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Longitudinal Associations Between Depression, Anxiety, Pain, and Pain-Related Disability in Chronic Pain Patients
Abstract
OBJECTIVE: The current study sets out to examine the longitudinal relationship between pain, pain-related disability, and symptoms of depression and anxiety. The latter symptoms are highly prevalent in chronic pain and seriously impede functioning and quality of life. Nevertheless, the direction of the relationship involving these variables among individuals with chronic pain is still unclear. METHODS: Four-hundred twenty-eight individuals with chronic pain (238 women, mean age 54.84 years, mean pain duration 85.21 months) treated at two pain clinics completed questionnaires regarding their pain (Short-Form McGill Pain Questionnaire), depression (Center for Epidemiological Studies-Depression Scale), state anxiety (State-Trait Anxiety Inventory), and pain-related disability (Pain Disability Index) at four time points, with an average of 5 months between measurements. Cross-lagged, structural equation modeling analyses were performed, enabling the examination of longitudinal associations between the variables. RESULTS: Significant symptoms of both depression and anxiety were reported by more than half of the sample on all waves. A latent depression/anxiety variable longitudinally predicted pain (β = .27, p < .001) and pain-related disability (β = .38, p < .001). However, neither pain (β = .10, p = .126) nor pain-related disability (β = -.01, p = .790) predicted depression/anxiety. CONCLUSIONS: Among adult patients with chronic pain treated at specialty pain clinics, high levels of depression and anxiety may worsen pain and pain-related disability.
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Chronic pain patients frequently experience sleep disturbance, fatigue, and a reduced quality of life.
“They frequently experience sleep disturbance, fatigue,17 and a reduced quality of life.18”
From Pain and Evil: From Local Nociception to Misery Following Social Harm (2020) · cites this paper as [18]
Asian Americans report greater daily joint pain intensity than non-Hispanic whites and show enhanced sensitivity to thermal and mechanical pain stimuli in the laboratory.
“Similar findings have been noted for Asian Americans, who report a greater intensity of daily joint pain than non-Hispanic whites, and who demonstrate enhanced sensitivity to thermal and mechanical pain stimuli applied in a laboratory setting 225, 226.”
From Evaluating psychosocial contributions to chronic pain outcomes (2018) · cites this paper as [226]
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Metadata
- Authors
- Lerman, S. F., Rudich, Z., Brill, S., Shalev, H., & Shahar, G.
- Affiliations
- Ben-Gurion University of the Negev (IL)
- Corresponding author
- Lerman, Sheera F.
- Venue
- Psychosomatic Medicine
- Published
- 2015-04
- Volume
- 77
- Issue
- 3
- Pages
- 333-341
- ISSN
- 0033-3174 (ISSN-L)
- OpenAlex
- W2067457834
- Cited by
- 408
- References
- 96
- Citations by year
- 2026: 24 · 2025: 46 · 2024: 70 · 2023: 55 · 2022: 39 · 2021: 42 · 2020: 46 · 2019: 37 · 2018: 21 · 2017: 17 · 2016: 9 · 2015: 1
- FWCI
- 11.53
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychosomatic Medicine (publishedVersion)
- PubMed (publishedVersion)
- 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 › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
- Keywords
- chronic pain, depression, anxiety, pain-related disability, pain intensity, longitudinal associations, psychosomatic pain, pain clinic, quality of life
- MeSH terms
- Activities of Daily Living, Adolescent, Adult, Aged, Aged, 80 and over, Anxiety, Depression, Disability Evaluation, Female, Humans, Longitudinal Studies, Male, Middle Aged, Pain Measurement, Prospective Studies, Quality of Life, Surveys and Questionnaires, Cohort Studies, Young Adult, Chronic Pain
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