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Mental Health Service Use by Older Adults: The Role of Chronic Pain

From the Department of Psychiatry & Behavioral Sciences (JBB, M-YF, JU, MDS), University of Washington School of Medicine, Seattle, WA; the Department of Psychiatry and Biobehavioral Sciences (LZ), University of California at Los Angeles, Los Angeles, CA; and the Department of Psychiatry (MJE), University of Arkansas for Medical Sciences, Little Rock, AR.

Objective: Mental health disorders commonly co-occur in patients with chronic pain, but little is known about the role of chronic pain in mental health service use. In this study, the authors explored the role of chronic pain in mental health service use by adults according to age group.

Method: The authors conducted a cross-sectional analysis of survey data from the second wave of the Health Care for Communities telephone survey collected in 2000–2001. Participants consisted of U.S. civilian adults (N = 6629) from randomly selected U.S. households. Common mental disorders were assessed using the short-form versions of the World Health Organization's Composite International Diagnostic Interview. Chronic pain conditions and mental health services received were identified by self-report. Physical and mental functioning was assessed using the Short Form-12.

Results: Adults older than age 60 had higher rates of chronic pain and lower rates of mental health service use compared with those aged 18–60 years. In multiple logistic regression models, an interaction effect was found between age and chronic pain (odds ratio: 3.0 [1.1–8.0]) with chronic pain significantly increasing the odds of any mental health care in the past year in adults older than 60 years of age.

Conclusions: Chronic pain increases the likelihood of mental health service use among older adults. Chronic pain may facilitate the presentation of distress in medical settings for these adults.

Key Words: pain • mental health • health services • geriatrics