Which patients fail to improve?
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Biomedical subjects
Publications and source records attributed to F W Brown.
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The use of methylprednisolone acetate (Depo-Medrol) injected by the epidural or intrathecal route for the relief of diskogenic back pain with or without radiculopathy is an adjunct to conservative management useful when conservative measures fail and surgical treatment is under consideration. This is especially true when symptoms have been present for only a few months. Corticosteroids injected in the same manner seem to have little effect on patients with symptoms persisting for periods longer than 3 months or in patients treated previously by surgical methods.
Lifetime prevalence rates were calculated for comorbid psychiatric disorders in 119 patients who were referred from primary care physicians for unexplained somatic complaints and who met DSM III-R criteria for somatization disorder. Comparisons were made with general population norms from the ECA study. Prevalence of nine comorbid conditions was significantly higher than in the general populations. The most prevalent comorbid diagnoses were major depression (54.6%), generalized anxiety disorder (33.6%), and phobic disorders (31.1%). The least common comorbid disorders were mania (4.2%) and drug abuse (4.9%); drug abuse prevalence rates did not significantly exceed general population estimates. Risk ratios were highest for panic disorder (16.25), major depression (9.41), schizophrenia (7.77), and obsessive-compulsive disorder (7.04).
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