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

BMC Psychiatry

Research Article

Stephanie S Leone¹  Harm WJ van Marwijk¹  Henriëtte E van der Horst¹  Marloes MJG Gerrits²  Patricia van Oppen²  Brenda W Penninx³ 

[1] 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;Department of Psychiatry, EMGO Institute for Health and Care Research, VU University Medical Center and Academic Outpatient Clinic for Affective Disorders, GGZ inGeest, Amsterdam, 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;Department of Psychiatry, EMGO Institute for Health and Care Research, VU University Medical Center and Academic Outpatient Clinic for Affective Disorders, GGZ inGeest, Amsterdam, The Netherlands;Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands;Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands;

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

DOI  :  10.1186/1471-244X-14-187

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

来源: Springer

【 摘 要 】

BackgroundStudies 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.Methods1122 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.ResultsChronic 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.ConclusionsPain, 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】

CC BY   
© Gerrits et al.; licensee BioMed Central Ltd. 2014