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

Authors Buono FD, Savage SR, Cerrito B, O'Connell J, Garakani A, Ackerman S, Cutter CJ

Received 20 February 2020

Accepted for publication 5 June 2020

Published 24 June 2020 Volume 2020:13 Pages 1515—1523

DOI https://doi.org/10.2147/JPR.S250568

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Robert B. Raffa


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, USA

Correspondence: Frank D Buono Tel + 1-203-9372309 *118
Fax + 1-203-6040542
Email frank.buono@yale.edu

Purpose: 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

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