Pain medicine : the official journal of the American Academy of Pain Medicine
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The purpose of this paper is to analyze the impact of major depressive disorder, both preoperatively and one year postoperatively, on the functional and psychosocial outcomes of total knee arthroplasty (TKA). ⋯ Depression was associated with poorer preoperative and postoperative TKA scores. Patients who were depressed 12 months after surgery demonstrated poorer recovery than patients who did not show depressive symptoms before TKA or within the year after.
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The safety and efficacy of long-term opioid treatment for chronic noncancer pain (CNCP) remains controversial. This study examined whether patients who report problematic opioid use sought help and/or perceived barriers to help-seeking. ⋯ The PODS is effective in identifying patients who are concerned about their opioid use. Strategies to address stigma related to drug treatment, including better integration of primary health, specialist pain, and addiction services, are important in reducing opioid-related harm.
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Editorial Comment
Rational vs Ritualistic Medicine: Is it Time to Abandon the Skin Wheal?