Treating Depression and Pain in Primary Care Patients

Depression and pain are, respectively, the most common mental and physical syndromes found in primary care patients. These researchers compared outcomes from an intervention and from usual care in 250 patients from community-based or Veterans Administration clinics with pain (≥3 months of low back, hip, or knee pain) plus depression of at least moderate severity. Intervention recipients received 12 weeks of optimized antidepressant treatment of depression, followed by 6 biweekly instructional sessions on the behavioral management of pain, and then 6 months of relapse prevention.

A nurse care-manager, supervised by a psychiatrist, optimized antidepressant selection and dose (venlafaxine or an SSRI in 93% of patients) and led the behavioral se…