We appreciate the thoughtful comments of Ruan et al,
1
regarding the definition of depression used in our recent study on the association
between opioid use and depression recurrence.
2
The authors argue that using International Classification of Diseases, Ninth Revision
(ICD-9) code 311 is not an appropriate measure for major depression. Selecting an
ICD-9 code for depression is multifactorial and partly influenced by whether patients
were treated in specialty mental health care or primary care. We do not have enough
information to distinguish between major depressive episode and the less specific
clinical features of sadness and depressed mood related to ICD-9 code 311. Therefore,
we refer to our outcome as depression, not major depression or by any other qualifier.
Had we excluded 311 from our depression diagnosis, the results would have been seriously
biased because many of these patients would be misclassified as nondepressed.To read this article in full you will need to make a payment
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References
- Increased risk of depression recurrence after initiation of prescription opioid in noncancer pain patients.J Pain. 2016; 17: 944-945
- Increased risk of depression recurrence after initiation of prescription opioids in noncancer pain patients.J Pain. 2016; 17: 473-482
Article info
Footnotes
This study was supported by the National Institute of Mental Health, Prescription Opioid Analgesics and Risk of Depression, R21MH101389.
The views expressed in this paper are not necessarily those of the Veterans Administration.
The authors have no conflicts of interest to declare.
Identification
Copyright
© 2016 by the American Pain Society. Published by Elsevier Inc. All rights reserved.
ScienceDirect
Access this article on ScienceDirectLinked Article
- Increased Risk of Depression Recurrence After Initiation of Prescription Opioids in Noncancer Pain PatientsThe Journal of PainVol. 17Issue 8
- PreviewWe read with interest the article by Scherrer and colleagues3 published in The Journal of Pain. The authors conducted a retrospective study using data from Veterans Health Administration (VA; n = 5,400), and Baylor Scott & White Health (n = 842). They reported that patients exposed to an opioid compared with those unexposed had a significantly greater risk of depression recurrence in both patient populations. They conclude that their results suggest opioid use doubles the risk of depression recurrence even after controlling for pain, psychiatric disorders, and opioid misuse.
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