Self-Reported Pain Intensity and Depressive Symptoms Among Community-Dwelling Older Adults with Schizophrenia Spectrum Disorders

Abstract

Older adults with schizophrenia have some of the highest rates of both medical and psychiatric comorbidities. Despite this, little is known about comorbid pain and depressive symptoms in schizophrenia research. This study aimed to examine the associations between levels of pain intensity and depressive symptoms among community-dwelling adults aged 50 years and older with schizophrenia spectrum disorders. Recruited from U.S. community mental health centers, participants reported on pain and depressive symptoms at the onset of the Helping Older People Experience Success (HOPES) study. Unadjusted and adjusted regression analyses were conducted. Higher pain intensity was associated with elevated depressive symptoms in all analyses, which is consistent with other studies in the general population. Given the widespread efforts to manage pain and related mental health complications in older adults without serious mental illnesses, it is likewise important that community-based mental health professionals monitor and address intense pain and related depressive symptoms among older adults with schizophrenia.

Pain Sensitivity in Schizophrenia Spectrum Disorders: A Narrative Review of Recent Work

“…Furthermore, the expression of pain depends to a large degree on the relationship of the patient with the person inquiring about the pain [49]. Empowering patients to share in decisions about control of pain has borne positive results [50].…”

“…In line with these investigations, Brooks and colleagues examined the association between levels of pain intensity and depressive symptoms in older patients with schizophrenia spectrum disorders [50]. Higher pain intensity was found to be associated with elevated depressive symptoms in patients with schizophrenia, as it is in the general population.…”

An Obsessive-Compulsive Symptom-Related Headache in a Patient with Schizophrenia

“…Schizophrenia is regarded as a disorder with hypoalgesia [ 1 – 4 ]. However, headache has been regarded as a widely reported symptom of schizophrenia [ 5 – 9 ].…”

The Life Course Paradigm as a Lens for Holistic Nursing Research in Older Adults Diagnosed With Schizophrenia

“…The increased vulnerability of older adults with mental illness has been associated with issues or syndromes also common among OADWS such as higher fall rates, substance and alcohol use, trips to the emergency department, less treatment for physiological health issues, and longer hospital stays (Brink et al, 2017; Crawford, Jayakumar, Lemmey, & Zalewska, 2018; Hendrie et al, 2013; Penkunas, Friedman, & Hahn-Smith, 2015). Potential complications of increased longevity in the mentally ill may include physical comorbidities such as cardiovascular and lung diseases (Almeida et al, 2014; Hendrie et al, 2012; Laursen et al, 2014; Olfson, Gerhard, Huang, Crystal, & Stroup, 2015; Seow et al, 2017), as well as psychiatric manifestations such as depression and suicidal thoughts (Brooks et al, 2019; Cohen, Abdallah, & Diwan, 2010; Siddi et al, 2019). The unique complications associated with being an older adult with a diagnosis of schizophrenia (see Table 1) present geriatric syndromes that call for sensitive, useful theoretical frameworks to understand the unique developmental process of OADWS.…”