Cited by 573Musculoskeletal pain and rehabilitationPsychosomatic Disorders and Their TreatmentsPain Mechanisms and Treatments

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Reciprocal Relationship Between Pain and Depression: A 12-Month Longitudinal Analysis in Primary Care

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Kroenke, Kurt, Wu, Jingwei, Bair, Matthew J., Krebs, Erin E., Damush, Teresa M., Tu, Wanzhu·2011·The Journal of Pain

DOI 10.1016/j.jpain.2011.03.003PMC PMC3222454

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Abstract

Unlabelled Pain and depression are the most prevalent physical and psychological symptom-based disorders, respectively, and co-occur 30 to 50% of the time. However, their reciprocal relationship and potentially causative effects on one another have been inadequately studied. Longitudinal data analysis involving 500 primary care patients with persistent back, hip, or knee pain were enrolled in the Stepped Care for Affective Disorders and Musculoskeletal Pain (SCAMP) study. Half of the participants had comorbid depression and were randomized to a stepped care intervention (n = 123) or treatment as usual (n = 127). Another 250 nondepressed patients with similar pain were followed in a parallel cohort. Outcomes were assessed at baseline, 3, 6, and 12 months. Mixed effects model repeated measures (MMRM) multivariable analyses were conducted to determine if change in pain severity predicted subsequent depression severity, and vice versa. Change in pain was a strong predictor of subsequent depression severity (t-value = 6.63, P < .0001). Likewise, change in depression severity was an equally strong predictor of subsequent pain severity (t-value = 7.28, P < .0001). Results from the full cohort were similar in the clinical trial subgroup. In summary, pain and depression have strong and similar effects on one another when assessed longitudinally over 12 months.Perspective This study strengthens the evidence for a bidirectional and potentially causative influence of pain and depression on one another. A change in severity of either symptom predicts subsequent severity of the other symptom. Thus, recognition and management of both conditions may be warranted, particularly when treatment focused on 1 condition is not leading to an optimal response.

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Authors: Kroenke, K., Wu, J., Bair, M. J., Krebs, E. E., Damush, T. M., & Tu, W.
Affiliations: Regenstrief Institute (US)
Indiana University Indianapolis (US)
Corresponding author: Kroenke, Kurt
ORCID: Kroenke, Kurt
Wu, Jingwei
Bair, Matthew J.
Krebs, Erin E.
Damush, Teresa M.
Tu, Wanzhu
Venue: The Journal of Pain
Publisher: Elsevier BV
Published: 2011-09
Volume: 12
Issue: 9
Pages: 964-973
ISSN: 1526-5900 (ISSN-L)
DOI: 10.1016/j.jpain.2011.03.003
PMC: PMC3222454
OpenAlex: W2012410632
Cited by: 573
References: 52
Citations by year: 2026: 34 · 2025: 32 · 2024: 48 · 2023: 33 · 2022: 41 · 2021: 63 · 2020: 44 · 2019: 44 · 2018: 46 · 2017: 26 · 2016: 40 · 2015: 43 · 2014: 38 · 2013: 25 · 2012: 16
FWCI: 18.50
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
www.elsevier.com/open-access/userlicense/1.0/ (vor, 4393 d)
Locations: Journal of Pain (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
IUScholarWorks (Indiana University) (submittedVersion)
Funders: Eli Lilly and Company
National Institute of Mental Health (MH 071268, R01MH071268)
Topics: Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
Health Sciences › Medicine › Physiology (medical) › Pain Mechanisms and Treatments
Keywords: pain, depression, bidirectional relationship, comorbidities, musculoskeletal pain, back pain, hip pain, knee pain, stepped care, primary care, pain intensity, depression severity, longitudinal change
MeSH terms: Adult, Aged, Cross-Sectional Studies, Depression, Female, Follow-Up Studies, Humans, Longitudinal Studies, Male, Middle Aged, Pain, Primary Health Care, Cohort Studies

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Reciprocal Relationship Between Pain and Depression: A 12-Month Longitudinal Analysis in Primary Care

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