Chronic Pain, Mood Disorders and Substance Use: Outcomes of Interdisciplinary Care in a Residential Psychiatric Hospital

Abstract

Frank D Buono,1 Seddon R Savage,2 Brianna Cerrito,3 Julianne O’Connell,3 Amir Garakani,1,3 Sigurd Ackerman,3 Christopher J Cutter4 1Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; 2Department of Anesthesiology, Geisel School of Medicine at Dartmouth, Hanover, NH, USA; 3Silver Hill Hospital, New Canaan, CT, USA; 4Yale Child Study Center, Yale University School of Medicine, Yale University, New Haven, CT, USACorrespondence: Frank D Buono Tel + 1-203-9372309 *118Fax + 1-203-6040542Email [email protected]: The objective is to report outcomes of an interdisciplinary group-based residential chronic pain recovery program (CPRC), located in a private non-profit psychiatric hospital. The chronic pain program was aimed at treatment and engagement in self-care of both pain and co-occurring disorders in a residential facility that also offered treatment for specific psychiatric disorders.Patients and Methods: A retrospective chart review was conducted that included a convenience sample of 131 patients admitted from March 2012 through August 2017 who completed treatment. An interdisciplinary team of professionals provided psycho-behavioral therapy, movement therapies and medication management. Patients completed a battery of psycho-social and demographic questionnaires on admission and before discharge of the program.Results: Significant differences were noted in pain severity, pain interference, depression and anxiety (p< .01) between admission and discharge, and the Chronic Pain Coping Inventory demonstrated significant differences in guarding (p < .001), asking (p =.018), exercise (p < .001), relaxation (p < .001), and pacing (p=.024). Of patients using opioids on admission, at discharge, 37% had tapered and remained off all opioids, 43% were using buprenorphine for opioid use disorder, and 20% continued on analgesic opioids.Conclusion: Treatment was associated with reductions in pain severity and interference, in anxiety and in depression as well as improvements in pain coping. Additionally, there was a reduction in reliance on opioids for pain relief.Keywords: interdisciplinary care, chronic pain management, residential treatment, medication management, psychosocial therapy

Keywords

• interdisciplinary care
• chronic pain management
• residential treatment
• medication management
• psychosocial therapy