Beneficial Effects of Improvement in Depression, Pain Catastrophizing, and Anxiety on Pain Outcomes: A 12-Month Longitudinal Analysis
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Unlabelled Depression, pain catastrophizing, and anxiety commonly co-occur with chronic pain. However, the degree to which improvement in these psychological comorbidities predicts subsequent pain outcomes and, in particular, the relative effects of these 3 psychological factors with respect to each other is only partially known. Longitudinal analysis of 250 primary care patients with chronic musculoskeletal pain enrolled in the Stepped Care to Optimize Pain care Effectiveness (SCOPE) trial was examined, using data gathered at baseline, and at 3 and 12 months. Mixed effects model repeated measures analyses were used to determine if changes in depression, pain catastrophizing, and anxiety predicted a subsequent reduction in pain intensity or interference and pain-related disability. Defining a clinically significant change as twice the standard error of measurement for each predictor, we found that a 2-standard error of measurement improvement in depression, pain catastrophizing, and anxiety resulted in, respectively, an effect size decrease in pain intensity or interference of .45, .33, and .12; a 14%, 12%, and 6% reduction in the number of pain-specific disability days; and a 43%, 30%, and 28% decreased likelihood of high disability (defined as ≥10 pain-specific disability days in the past 4 weeks). In summary, improvements in 3 common psychological comorbidities predicted better pain outcomes.Perspective Because depression, pain catastrophizing, and anxiety commonly accompany chronic pain and might adversely affect pain outcomes, treatment of these modifiable psychological factors is warranted to optimize the effectiveness of pain-specific therapies.
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Improvement in depression and anxiety during treatment could improve pain outcomes, such as pain intensity/interference and disability.
“Improvement in depression and anxiety during treatment could improve pain outcomes, such as pain intensity/interference and disability, as well.14”
From Psychological interventions for depression and anxiety: a systematic review and meta-analysis of Iranian chronic pain trials. (2020) · cites this paper as [14]
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- Authors
- Scott, E. L., Kroenke, K., Wu, J., & Yu, Z.
- Affiliations
- Indiana University Indianapolis (US)
- Regenstrief Institute (US)
- Corresponding author
- Kroenke, Kurt
- Venue
- The Journal of Pain
- Publisher
- Elsevier BV
- Published
- 2016-02
- Volume
- 17
- Issue
- 2
- Pages
- 215-222
- ISSN
- 1526-5900 (ISSN-L)
- OpenAlex
- W2126059053
- Cited by
- 98
- References
- 41
- Citations by year
- 2026: 5 · 2025: 3 · 2024: 8 · 2023: 5 · 2022: 14 · 2021: 13 · 2020: 15 · 2019: 14 · 2018: 9 · 2017: 8 · 2016: 4
- FWCI
- 5.03
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Pain (publishedVersion)
- PubMed (publishedVersion)
- Funders
- U.S. Department of Veterans Affairs
- Health Services Research and Development
- Topics
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Pain Management Techniques
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Keywords
- chronic musculoskeletal pain, depression, pain catastrophizing, anxiety, psychological comorbidity, pain intensity, pain interference, pain-related disability, stepped care, primary care, pain outcomes, treatment response prediction
- MeSH terms
- Adult, Aged, Anxiety, Depression, Female, Humans, Longitudinal Studies, Male, Middle Aged, Random Allocation, Comorbidity, Outcome Assessment, Health Care, Catastrophization, Chronic Pain
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