Cited by 290Musculoskeletal pain and rehabilitationMental Health Treatment and AccessChronic Disease Management Strategies

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Depression in patients with chronic pain attending a specialised pain treatment centre: prevalence and impact on health care costs

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Rayner, Lauren, Hotopf, Matthew, Petkova, Hristina, Matcham, Faith, Simpson, Anna, McCracken, Lance M.·2016·Pain

DOI 10.1097/j.pain.0000000000000542PMC PMC4912238

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Abstract

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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Effect of different weekly frequencies of Chen-style Tai Chi in elders with chronic non-specific low back pain: Study protocol for a randomised controlled trialPreprint
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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
ORCID: Rayner, Lauren
Hotopf, Matthew
Matcham, Faith
Simpson, Anna
McCracken, Lance M.
Venue: Pain
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2016-03-08
Volume: 157
Issue: 7
Pages: 1472-1479
ISSN: 0304-3959 (ISSN-L)
1872-6623
DOI: 10.1097/j.pain.0000000000000542
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
Licence: cc-by
creativecommons.org/licenses/by/4.0/ (unspecified)
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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Depression in patients with chronic pain attending a specialised pain treatment centre: prevalence and impact on health care costs

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