Depression and Pain in Asian and White Americans With Knee Osteoarthritis

Abstract

Few studies have examined the underlying psychosocial mechanisms of pain in Asian Americans. Using the biopsychosocial model, we sought to determine whether variations in depression contribute to racial group differences in symptomatic knee osteoarthritis pain between Asian Americans and non-Hispanic whites. The sample consisted of 100 participants, including 50 Asian Americans (28 Korean Americans, 9 Chinese Americans, 7 Japanese Americans, 5 Filipino Americans, and 1 Indian American) and 50 age- and sex-matched non-Hispanic whites with symptomatic knee osteoarthritis pain. The Centers for Epidemiologic Studies Depression Scale was used to assess symptoms of depression, and the Western Ontario and McMaster Universities Osteoarthritis Index and the Graded Chronic Pain Scale were used to measure clinical pain. In addition, quantitative sensory testing was used to measure experimental sensitivity to heat- and mechanically-induced pain. The results indicated that higher levels of depression in Asian Americans may contribute to greater clinical pain and experimental pain sensitivity. These findings add to the growing literature regarding ethnic and racial differences in pain and its associated psychological conditions, and additional research is warranted to strengthen these findings. Perspective This article demonstrates the contribution of depression to clinical pain and experimental pain sensitivity in Asian Americans with knee osteoarthritis. Our results suggest that Asian Americans have higher levels of depressive symptoms and that depression plays a relevant role in greater clinical pain and experimental pain sensitivity in Asian Americans.

Knee osteoarthritis and its association with mental health and health‐related quality of life: A nationwide cross‐sectional study

“…Our results are consistent with previous studies showing patients with knee osteoarthritis had more frequent episodes of depressive mood and poorer QoL compared with healthy controls. 3,11 Alkan et al reported that patients with knee osteoarthritis had lower scores on the generic instrument Short Form-36 compared with healthy controls. 3,11 Another cross-sectional study reported that higher levels of depression were significantly associated with greater pain sensitivity in patients with osteoarthritis.…”

“…3,11 Alkan et al reported that patients with knee osteoarthritis had lower scores on the generic instrument Short Form-36 compared with healthy controls. 3,11 Another cross-sectional study reported that higher levels of depression were significantly associated with greater pain sensitivity in patients with osteoarthritis. 3,11 However, no extensive population-based study has comprehensively examined the association of radiologically determined osteoarthritis with three dimensions of mental health (depressive mood, psychological distress and suicidal ideations) and five domains of health-related QoL (impaired mobility, impaired self-care, impaired usual activities, pain/discomfort and anxiety/depression).…”

“…According to research by the Centers for Disease and Prevention, approximately 240 million people worldwide are affected by osteoarthritis, including >30 million in the USA; an increase from 21 million in 1990 and 27 million in 2005 . Osteoarthritis is one of the leading causes of physical disability and impairment in activities of daily living among older adults, and a major public health problem throughout the world . Pain and limitations in physical activity result primarily from mechanical changes in the affected joints, but patients with osteoarthritis have various psychological discomforts, including sleep disturbance, depressive mood, and individual's subjective assessment of their mental and physical well‐being manifested by health‐related quality of life (QoL), as well as joint‐related symptoms.…”

Prevalence of depressive symptoms among medical students: overview of systematic reviews

“…12 Although the use of the model was criticised 42 and modification was proposed, 43 it has been widely used in studying factors associated with depression. [44][45][46][47] In the current overview, most included reviews searched two or more databases, except for Coentre and Figueira, 25 who used only MEDLINE. The use 29 Lei et al 17 and Pacheco et al 16 were not covered by other reviews, which merely used English databases in their search.…”

Osteoarthritis and Depression

“…Так H. Achn и соавт. [39] установили, что, по сравнению с бе-лыми американцами, американцы азиатского происхожде-ния (корейцы, китайцы, японцы) имеют более выражен-ную депрессивную симптоматику, а также большую чувст-вительность к боли, индуцированной температурными и механическими раздражителями, что существенно влия-ет на формирование клинической картины в целом. Де-прессия препятствует эффективному обезболиванию при ОА КС [40], и у половины больных ОА крупных суставов (КС и ТБС) адекватно контролировать боль, к сожалению, не удается [41].…”