Bulgarian Journal of Psychiatry, 2022; 7(1):3-13


Tatyana Telbizova1, Ivan Aleksandrov2

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

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

Abstract: Depression is a factor that probably affects not only the sensation of pain, but also the pain experiences. The aim of the study was to analyze and summarize the specific experiences during pain in patients with chronic pain and depression. Materials and methods: A phase study of a sample of 120 patients with chronic pain was performed in two stages with a period of three months between them. According to the presence of a depressive episode, the sample was organized into two groups – 61 patients without depression and 59 patients with symptoms of depression. All patients with depression were treated with antidepressants between the two stages. Two types of methods were used to assess the sample: 1) quantitative methods – HAM-D-17 – to assess the severity of depression, Spielberger questionnaire – to assess the degree of state and trait anxiety and VAS – to assess the pain intensity; 2) qualitative method – content-analysis of the answers to the question “How do you feel during pain?”. Results: The mean age of the sample was 51.90 ± 11.94. The share of women predominated (81.7%) over that of  men (18.3%). The group with depression had high mean values of state and trait anxiety during the two stages of the study. In the first stage, when the mean value of the severity of depression was moderate, the content-analysis revealed specific experiences during pain of despair, low self-esteem, guilt, and suicidal ideation. The reduction of the mean value of the severity of depression from moderate to mild in the second stage, led to a decrease in the number of specific experiences. Conclusion: Depression affects the specifics of experiences during pain, revealing a potential risk of auto-aggressive behavior. Therefore, the search for depressive symptoms and specific experiences during pain, and subsequently, their management, are crucial for coping with chronic pain in patients with depression and chronic pain.

Key words: chronic pain, depression, chronic pain experiences, content analysis

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