Bulgarian Journal of Psychiatry, 2022; 7(4):23-29


Tatyana Telbizova1, Svetlin Varbanov2

1Department of Psychiatry and Medical Psychology, Medical University – Varna

2Department of Health Care, Sliven Affiliate, Medical University – Varna

Abstract. The way a person perceives the situation during pain depends on emotions and predetermines one’s behavior. Objective: The aim of the study is to analyze the assessment of the situation during pain in patients with chronic pain and depression. Materials and methods: A phased study of 61 patients with chronic pain and depression was performed in two stages. For a period of three months, all participants were treated with antidepressants. Patients were assessed using the following scales: 1) HAM-D – 17 – to assess the severity of depression; 2) Spielberger questionnaire – a scale (S) for assessing state anxiety (STAI – form Y1) and a scale (T) for assessing trait anxiety (STAI – form Y2) and 3) VAS – for assessing pain intensity. A model of four situations was applied to assess the situation during pain: unique, risky, routine, and situation of uncertainty. Results: The average age of the studied sample was 55,60 ± 10,91. The share of women is overtly predominant (91,8%) over that of men (8,2%). The group was characterized by high state and trait anxiety and moderate pain intensity for both stages of the study. Depression severity score decreased from moderate (16,15 ± 5,87) to mild (13,36 ± 6,96) and showed significant differences between the two stages (p = ,002). Assessment of the situation during pain showed dynamics. At the first stage, 48,4% of the sample assessed the situation as risky and/or uncertain, and 26,7% as routine, and at the second stage the portion of these groups was 38,2% and 37,1%, respectively. Conclusion: Assessment of the situation during pain as risk and/or uncertainty reveals the need for psychotherapeutic interventions in patients with chronic pain and depression. Cognitive restructuring enables the formation of adaptive patterns of behavior to cope with chronic pain and to perceive it as a routine or part of life.

Key words: chronic pain, depression, state and trait anxiety, situation

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