Depression Augments Activity‐Related Pain in Women but not in Men with Chronic Musculoskeletal Conditions

Adams, Heather; Thibault, Pascal; Davidson, Nicole; Simmonds, Maureen J.; Velly, Ana Míriam; Sullivan, Michael

doi:10.1155/2008/963216

Cited by 17 publications

(14 citation statements)

References 64 publications

(75 reference statements)

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“…When depressed, women have a greater probability of becoming internally focused and ruminating, which acts to increase attention to painful symptoms. Increased attentional focus from the depression and catastrophizing may manifest in reports of more severe pain . Indeed, previous studies suggest that pain catastrophizing is associated with a heightened attentional bias to pain‐relevant stimuli and an inability to disengage from pain or pain cues .…”

Section: Discussionmentioning

confidence: 99%

Disability in women suffering from interstitial cystitis/bladder pain syndrome

et al. 2012

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What's known on the subject? and What does the study add? Interstitial cystitis/bladder pain syndrome (IC/BPS) is a disease that is associated with significant disability in the areas of self‐care, sexual functioning, occupation, family and home responsibilities, and social functions. Compared to age‐ and cohort‐matched controls, patients with IC/BPS reported poorer mental and physical quality of life (QoL), as well as greater pain, depression, anxiety, catastrophizing, sexual dysfunction and less social support. In particular, catastrophizing and depression are suggested to be important for understanding the factors promoting a poorer QoL in IC/BPS. The findings of the present study suggest that psychosocial factors are significant in mediating the relationship between impairments and patient disability, with negative affect (i.e. depression, anxiety) and pain catastrophizing acting as significant mediators. These findings argue that catastrophizing and negative affect may be the mechanisms by which pain and symptoms elevate reports of patient disability. Understanding how pain and pain‐associated symptoms may become disabling through cognitive mechanisms represents an importance advance for IC/BPS management. Clinical interventions in women suffering from IC/BPS should target catastrophizing and mood for reduction using cognitive behavioural strategies aiming to decrease pain‐related disability. Objectives To examine a biopsychosocial framework of patient disability in patients suffering from interstitial cystitis/bladder pain syndrome (IC/BPS). To evaluate the impact of psychosocial factors on the relationship between pain and disability within women with IC/BPS. Patients and Methods Women with IC/BPS completed questionnaires including demographics, symptoms and problems (IC Symptom and Problem Indices), pain (McGill Pain Questionnaire), quality of life (Medical Outcomes Study – Short Form 12), disability (Pain Disability Index) and psychosocial variables (Center for Epidemiological Studies – Depression Scale; State Trait Anxiety Inventory; Pain Catastrophizing Scale; Multidimensional Scale of Perceived Social Support). Exploratory and confirmatory factor analyses were employed to determine the factor structure and composition of the measured variables. Structural equation modelling was used to examine model fit and the mediation effect of the psychosocial factors (negative affect, catastrophizing and social support) on impairments and functional disability. Results Questionnaires completed by 196 women with IC/BPS provided data for the present study. The measurement model showed good fit to the data. Negative affect (P < 0.001) and catastrophizing (P < 0.001) were significant in explaining the relationship between impairments and functional disability, whereas social support did not. Conclusions Disability in patients suffering from IC/BPS is partially explained by the impact of negative affect and catastrophizing. As a result of the refractory nature of IC/BPS, patient management within a b...

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Section: Discussionmentioning

confidence: 99%

Disability in women suffering from interstitial cystitis/bladder pain syndrome

et al. 2012

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“…Although pain and functional disability are its primary symptoms, OA is associated with a wide range of other outcomes. Beyond basic functional impairment, persons with OA are known to experience a limitation of leisure activities , high levels of depressive symptoms , and reduced quality of life .…”

Section: Introductionmentioning

confidence: 99%

Within‐Day Variability of Fatigue and Pain Among African Americans and Non‐Hispanic Whites With Osteoarthritis of the Knee

Smith

Parmelee

2015

Arthritis Care & Research

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Objective Fatigue is common among persons with osteoarthritis (OA), but little is known about racial/ethnic differences in the prevalence, correlates, or dynamics of fatigue in OA. This research therefore used experience sampling methodology (ESM) to examine fatigue and pain at global and momentary levels among African Americans and non-Hispanic whites with OA. Methods Thirty-nine African Americans and 81 non-Hispanic whites with physician-diagnosed knee OA completed a baseline interview and an ESM protocol assessing fatigue, pain, and mood 4 times daily for 7 days. In addition to analyzing basic group differences, multilevel modeling examined within- versus between-subject patterns and correlates of variability in momentary fatigue, controlling for demographics and other potential confounders. Results Both racial groups experienced moderate levels of fatigue; however, there were clear individual differences in both mean fatigue level and variability across momentary assessments. Mean fatigue levels were associated with global pain and depression. Increase in fatigue over the course of the day was much stronger among non-Hispanic whites than African Americans. Momentary fatigue and pain were closely correlated. Mean fatigue predicted variability in mood; at the momentary level, both fatigue and pain were independently associated with mood. Conclusion Fatigue is a significant factor for both African Americans and non-Hispanic whites with OA, and is negatively related to quality of life. Pain symptoms, at both the momentary level and across individuals, were robust predictors of fatigue. Although overall levels of reported symptoms were similar across these 2 groups, the pattern of fatigue symptoms across the day differed.

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“…Myriad studies conducted to elucidate risk factors for development of depressed mood in the setting of chronic pain indicate that age, sex, and psychosocial factors, e.g., social support (9, 10), self‐efficacy (11), coping (9, 12), poor sleep quality and fatigue (13), and physical disability (loss of ability to perform valued activities) (14, 15), play an important role (14–19). However, to date, most studies that have examined the pain‐depression link in this setting have only considered these factors in isolation; therefore, the independent relationship between pain and depressed mood controlling for all these factors remains unclear.…”

Section: Introductionmentioning

confidence: 99%

A longitudinal study to explain the pain‐depression link in older adults with osteoarthritis

Hawker

Gignac

Badley

et al. 2011

Arthritis Care & Research

274

212

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Objective. To evaluate whether osteoarthritis (OA) pain determines depressed mood, taking into consideration fatigue and disability and controlling for other factors. Methods. In a community cohort with hip/knee OA, telephone interviews assessed OA pain and disability (Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC]), fatigue (Multidimensional Fatigue Symptom Inventory), depressed mood (Center for Epidemiologic Studies Depression Scale), and covariates (demographics, self-rated health, comorbidity, pain coping, pain catastrophizing, and social support) at 3 time points over 2 years. Drawing on previous research, a path model was developed to test the interrelationships among the key concepts (pain, depression, fatigue, disability) over time, controlling for covariates. Results. The baseline mean age was 75.4 years; 78.5% of the subjects were women, 37.2% were living alone, and 15.5% had >3 comorbid conditions. WOMAC scores indicated moderate OA symptoms and disability. From the final model with 529 subjects, adjusting for covariates, we found that current OA pain strongly predicted future fatigue and disability (both short and long term), that fatigue and disability in turn predicted future depressed mood, that depressed mood and fatigue were interrelated such that depressed mood exacerbated fatigue and vice versa, and that fatigue and disability, but not depressed mood, led to worsening of OA pain. Conclusion. Controlling for other factors, OA pain determined subsequent depressed mood through its effect on fatigue and disability. These effects led to worsening of pain and disability over time. These results support the need for improved pain management in OA to prevent or attenuate the downstream effects of pain on disability and mood.

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Depression Augments Activity‐Related Pain in Women but not in Men with Chronic Musculoskeletal Conditions

Abstract: The present discussion addresses the mechanisms through which depression may differentially affect pain in women and men. It also addresses the potential clinical implications of pain-augmenting effects of depression in women.

Cited by 17 publications

References 64 publications

Disability in women suffering from interstitial cystitis/bladder pain syndrome

Disability in women suffering from interstitial cystitis/bladder pain syndrome

Within‐Day Variability of Fatigue and Pain Among African Americans and Non‐Hispanic Whites With Osteoarthritis of the Knee

A longitudinal study to explain the pain‐depression link in older adults with osteoarthritis

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