chronic pain and depression correlation/behavioral health integration need

• Your literature review should be inclusive of the following:

1. Cover Page (APA Guidelines)
   • Student Name
   • Project Title

2. Table of Contents
3. Abstract): A brief summary of the project similar to an abstract in a peer reviewed research article
4. Literature Review
5. Statement of Problem and Research Questions or Hypotheses: A statement of the focus of the project and questions to be addressed in the context of the key findings in the literature review.

Literature Review: A review of relevant research and a synthesis of the research in which the student summarizes key findings, trends, and current issues or questions relevant to the topic.

• For the final paper, students are expected to utilize 20-25 research articles. The literature review at this stage should be 7-20 pages in length.
• A literature review IS NOT a description of each article or research piece related to the topic or an annotated bibliography. It is a synthesis of the literautrereivew/facts with citations to support. A literature review often will include information summarizing relevant research, critical evaluation of the extent of the research, and clear presentation of the topic or theme of the review. Illustrate your thinking for the reader. Identify significance of the literature and what gaps emerged.
• Consider subheadings to organize your information (as needed)
• Review the videos on literature reviews

Statement of the Problem

            Depression is a condition that is commonly manifested in patients of chronic pain and evidently reduces the quality of life of the patients. Although various individual researchers have identified different psychological and pharmacological approach to manage the problem, there is lack of universal and identical approach to manage the risk factors associated with depression and chronic pain. Behavioral integrated health approach of treatment is therefore proposed as a major means of managing chronic pain and symptoms of depression among patients.

2.0 Literature Review

            The review of literature synthesizes data and information from various scholarly journals that are relevant to the topic of the study. The review of literature aims at discussing all relevant literature from previous research on the correlation of depression and chronic pain in significance to behavioral health integration need. This will hence provide the research with in-depth insight on the topic of the study and will guide the study’s expected findings and methodology. Kroenke et al (2007) indicates that other than depression affecting the brain and behavior of a person, it also affects the entire body. The authors argue that depression is connected with several other health problems chronic pain being one of them. Baliki et al (2008) argues that there is need for proper and effective treatment for depression due to its multifaceted nature of health problem.

2.1 Depression and Chronic Pain

            Kroenke et al (2007) in a study observes depression as a serious mental disorder which interferes with the daily routine of a person and significantly reduces an individual’s value of life. The study indicates that depression and chronic pain are usually comorbid. Further, the researchers indicate that existence of depression in a patient suffering from chronic pain to be closely associated with poor response to treatment, increased cost of health care as well as reduced functions. de Heer et al (2014) in a study explains chronic pain as pain that persists for a longer period of time than it would normally occur under normal circumstances of the original problem. The study indicates that chronic pain may lead the human body to react in diverse ways inclusive of brain hormone abnormalities, disorder in mood, impaired performance of the mind and the body as well as pain in the muscles. The study cited that chronic pain may lead to nerve disorders which triggers neural chemical changes leading to increased feeling of pain. The study established that chronic pain ultimately lead to depression.

Grashorn et al (2013) in their study describes pain as repulsive sensory and expressive experience connected to actual or impending tissue damage. The authors indicate that pain is classified as chronic if it persists for more than one month after expected healing of the tissue or if it persist for at least three months of preceding six months. Further, pain is classified as either neuropathic or nociceptive where neuropathic pain results from a disease of the nervous system and nociceptive pain resulting from impending damage to the non-neural body tissues. The neuropathic pain is administered using agents that target the nervous system while the nociceptive pain is responsive to anti-inflammatory drugs and general basic analgesics. Baliki et al (2008) in their study established that there exists a rage of experiences from pain effects. The researchers identified that a person’s reaction to chronic pain reveals the characteristics of pain and is indicative of the behavioral changes of the pain bearer during the period of illness. The study indicated that accelerated and persistent chronic pain leads to mental disorders with depression being the most common effect.

Kroenke et al (2007) indicated that depression and chronic pain are familiar comorbid situations and have mutual undesirable effects on treatment and disability results. The study observed that chronic pain recurrently display aspects of comorbid depression. The authors argue that persistent pain amplifies the neural activity consistently in a network of structures in the brain that are involved in controlling the cognition, emotions and body sensations. Chronic pain is hence evidenced to interfere with normal functionality of the brain leading to adverse effects on emotions. Chronic pain leads to imbalanced blood flow in the brain characterized with constrained blood flow in the cerebrum which usually leads to comorbid depression. The study suggests that the situation can be reversed using antidepressants. Haggman, Maher & Refshauge (2004) in their research indicates that there exist significant correlation between chronic pain and depression. In their study which focused on testing the occurrence of depressing symptoms by therapists involved in managing low back pain, the authors indicated a strong connection between depression and chronic pain. In their study, the researchers cited that depression exacerbates the diagnosis of low back pain. From the study, it is visible that most patients diagnosed with severe and chronic low back pain showed symptoms of potential depression.

2.2 Assessment and Diagnosis of Depression

            de Heer et al (2014) suggests that a patient suffering from chronic pain should be assessed for depression as well as an assessment for pain. An assessment for pain characterizes the level of the pain and enables identification of major behavior and cognition changes that are resultant from the pain. It also helps determine the nature, type and impact of the pain. Comprehensive pain assessment may involve a range of disciplines for an accurate outcome inclusive of pain medicines. Detweiler et al (2008) in a study about integrating comorbid depression and chronic pain identified that there exists difficulties in diagnosing depression in patients suffering from acute chronic pain. This is because there is possibility of a mix in symptoms of comorbid physical sickness and pain with the symptoms of depression. Based on the study, for the diagnosis acute depression symptoms, one requires identifying presence of a depressed mood which have persisted for not less than two weeks or reduced concern for pleasure, cognitive as well as somatic symptoms which lead to physical and psychological dysfunctions.