The DOI matches its Crossref record; 37 of the 38 references it cites were found in a registry or an index.
Depression in patients with chronic pain attending a specialised pain treatment centre: prevalence and impact on health care costs
Open accessAbstract
This cross-sectional study aimed to determine the prevalence and impact of depression on health care costs in patients with complex chronic pain. The sample included 1204 patients attending a tertiary pain management service for people with chronic disabling pain, unresponsive to medical treatment. As part of routine care, patients completed a web-based questionnaire assessing mental and physical health, functioning, and service use in the preceding 3 months. Depression was assessed using the 9-item Patient Health Questionnaire. Self-report health care utilisation was measured across 4 domains: general practitioner contacts, contacts with secondary/tertiary care doctors, accident and emergency department visits, and days hospitalised. The participation rate was 89%. Seven hundred and thirty-two patients (60.8%; 95% CI 58.0-63.6) met criteria for probable depression, and 407 (33.8%) met the threshold for severe depression. Patients with depression were more likely to be unable to work because of ill health and reported greater work absence, greater pain-related interference with functioning, lower pain acceptance, and more generalised pain. Mean total health care costs per 3-month period were £731 (95% CI £646-£817) for patients with depression, compared with £448 (95% CI £366-£530) for patients without depression. A positive association between severe depression and total health care costs persisted after controlling for key demographic, functional, and clinical covariates using multiple linear regression models. These findings reveal the extent, severity, and impact of depression in patients with chronic pain and make evident a need for action. Effective treatment of depression may improve patient health and functioning and reduce the burden of chronic pain on health care services.
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“Chronic pain is highly prevalent worldwide and associated with major personal and societal burden.1–5”
From Clinical and cost-effectiveness of a guided internet-based Acceptance and Commitment Therapy to improve chronic pain-related disability in green professions (PACT-A): Study protocol of a pragmatic randomised controlled trial (2020) · cites this paper as [4]
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Citations
Cites
Depression and Pain Comorbidity: A Literature Review
Bair, M. J., Robinson, R. L., Katon, W., & Kroenke, K. (2003) · Archives of Internal Medicine · doi:10.1001/archinte.163.20.2433 · Cited by 3,463
Utility of a new procedure for diagnosing mental disorders in primary care. The PRIME-MD 1000 study
Spitzer, R. L. (1994) · JAMA · doi:10.1001/jama.272.22.1749 · Cited by 2,648
Utility of a New Procedure for Diagnosing Mental Disorders in Primary Care: The PRIME-MD 1000 Study
Spitzer, R. L. (1994) · JAMA · doi:10.1001/jama.1994.03520220043029 · Cited by 1,873
Psychological therapies for the management of chronic pain (excluding headache) in adults
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Development of the Wisconsin Brief Pain Questionnaire to assess pain in cancer and other diseases
Daut, R. L., Cleeland, C. S., & Flanery, R. C. (1983) · Pain · doi:10.1016/0304-3959(83)90143-4 · Cited by 1,562
Validation of the Brief Pain Inventory for chronic nonmalignant pain
Tan, G., Jensen, M. P., Thornby, J. I., & Shanti, B. F. (2004) · The Journal of Pain · doi:10.1016/j.jpain.2003.12.005 · Cited by 1,416 · cited 1×
“Higher score 5 greater relief, median (IQR) 30 (20-50) 30 (20-50) 40 (20-50) z 521.”
Acceptance of chronic pain: component analysis and a revised assessment method
McCracken, L. M., Vowles, K. E., & Eccleston, C. (2004) · Pain · doi:10.1016/j.pain.2003.10.012 · Cited by 1,101
Self-citationSelf-Reported Utilization of Health Care Services: Improving Measurement and Accuracy
Bhandari, A., & Wagner, T. H. (2006) · Medical Care Research and Review · doi:10.1177/1077558705285298 · Cited by 754
Learning to live with the pain: acceptance of pain predicts adjustment in persons with chronic pain
McCracken, L. M. (1998) · Pain · doi:10.1016/s0304-3959(97)00146-2 · Cited by 685
Self-citationComorbid Depression, Chronic Pain, and Disability in Primary Care
Arnow, B. A., Hunkeler, E. M., Blasey, C. M., Lee, J., Constantino, M. J., FIREMAN, B. H., KRAEMER, H. C., Dea, R., Robinson, R., & Hayward, C. (2006) · Psychosomatic Medicine · doi:10.1097/01.psy.0000204851.15499.fc · Cited by 542
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The excess costs of depression: a systematic review and meta-analysis
König, H., König, H.-H., & Konnopka, A. (2019) · Epidemiology and Psychiatric Sciences · doi:10.1017/s2045796019000180 · Cited by 411
Aaron, R. V., Fisher, E., de la Vega, R., Lumley, M. A., & Palermo, T. M. (2019) · Pain · doi:10.1097/j.pain.0000000000001487 · Cited by 176
The IASP classification of chronic pain for ICD-11: functioning properties of chronic pain
Nugraha, B., Gutenbrunner, C., Barke, A., Karst, M., Schiller, J., Schäfer, P., Falter, S., Korwisi, B., Rief, W., Treede, R.-D., et al. (2019) · Pain · doi:10.1097/j.pain.0000000000001433 · Cited by 153
Khedr, E. M., Omran, E. A. H., Ismail, N. M., El-Hammady, D. H., Goma, S. H., Kotb, H. I., Galal, H., Osman, A. M., Farghaly, H. S. M., Karim, A. A., et al. (2017) · Brain stimulation · doi:10.1016/j.brs.2017.06.006 · Cited by 144
Becker, L. J., Fillinger, C., Waegaert, R., Journée, S. H., Hener, P., Ayazgök, B., Humo, M., Karatas, M., Thouaye, M., Gaikwad, M., et al. (2023) · Nature Communications · doi:10.1038/s41467-023-37878-y · Cited by 122
Metadata
- Authors
- Rayner, L., Hotopf, M., Petkova, H., Matcham, F., Simpson, A., & McCracken, L. M.
- Affiliations
- Psychological Medicine and
- King's College London (GB)
- Corresponding author
- Rayner, Lauren
- Venue
- Pain
- Published
- 2016-03-08
- Volume
- 157
- Issue
- 7
- Pages
- 1472-1479
- ISSN
- 0304-3959 (ISSN-L)
- 1872-6623
- PMC
- PMC4912238
- OpenAlex
- W2293157729
- Cited by
- 290
- References
- 38
- Citations by year
- 2026: 21 · 2025: 26 · 2024: 36 · 2023: 42 · 2022: 34 · 2021: 30 · 2020: 33 · 2019: 32 · 2018: 19 · 2017: 15 · 2016: 2
- FWCI
- 18.35
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Pain (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Research Portal (King's College London) (submittedVersion, cc-by)
- Funders
- South London and Maudsley NHS Foundation Trust
- National Institute for Health and Care Research (NF-SI-0515-10102)
- King's College London
- King's Health Partners
- Topics
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Health Sciences › Medicine › Epidemiology › Chronic Disease Management Strategies
- Keywords
- depression, chronic pain, health care costs, depression prevalence, severe depression, absenteeism, pain interference, pain acceptance, general practitioner contact, hospitalization, Patient Health Questionnaire
- MeSH terms
- Absenteeism, Adult, Cross-Sectional Studies, Depressive Disorder, Female, Humans, Male, Middle Aged, Prevalence, Health Care Costs, Chronic Pain, Pain Management
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