoring for psychiatric sequelae, such as depression, cognitive change, and synergistic physical side effects are necessary. Areas covered: This review covers an extensive multi-database wide search of the pharmacotherapy of pain and depression in older adults, including biopsychosocial approaches. One of these, on which this review focuses, is Functional Restoration, an interdisciplinary application of quantified physical rehabilitation, case management, and cognitive behavioral and educational therapies to achieve improved well- being and better physical functioning. The biopsychosocial model incorporates an overview of the overlapping and interactive dimensions of a patient's life and addresses them within a comprehensive plan of treatment. Expert commentary: A multifactorial, rather than a single factor approach to the treatment of complicated health care problems such as chronic pain in an elderly patient is emphasized as an important change in perspective for the health care provider.
最近的一篇文献综述得出结论，成年人慢性疼痛和抑郁共病的比例约为 50%-65%。身体和认知能力下降、同时存在多种健康状况以及复杂的药物治疗方案增加了老年人群体有效治疗疼痛的独特和复杂挑战。需要多学科医疗干预和监测精神后遗症，如抑郁、认知改变和协同的身体副作用。涵盖领域：本综述涵盖了对老年人群体疼痛和抑郁的药物治疗的广泛多数据库搜索，包括生物心理社会方法。其中之一，也是本综述的重点，是功能康复，这是量化物理康复、病例管理以及认知行为和教育疗法的跨学科应用，旨在实现更好的健康和更好的身体功能。生物心理社会模型概述了患者生活中重叠和相互作用的各个方面，并在综合治疗计划中对其进行处理。专家评论：强调了针对老年患者慢性疼痛等复杂医疗问题的多因素而非单一因素治疗方法，这是医疗保健提供者观念的重要转变。
