AB102. SOH22ABS236. Depression and therapeutic alliance in chronic pain: a systematic review
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AB102. SOH22ABS236. Depression and therapeutic alliance in chronic pain: a systematic review

Cathal Freeman1, Phelim Ryan2, Dominic Harmon2, Harry McGrath3

1School of Medicine, University of Limerick, Limerick, Ireland; 2Department of Anaesthesia, University Hospital Limerick, Limerick, Ireland; 3Department of Anaesthesia, Cork University Hospital, Cork, Ireland

Background: Depression and therapeutic alliance are important in chronic pain. There is an incomplete understanding of the influence of depression on the therapeutic alliance in the context of chronic pain.

Methods: In June 2021 a search was carried out using several electronic databases (Academic Search Complete, AMED, PubMed, Biomedical Reference Collection, General Science, Medline, PsycArticles, PsycInfo, Social Sciences Full Text and SPORTDiscus). The database search was carried out using the key words ‘depression, ‘chronic pain’ and ‘therapeutic alliance or therapeutic relationship or working alliance or helping alliance’. Inclusion and exclusion criteria were applied using PRISMA guidelines for systematic reviews.

Results: Of the three studies assessed in this review, Bliss (2009) was the sole study to support the hypothesis that patient depression negatively impacts the working alliance independent of other variables. This study used the WAI and mapped these scores on to the CES-D 10 scores, finding that higher depressive symptom scores related to lower scores for the therapeutic alliance between patient and healthcare provider.

Conclusions: The review highlights the role that depression and depressive symptoms can play in the forging of the therapeutic alliance. Depression should be assessed in all patients that are suffering from chronic pain and doctors need to be aware of its implications for the therapeutic alliance. The review provokes the need for further research on the topic which could lead to potential therapeutic interventions for such patient groups.

Keywords: Chronic pain; depression; structured review; working alliance; therapeutic alliance

Acknowledgments

Funding: None.

Footnote

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-22-ab102
Cite this abstract as: Freeman C, Ryan P, Harmon D, McGrath H. AB102. SOH22ABS236. Depression and therapeutic alliance in chronic pain: a systematic review. Mesentery Peritoneum 2022;6:AB102.

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