Sunday, July 19, 2009

Who is Most Likely to Have Depression with Pain?

Researchers at Wayne State University, Detroit, MI, examined the prevalence of chronic pain, its coexistence with depression, and demographic factors that might explain a link between pain and depression. They used computer-assisted telephone interviews to obtain a representative community sample (n=1,179) in the state of Michigan.

The sample prevalence of chronic pain due to any cause was about 22%, and more than a third (35%) of those participants with chronic pain also had depression. Overall, participants with either chronic pain or pain-plus-depression were more likely to be female, employed less than full-time, and have less education than persons without either condition. Having depression along with chronic pain was not associated with a particular pain condition or site.

Middle-aged women in the sample were most likely to have both pain and depression, as were African Americans. The authors suggested that in middle-aged women chronic pain might not be the cause of depression, rather preexisting mood problems could be associated with a vulnerability to developing chronic pain in some cases. Concurrent depression appears to decrease with age, although pain tends to be worse among older persons.

Based on their findings, the authors recommend that healthcare providers should screen patients complaining of chronic pain for depression, paying close attention to middle-aged women and African Americans in whom risks of comorbid depression appear to be greatest. While this seems like prudent guidance, it also should be noted that this was a somewhat modest-sized survey, covering a small portion of the United States, and relied upon participant self-reports of their pain and mood disorders rather than verified clinical records.

Reference: Miller LR, Cano A. Comorbid Chronic Pain and Depression: Who Is at Risk? J Pain. 2009;10(6):619-627. [See abstract.]