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Cited by 212Musculoskeletal pain and rehabilitationAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesChronic Disease Management Strategies

The DOI matches its Crossref record; 65 of the 65 references it cites were found in a registry or an index.

Association between anxiety, health-related quality of life and functional impairment in primary care patients with chronic pain

Kroenke, Kurt, Outcalt, Samantha, Krebs, Erin, Bair, Matthew J., Wu, Jingwei, Chumbler, Neale, Yu, Zhangsheng·2013·General Hospital Psychiatry
DOI 10.1016/j.genhosppsych.2013.03.020
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Abstract

Objective Anxiety and chronic pain are prevalent and frequently co-occur. Our purpose was to examine the association between anxiety, health-related quality of life (HRQL) and functional impairment in primary care patients with chronic musculoskeletal pain.Methods Data were drawn from baseline interviews of the 250 primary care patients enrolled in the Stepped Care to Optimize Pain care Effectiveness trial. Validated measures were used to determine the proportion of patients screening positive for five common anxiety disorders: generalized anxiety, panic, social anxiety, posttraumatic stress and obsessive-compulsive disorder. Bivariate analyses examined associations between the type and number of anxiety disorders for which patients screened positive and representative pain, psychological and other HRQL outcomes. Multivariable models controlling for major depression and other covariates examined the association between the number of screen-positive anxiety conditions and functional impairment in psychological [SF-12 mental component summary (MCS) score], pain [Brief Pain Inventory (BPI) interference score] and work (disability days) domains.Results One hundred fourteen (45%) patients screened positive for at least one anxiety disorder and, compared to the 136 screen-negative patients, had significantly worse scores across multiple pain, psychological and other HRQL domains. Substantial impairment was seen for each of the five screen-positive anxiety conditions and progressively worsened as the number of conditions increased from one (n=54) to two (n=26) to ≥3 (n=34). The number of screen-positive anxiety conditions was strongly associated (P<.0001) with worse BPI interference and MCS scores and more disability days in models adjusting for age, sex and medical comorbidity. After further adjusting for major depression, associations were attenuated but remained significant for BPI interference (P<.0001) and MCS (P=.018) and marginally significant for disability days (P=.062).Conclusion Nearly half of primary care patients with chronic pain screen positive for one or more anxiety disorders, which in turn are adversely associated with impairment across multiple domains of HRQL. Detecting and treating anxiety may be an important component of pain management.

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Metadata

Authors
Kroenke, K., Outcalt, S., Krebs, E., Bair, M. J., Wu, J., Chumbler, N., & Yu, Z.
Affiliations
  • Regenstrief Institute (US)
  • Richard L. Roudebush VA Medical Center (US)
  • University of Minnesota (US)
  • Indiana University Indianapolis (US)
  • University of Georgia (US)
Corresponding author
Kroenke, Kurt
ORCID
Venue
General Hospital Psychiatry
Publisher
Elsevier BV
Published
2013-07
Volume
35
Issue
4
Pages
359-365
ISSN
0163-8343 (ISSN-L)
DOI
10.1016/j.genhosppsych.2013.03.020
OpenAlex
W2147740297
Cited by
212
References
65
Citations by year
2026: 11 · 2025: 16 · 2024: 13 · 2023: 13 · 2022: 13 · 2021: 20 · 2020: 16 · 2019: 23 · 2018: 22 · 2017: 18 · 2016: 20 · 2015: 12 · 2014: 12 · 2013: 1
FWCI
11.01
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • General Hospital Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Health Sciences › Medicine › Epidemiology › Chronic Disease Management Strategies
Keywords
anxiety disorders, chronic musculoskeletal pain, health-related quality of life, functional disability, primary care patients, generalized anxiety disorder, panic disorder, social anxiety, post-traumatic stress disorder, obsessive-compulsive disorder, pain interference, work disability, major depressive disorder, stepped care
MeSH terms
Anxiety Disorders, Major Depressive Disorder, Female, Health Status, Humans, Male, Middle Aged, Obsessive-Compulsive Disorder, Pain Measurement, Phobic Disorders, Primary Health Care, Quality of Life, Stress Disorders, Post-Traumatic, Comorbidity, Multivariate Analysis, Panic Disorder, Chronic Pain

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