Case History
A 42-year-old adult male patient, 168cm in height, 65kgs was referred from the department of Orthopaedics to the Pain Clinic Outpatient Department (OPD) for CBP secondary to Prolapsed intervertebral disc (PIVD) for 2 years. He was on non-steroidal anti-inflammatory drugs (NSAIDS) since last 3 months. He was also a diagnosed patient of TRD on multiple oral medications for 8 years but had stopped treatment for last 3 months owing to no relief in his symptoms.
On examination, pain NRS for CBP was 8. Patient was assessed by psychiatry department in detail where examination revealed Hamilton Depression Rating Scale (HDRS) or HAMD 17 scale score of 26 (severe depression), DSM-5 criteria for Major Depressive Disorder (MDD) (recurrent depressive episode), Mini-International Neuropsychiatric Interview (MINI) score of 3 (moderately severe depression), Beck’s Depression Inventory (BDI) score was 44. He was non-responsive to one or more antidepressants, given for at the past 8 years in an adequate dose. However, he discontinued all antidepressants for the past 3 months. The authors communicated with him in vernacular. He displayed compliance and good understanding of the Hindi language (including writing). Written informed consent was taken from the patient for the present report.