Depression Predicts Chronic Pain Interference in Racially Diverse, Income-Disadvantaged Patients

Abstract

Background Chronic pain is one of the most common reasons adults seek medical care in the US, with prevalence estimates ranging from 11% to 40%. Mindfulness meditation has been associated with significant improvements in pain, depression, physical and mental health, sleep, and overall quality of life. Group medical visits are increasingly common and are effective at treating myriad illnesses, including chronic pain. Integrative Medical Group Visits (IMGV) combine mindfulness techniques, evidence based integrative medicine, and medical group visits and can be used as adjuncts to medications, particularly in diverse underserved populations with limited access to non-pharmacological therapies. Objective and Design The objective of the present study was to use a blended analytical approach of machine learning and regression analyses to evaluate the potential relationship between depression and chronic pain in data from a randomized clinical trial of IMGV in diverse, income disadvantaged patients suffering from chronic pain and depression. Methods The analytical approach used machine learning to assess the predictive relationship between depression and pain and identify and select key mediators, which were then assessed with regression analyses. It was hypothesized that depression would predict the pain outcomes of average pain, pain severity, and pain interference. Results Our analyses identified and characterized a predictive relationship between depression and chronic pain interference. This prediction was mediated by high perceived stress, low pain self-efficacy, and poor sleep quality, potential targets for attenuating the adverse effects of depression on functional outcomes. Conclusions In the context of the associated clinical trial and similar interventions, these insights may inform future treatment optimization, targeting, and application efforts in racialized, income disadvantaged populations, demographics often neglected in studies of chronic pain. Trial Registration NCT from clinicaltrials.gov: 02262377

Determinants of implementation for group medical visits for patients with chronic pain: a systematic review

“… Did the participants adhere to the assigned intervention? Gardiner, Luo, et al 2019 [ 45 ] Yes Yes Yes Yes Yes Yes No 80 Gardiner, Lestoquoy, et al 2019 [ 46 ] Yes Yes Can’t Tell Yes Yes Yes Yes 80 Nephew et al 2022 [ 47 ] Yes Yes Yes Yes Yes Not Assessable Yes 80 Smith et al 2016 [ 62 ] Yes Yes Yes No No Yes Yes 60 Seesing et al 2014 [ 59 ] Yes Yes Yes Yes Yes Not Assessable Yes 80 Seesing et al 2015 [ 60 ] Yes Yes Yes Yes Yes No Not Assessable 60 …”

Consumer Perceptions of Home-Based Percussive Massage Therapy for Musculoskeletal Concerns: Inductive Thematic Qualitative Analysis

“…Not only that, but also this accessibility allows numerous consumers of varying backgrounds to find personal therapeutic purposes in the device. Additionally, it is imperative to recognize how the burden of musculoskeletal pain disproportionately impacts low-income populations [44][45][46][47]. While social determinants of health impede one's ability to access comprehensive care, it also increases an individual's risk to such conditions and amplifies the burden of disease [45][46][47][48].…”

“…Additionally, it is imperative to recognize how the burden of musculoskeletal pain disproportionately impacts low-income populations [44][45][46][47]. While social determinants of health impede one's ability to access comprehensive care, it also increases an individual's risk to such conditions and amplifies the burden of disease [45][46][47][48]. The gaps in accessing health care providers, psychosocial support, and health resources perpetuate the disparities experienced by these communities and have negative implications for health outcomes [46,48].…”

“…While social determinants of health impede one's ability to access comprehensive care, it also increases an individual's risk to such conditions and amplifies the burden of disease [45][46][47][48]. The gaps in accessing health care providers, psychosocial support, and health resources perpetuate the disparities experienced by these communities and have negative implications for health outcomes [46,48]. Therefore, creating cost-effective, home-based interventions for musculoskeletal ailments may act as a therapeutic modality for wide-ranging populations and serve as one plausible method of bridging the gap between the health care system and vulnerable populations.…”

Association between depression and dysmenorrhea among adolescent girls: multiple mediating effects of binge eating and sleep quality

“…During adolescence, the prevalence of sleep disorders is higher in girls than in boys [ 26 ]. Sleep quality has a partially mediated effect on depression and pain [ 27 ]; however, it is unclear whether this relationship holds true for dysmenorrhea.…”