Depressive Disorder News Archive

Midlife Fitness Associated With Lower Risk for Depression and CVD Death

Midlife Fitness Associated With Lower Risk for Depression and CVD Death

These results demonstrate the importance of midlife fitness to prevent depression and subsequent CVD mortality in older age.

Depression, Anxiety May Correlate With Disease Activity in Early Rheumatoid Arthritis

Depression, Anxiety May Correlate With Disease Activity in Early Rheumatoid Arthritis

This research provides further support to compelling data linking inflammation and depression.

Remission of Treatment-Resistant Depression in Veterans Depends on Close Clinical Observation

Remission of Treatment-Resistant Depression in Veterans Depends on Close Clinical Observation

This study supports the effects of close clinical observation and the use of combined treatment interventions including repetitive transcranial magnetic stimulation for achieving remission in veterans with treatment-resistant depression.

Depression Associated With Balance Impairments in Multiple Sclerosis

Depression Associated With Balance Impairments in Multiple Sclerosis

Investigators note that depression should be evaluated and treated in patients with multiple sclerosis and may hinder balance rehabilitation.

Increased Suicide Risk in Cardiovascular Disease With Highest Rates in Younger Patients

Increased Suicide Risk in Cardiovascular Disease With Highest Rates in Younger Patients

Patients with these cardiovascular diseases would benefit from early psychiatric help.

Cannabis Associated With Poorer Symptom Course in Anxiety, Mood Disorders

Cannabis Associated With Poorer Symptom Course in Anxiety, Mood Disorders

These data may be useful to clinicians in gaining insight on the potential risks of cannabis use among their patients with anxiety or mood disorders.

Technology-Enhanced Intervention in the ED Appears Promising for Reducing Underage Drinking, Consequences

Technology-Enhanced Intervention in the ED Appears Promising for Reducing Underage Drinking, Consequences

This intervention provides flexibility in the clinical setting, allowing for therapist delivery when staff is available and computer delivery when staff resources are not available.

Brexpiprazole Effective as Adjunct Therapy in Major Depressive Disorder

Brexpiprazole Effective as Adjunct Therapy in Major Depressive Disorder

Clinicians may find these data useful in treating patients with major depressive disorder and an inadequate response to antidepressant treatment alone.

Negative Social Media Interactions Have Significant Effects on Depressive Symptoms

Negative Social Media Interactions Have Significant Effects on Depressive Symptoms

It may be important to increase awareness of avoiding negative social media encounters to reduce the risk for depressive symptoms.

No Evidence Found That Efavirenz Use Increases Depression in HIV Antiretroviral Therapy

No Evidence Found That Efavirenz Use Increases Depression in HIV Antiretroviral Therapy

The researchers believe this study is the first to detect a statistically significant, unexpected inverse association between efavirenz use and depression.

Older Age Associated With Worse Major Depressive Disorder Outcomes

Older Age Associated With Worse Major Depressive Disorder Outcomes

The age association remained significant after additional adjustments for clinical and social factors such as loneliness and pain. As such, age-specific factors cannot alone explain the poorer MDD course associated with older age.

Women With Epilepsy More Likely to Have Major Depressive Disorder

Women With Epilepsy More Likely to Have Major Depressive Disorder

Investigators sought to determine the frequency of major depressive disorder in patients in epilepsy clinics.

Cognitive Performance, Mood Deficits, White Matter Hyperintensities in Migraine

Cognitive Performance, Mood Deficits, White Matter Hyperintensities in Migraine

Carefully assessing cognitive performance using a screening test to detect visuospatial/executive, attention, and memory dysfunction in patients with migraine.

Medications With Adverse Effect of Depression Are Commonly Used

Medications With Adverse Effect of Depression Are Commonly Used

An estimated 37.2% of people in the United States use medications that have an adverse effect of depression.

Loneliness, Low Social Support Associated With Poorer Mental Health Outcomes

Loneliness, Low Social Support Associated With Poorer Mental Health Outcomes

Preliminary generalizations point toward the potential therapeutic efficacy of targeting loneliness and social support for patients.

Belief That Abortion Harms Women's Mental Health Appears Misinformed

Belief That Abortion Harms Women's Mental Health Appears Misinformed

The notion that abortion harms women's mental health may be misinformed and should be re-examined according to scientific data such as these.

Caffeine Sodium Benzoate Effective as Electroconvulsive Therapy Augmentation

Caffeine Sodium Benzoate Effective as Electroconvulsive Therapy Augmentation

This study was prompted by an ongoing shortage of injectable caffeine sodium benzoate in the United States from 2011 to 2017.

Psychiatric Morbidity Decreased After Assisted Reproductive Technology Treatment

Psychiatric Morbidity Decreased After Assisted Reproductive Technology Treatment

These analyses may serve clinicians in addressing potential psychiatric obstacles in patients undergoing fertility treatments.

Efficacy of 1-on-1 Intervention for Mothers and Babies for Postpartum Depression

Efficacy of 1-on-1 Intervention for Mothers and Babies for Postpartum Depression

These data may be helpful in developing targeted interventions for women at risk for postpartum depression.

When Antidepressants Fail, Dose Increase May Be a Less Effective Response

When Antidepressants Fail, Dose Increase May Be a Less Effective Response

As this and previous research on dose increase strategies have produced inconsistent findings, the researchers recommended clinicians consider other responses to antidepressant treatment failure, at least for selective serotonin reuptake inhibitors.

Examining Treatment Modalities for Noninvasive Brain Stimulation for Adult Depression

Examining Treatment Modalities for Noninvasive Brain Stimulation for Adult Depression

These data could be useful to clinicians and patients alike in selecting the proper treatment method.

Esketamine Nasal Spray: A New Treatment Possibility for Treatment-Resistant Depression

Esketamine Nasal Spray: A New Treatment Possibility for Treatment-Resistant Depression

The Janssen Pharmaceutical Companies of Johnson & Johnson have announced the results of 2 long-term phase 3 clinical trials examining esketamine nasal spray in patients with treatment-resistant depression.

Effects of Male, Female Major Depression on Fertility Treatment Outcomes

Effects of Male, Female Major Depression on Fertility Treatment Outcomes

Among men, those with active major depression were less likely to have a partner achieve conception.

Examining the Relationship Between Childhood Anxiety, Depression and Risk for Cardiovascular Disease

Examining the Relationship Between Childhood Anxiety, Depression and Risk for Cardiovascular Disease

The potential plasticity of the cardiovascular system during childhood may explain the lack of significant relationship between depression and anxiety symptomatology and CVD risk in this study population.

Using Psychological Vulnerability Markers to Predict the Course of Affective Disorders

Using Psychological Vulnerability Markers to Predict the Course of Affective Disorders

Routine assessments of these markers should be conducted before and during treatment as they may inform prognoses.

Pain, Cognitive Dysfunction in SLE Mediated by Sleep Disturbance, Depression

Pain, Cognitive Dysfunction in SLE Mediated by Sleep Disturbance, Depression

The relationship between pain and cognitive dysfunction was explained by sleep disturbance and depressive symptoms.

Carbamazepine, Lamotrigine May Pose Fewer Psychiatric Risks Than Other Antiepileptic Drugs

Carbamazepine, Lamotrigine May Pose Fewer Psychiatric Risks Than Other Antiepileptic Drugs

Carbamazepine, in particular, was associated with lower hazards for depression and anxiety in secondary analyses.

Major Depression in Men May Lower Chances of Conception

Major Depression in Men May Lower Chances of Conception

Active major depression in the male partner may lower the likelihood of pregnancy.

The Psychosocial Impact of Rosacea: Should Clinicians Be Concerned?

The Psychosocial Impact of Rosacea: Should Clinicians Be Concerned?

The erythematotelangiectatic, papulopustular, phymatous, and ocular forms of rosacea can lead to psychological distress.

HIV Viral Suppression Rates in Psychiatric Inpatients With Comorbid Substance Use Disorders

HIV Viral Suppression Rates in Psychiatric Inpatients With Comorbid Substance Use Disorders

A substantial proportion of these individuals diagnosed with HIV, psychiatric disorders, and substance use disorders are out of care and urgently require intervention.

Effects of Depressive Symptoms on Cognition, Markers of Brain Aging

Effects of Depressive Symptoms on Cognition, Markers of Brain Aging

These findings suggest a strong association between greater depressive symptoms and markers of brain aging as well as impaired episodic memory.

Antidepressant Use May Be Linked With Sustained Risk for Weight Gain

Antidepressant Use May Be Linked With Sustained Risk for Weight Gain

Widespread use of antidepressants may be contributing to long-term increased risk for weight gain.

Family History of Psychiatric Disorders an Important Predictor of Postpartum Psychiatric Illness

Family History of Psychiatric Disorders an Important Predictor of Postpartum Psychiatric Illness

When assessing risk for postpartum episodes, clinicians should inquire about family history of psychiatric disorders broadly and not limit discussion to postpartum psychiatric disorders or psychiatric disorders in female relatives.

Depressive Symptoms Predict Future Pain, Disability in Adolescent JIA

Depressive Symptoms Predict Future Pain, Disability in Adolescent JIA

Baseline depressive symptoms were associated with pain and disability in adolescents with juvenile idiopathic arthritis.

Gender-Related Association Between Physical Activity, Psychological Status in T2D

Gender-Related Association Between Physical Activity, Psychological Status in T2D

Sedentary behavior is closely linked to a more articulated pattern of psychological variables, largely influenced by sex-related differences in the individual psychological characteristics.

Gender May Not Affect Depression Risk During Interferon Therapy for Hepatitis C

Gender May Not Affect Depression Risk During Interferon Therapy for Hepatitis C

Gender may not influence vulnerability for developing new-onset depression during interferon-alpha therapy.

Sertraline Effective for Treating Depression in Vascular Cognitive Impairment

Sertraline Effective for Treating Depression in Vascular Cognitive Impairment

A placebo-controlled study could further clarify these results and possibly strengthen the case for antidepressant treatment for depression in vascular cognitive impairment.

Review Examines the Effectiveness of Antidepressants for Insomnia

Review Examines the Effectiveness of Antidepressants for Insomnia

Despite the widespread use of antidepressants for treating insomnia, the evidence for their effectiveness remains limited.

Rates of Major Depression Up Among US Insured, Especially Youth

Rates of Major Depression Up Among US Insured, Especially Youth

Diagnoses of major depression have increased since 2013, particularly among adolescents and millennials.

Circadian Rhythm Disruptions Associated With Mood Disorders, Adverse Quality of Life

Circadian Rhythm Disruptions Associated With Mood Disorders, Adverse Quality of Life

This study had a sample size large enough to assess the effect of circadian disruption on mental health disorders, and was the first to objectively measure patterns of rest and activity (using accelerometers).

Why Treating Major Depressive Disorder Improves Outcomes in HIV

Why Treating Major Depressive Disorder Improves Outcomes in HIV

Mental health problems are 1 of the most important reasons for failing to engage in long-term control of HIV.

FNIH Launches Project to Identify Biosignatures of Neurodegenerative, Psychiatric Conditions

FNIH Launches Project to Identify Biosignatures of Neurodegenerative, Psychiatric Conditions

Multimarker inflammatory biosignatures are expected to facilitate diagnosis and predict treatment outcomes for various central nervous system disorders, particularly Alzheimer disease and major depressive disorder.

Child Developmental Milestones Hindered by Maternal Depressive Symptoms

Child Developmental Milestones Hindered by Maternal Depressive Symptoms

Investigators assessed whether depressive symptoms during and after pregnancy were associated with neurodevelopmental disadvantages in children.

Depression in Patients With Dementia May Increase Risk for Heart Disease

Depression in Patients With Dementia May Increase Risk for Heart Disease

Clinicians should take depression into careful consideration when treating patients with Alzheimer dementia, as the two conditions combined may predispose patients to cardiovascular disease more than either condition alone.

Novel Buprenorphine Combination Therapy Shows Efficacy for MDD in Long-Term Trial

Novel Buprenorphine Combination Therapy Shows Efficacy for MDD in Long-Term Trial

The average MADRS-10 scores decreased from baseline, and this decrease was maintained at the end of the study.

Trintellix Labeling Updated With Data on Improved Processing Speed in MDD

Trintellix Labeling Updated With Data on Improved Processing Speed in MDD

Lundbeck announced that the Food and Drug Administration has approved a supplemental New Drug Application for Trintellix.

Mental Health Comorbidity Examined in Transgender and Gender-Nonconforming Youth

Mental Health Comorbidity Examined in Transgender and Gender-Nonconforming Youth

These findings suggest an urgent need for improved measures of social and clinical support in transgender and/or gender-nonconforming youth.

Cumulative Depression Increases Mortality in Women With HIV

Cumulative Depression Increases Mortality in Women With HIV

Findings highlight the clinical importance of enhanced treatment protocols designed to reduce the duration and frequency of depressive episodes in women living with HIV.

Intranasal Esketamine Rapidly Improves Symptoms of Depression and Suicidality

Intranasal Esketamine Rapidly Improves Symptoms of Depression and Suicidality

Although there were no indications of esketamine dependence, misuse, diversion, or withdrawal symptoms in this trial, this is a possible concern, and the authors call for further evidence from clinical trials to evaluate the drug's potential for abuse.

Grip Strength Indicative of Cognition in Major Depression

Grip Strength Indicative of Cognition in Major Depression

For individuals with major depression and bipolar disorder, grip strength is positively associated with cognition.

NDA Submitted for Postpartum Depression Treatment Brexanolone

NDA Submitted for Postpartum Depression Treatment Brexanolone

Results in the 202B and 202C trials showed that brexanolone achieved the primary endpoint of mean reduction from baseline in the Hamilton Rating Scale for Depression.

Children of Consanguineous Marriage at Increased Risk for Mood Disorders, Psychoses

Children of Consanguineous Marriage at Increased Risk for Mood Disorders, Psychoses

Communities that favor consanguineous marriage should receive sensitive advice on the risks involved to aid in reproductive decision making.

Psychiatric Comorbidities Increase Neurologic Disability in Multiple Sclerosis

Psychiatric Comorbidities Increase Neurologic Disability in Multiple Sclerosis

Patients with MS and comorbid psychiatric conditions have increased severity of subsequent neurological disability.

Prenatal SSRI Exposure Associated With Fetal Neurodevelopmental Changes

Prenatal SSRI Exposure Associated With Fetal Neurodevelopmental Changes

These data indicate a potential association between prenatal SSRI exposure and the development of the fetal amygdala-insula circuit, possibly via anomalous serotonin signaling.

Increased Prevalence of Depression, Anxiety After Colorectal Cancer

Increased Prevalence of Depression, Anxiety After Colorectal Cancer

The prevalence of depression and anxiety are increased among survivors of colorectal cancer.

Psychiatric Illness, Not Antidepressants, Associated With Breast Milk Insufficiency

Psychiatric Illness, Not Antidepressants, Associated With Breast Milk Insufficiency

Mothers struggling with depression may benefit from additional breastfeeding education and support.

Clinical Outcomes Assessed for Major Depressive Disorder With Psychotic Features

Clinical Outcomes Assessed for Major Depressive Disorder With Psychotic Features

Major depressive disorder with psychotic features had comparative long-term outcomes with schizophrenia, schizoaffective disorder, and bipolar disorder.

Children With Autism, ADHD at Increased Risk for Anxiety, Mood Disorders

Children With Autism, ADHD at Increased Risk for Anxiety, Mood Disorders

Recognizing the increased risk for mood disorders in children with ASD and ADHD may be useful for clinicians and parents in developing proper screening and treatment strategies.

Mood Disorders Up for Children of Consanguineous Parents

Mood Disorders Up for Children of Consanguineous Parents

Children of first-cousin consanguineous parents have increased odds of mental health issues and needing antidepressant medications.

Antidepressant Types Linked to Different Adverse Outcomes in Adults With Depression

Antidepressant Types Linked to Different Adverse Outcomes in Adults With Depression

Selective serotonin reuptake inhibitors and other antidepressants, such as tricyclic antidepressants, are associated with increased adverse outcomes in patients aged 20 to 64 years diagnosed with depression.

Stopping Exercise Found to Increase Depressive Symptoms

Stopping Exercise Found to Increase Depressive Symptoms

Ceasing regular exercise increases depressive symptoms, particularly in women.

Depression-Associated Stigma May Limit Access to Chronic Pain Care

Depression-Associated Stigma May Limit Access to Chronic Pain Care

Individuals with chronic pain and comorbid depression may experience higher levels of stigma related to their conditions compared with patients with chronic pain alone.

Untreated Depression Common in Women of Childbearing Age

Untreated Depression Common in Women of Childbearing Age

Many non-pregnant women of childbearing age are suffering from untreated depression.

Incidence of Psychiatric Disorders in Rheumatoid Arthritis

Incidence of Psychiatric Disorders in Rheumatoid Arthritis

The incidence and prevalence of psychiatric disorders such as depression, anxiety, and bipolar disorder are higher in the rheumatoid arthritis population.

Updated Guidelines for Identifying, Managing Depression in Adolescents

Updated Guidelines for Identifying, Managing Depression in Adolescents

Practice guidelines have been updated to assist primary care physicians in the screening and treatment of adolescent depression.

Early Menarche Linked to Antisocial Behavior, Depression That Persists Into Adulthood

Early Menarche Linked to Antisocial Behavior, Depression That Persists Into Adulthood

These results indicated a persistence of depressive and antisocial symptoms and related behavioral patterns far beyond what has been demonstrated in prior research.

Quality of Life May Be Improved in Chronic Pain With Multidisciplinary Social Cognitive Intervention

Quality of Life May Be Improved in Chronic Pain With Multidisciplinary Social Cognitive Intervention

Social cognitive intervention may lead to improvements in health-related QoL in patients with chronic pain.

Treatment Initiation for Depression Suboptimal in Primary Care

Treatment Initiation for Depression Suboptimal in Primary Care

Treatment initiation for depression is suboptimal in the primary care setting despite availability.

Antidepressants More Effective Than Placebo for Acute Depression in Adults

Antidepressants More Effective Than Placebo for Acute Depression in Adults

By bringing together published and unpublished data from more than 500 double-blind, randomized, controlled trials, this study represents the best currently available evidence base to guide the choice of pharmacologic treatment for adults with acute depression.

Effects of Depression, Alcohol Use on Retention in Antiretroviral Therapy

Effects of Depression, Alcohol Use on Retention in Antiretroviral Therapy

Alcohol use disorder and depression were both associated with higher disengagement from antiretroviral therapy for patients with HIV.

Third Trimester Maternal SSRI Exposure Linked to Depression, Anxiety in Offspring

Third Trimester Maternal SSRI Exposure Linked to Depression, Anxiety in Offspring

The issue of whether and how prenatal SSRI exposure affects offspring has remained murky.

Dermatologists May Need Further Training in Identifying Depression

Dermatologists May Need Further Training in Identifying Depression

Fair to poor concordance was seen between dermatologist assessment and patient self-reporting.

Neuroinflammation Associated With Anxiety, Depression in Multiple Sclerosis

Neuroinflammation Associated With Anxiety, Depression in Multiple Sclerosis

In patients with multiple sclerosis, neuroinflammation is linked to anxiety and depression.

Psychosocial Intervention Improves Early Adherence to Antidepressants

Psychosocial Intervention Improves Early Adherence to Antidepressants

Early adherence is an especially problematic, significant and modifiable barrier to quality care for depression.

Risk of Anxiety Disorder Relapse After Discontinuing Antidepressants

Risk of Anxiety Disorder Relapse After Discontinuing Antidepressants

Researchers examined whether the risk of relapse or time to relapse was related to type of anxiety disorder, duration of previous treatment, and other factors.

Augmentation Therapy for Treatment-Resistant Major Depressive Disorder

Augmentation Therapy for Treatment-Resistant Major Depressive Disorder

Augmentation therapy for treatment-resistant major depressive disorder includes multiple options with different strengths and limitations.

Anxiety and Depression's Effect on BMD in Anorexia

Anxiety and Depression's Effect on BMD in Anorexia

Scores for both anxiety and depression are associated with low BMD.

Depression, Anxiety May Affect Bone Metabolism in Young Adults

Depression, Anxiety May Affect Bone Metabolism in Young Adults

In young adults, MDD, GAD, and SSRI use is associated with bone metabolism.

Depression Treatment May Benefit from Use of Ketamine

Depression Treatment May Benefit from Use of Ketamine

Ketamine can provide acute benefits for treatment-resistant depression, bipolar depression, and major depressive disorder with suicidal ideation.

Bipolar Disorder Symptoms Lessened by Cognitive-Behavioral Therapy

Bipolar Disorder Symptoms Lessened by Cognitive-Behavioral Therapy

CBT is effective in patients with bipolar disorder in decreasing the relapse rate and improving symptoms of depression and mania severity.

Antidepressant Side Effects More Common with Comorbid Panic Disorder

Antidepressant Side Effects More Common with Comorbid Panic Disorder

Therapeutic response to antidepressants is highly variable, which may be partially due to associated side effects.

Assessing Internet-Based Depression Prevention in Chronic Back Pain

Assessing Internet-Based Depression Prevention in Chronic Back Pain

Methods to prevent depression could help reduce the disease burden for both affected persons and society.

Increased Risk of PTSD in Parents of Kids With Critical Heart Defects

Increased Risk of PTSD in Parents of Kids With Critical Heart Defects

The researchers proposed integrating mental health screening and treatment into pediatric cardiology care.

Rapid Increase in Opioid Dose Increases Risk of New-Onset Depression

Rapid Increase in Opioid Dose Increases Risk of New-Onset Depression

Dose escalation may be a proxy for loss of control or undetected abuse known to be associated with depression.

Depression Often Untreated in Dialysis Patients

Depression Often Untreated in Dialysis Patients

Many dialysis patients also do not wish to receive aggressive treatment for their depression.

Which Antidepressants May Cause Birth Defects?

Which Antidepressants May Cause Birth Defects?

Anything that has the potential to disturb the serotonin signaling process has the potential to result in a wide variety of malformations.

Worse Psychological Outcomes for Women Denied Abortion

Worse Psychological Outcomes for Women Denied Abortion

There is no evidence that protecting women's mental health concerns should restrict abortion access.

Modifiable Psychological Factors Influence TKA for OA

Modifiable Psychological Factors Influence TKA for OA

Psychological factors drive expectations of poor outcomes following total knee arthroplasty.

Aging a Stronger Predictor of Depression, Negative Mood Than Menopause

Aging a Stronger Predictor of Depression, Negative Mood Than Menopause

Women in the menopausal transition and early postmenopause are at higher risk for depressive symptoms and negative mood than those in late postmenopause.

Depression Medication Linked to Increased Risk of ICH

Depression Medication Linked to Increased Risk of ICH

Concomitant use of oral anticoagulants among people taking SSRIs contributed to a significantly higher risk for ICH.

Youth Depression Onset Predicted by Anxiety, Family History, Adversity

Youth Depression Onset Predicted by Anxiety, Family History, Adversity

Fear and anxiety showed the strongest correlation with development of major depression in children.

Link Found Between Tension Headaches and Anxiety, Depression

Link Found Between Tension Headaches and Anxiety, Depression

Patients with tension-type headaches had a significantly higher prevalence of anxiety and depression.

Cytokine Levels May Predict SSRI Response in Children and Adolescents

Cytokine Levels May Predict SSRI Response in Children and Adolescents

Elevated cytokine levels could help to identify children who are unlikely to respond to treatment with fluoxetine.

Executive Dysfunction in Idiopathic Depression vs Epilepsy-associated Depression

Executive Dysfunction in Idiopathic Depression vs Epilepsy-associated Depression

Individuals suffering from depression, as well as persons diagnosed with temporal lobe epilepsy, present with dysfunction across several cognitive domains.

Cigarette Smoking Predicts Development of Depression

Cigarette Smoking Predicts Development of Depression

Cigarette smoking prevalence among persons with severe mental illness is approximately 3 times greater than the rate observed in the general population.

Depressive Symptoms Linked to Shorter Survival With Lung Cancer

Depressive Symptoms Linked to Shorter Survival With Lung Cancer

Depression symptoms at baseline correlated with increased mortality among participants with early- but not late-stage disease.

Sertraline Prevents Depression Following Traumatic Brain Injury

Sertraline Prevents Depression Following Traumatic Brain Injury

Approximately 80% of depressive episodes have their onset during the first six months following traumatic brain injury.

Pupillometric Analysis For Assessment of Depression Recurrence

Pupillometric Analysis For Assessment of Depression Recurrence

Pupillary reactivity to emotional stimuli has been investigated to provide objective information about the risk for recurrence of depressive symptoms in women.

Mood Disorders and the Disrupted Gut Microbial Milieu

Mood Disorders and the Disrupted Gut Microbial Milieu

Lower diversity of microbial populations in the human gut has been identified in individuals with major depressive disorder.

Comprehensive Assessment Essential for Treating All Aspects of Pain

Comprehensive Assessment Essential for Treating All Aspects of Pain

Regular evaluation and assessment along with a personalized "step approach" is essential for effective pain management.

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