Pain, not chronic disease, is associated with the recurrence of depressive and anxiety disorders

BMC Psychiatry

Brenda W Penninx¹  Henriëtte E van der Horst²  Harm WJ van Marwijk²  Stephanie S Leone²  Patricia van Oppen²  Marloes MJG Gerrits² 

[1] Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands;Department of General Practice and Elderly Care Medicine, EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands

关键词: Chronic diseases;    Pain;    Recurrence;    Anxiety disorder;    Depressive disorder;   

Others  :  1123493
DOI  :  10.1186/1471-244X-14-187

 received in 2014-02-13, accepted in 2014-06-18,  发布年份 2014

【 摘 要 】

Background

Studies suggest that poor physical health might be associated with increased depression and anxiety recurrence. The objectives of this study were to determine whether specific chronic diseases and pain characteristics are associated with depression and anxiety recurrence and to examine whether such associations are mediated by subthreshold depressive or anxiety symptoms.

Methods

1122 individuals with remitted depressive or anxiety disorder (Netherlands Study of Depression and Anxiety) were followed up for a period of four years. The impact of specific chronic diseases and pain characteristics on recurrence was assessed using Cox regression and mediation analyses.

Results

Chronic diseases were not associated with recurrence. Neck (HR 1.45, p < .01), chest (HR 1.65, p < .01), abdominal (HR 1.52, p < .01) pain, an increase in the number of pain locations (HR 1.10, p < .01) and pain severity (HR 1.18, p = .01) were associated with an increased risk of depression recurrence but not anxiety. Subthreshold depressive symptoms mediated the associations between pain and depression recurrence.

Conclusions

Pain, not chronic disease, increases the likelihood of depression recurrence, largely through its association with aggravated subthreshold depressive symptoms. These findings support the idea of the existence of a mutually reinforcing mechanism between pain and depression and are indicative of the importance of shedding light on neurobiological links in order to optimize pain and depression management.

【 授权许可】

   
2014 Gerrits et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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