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
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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“It has been used and validated with chronic condition populations.17”
From Investigating the effectiveness of an online acceptance and commitment therapy (ACT) intervention versus a waiting list control condition on pain interference and quality of life in adults with chronic pain and multimorbidity: Protocol for a randomised controlled trial (2019) · cites this paper as [17]
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“There is also increasing evidence to support the co-occurrence of persistent pain and anxiety disorders such as generalised anxiety disorder, panic attacks, social anxiety or post-traumatic stress disorder.6–8”
From Protocol for a feasibility and acceptability study using a brief ACT-based intervention for people from Southwest Wales who live with persistent pain (2018) · cites this paper as [8]
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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
- Venue
- General Hospital Psychiatry
- Publisher
- Elsevier BV
- Published
- 2013-07
- Volume
- 35
- Issue
- 4
- Pages
- 359-365
- ISSN
- 0163-8343 (ISSN-L)
- 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
- 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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