The DOI matches its Crossref record; 74 of the 75 references it cites were found in a registry or an index.
Association of Depression and Anxiety Alone and in Combination With Chronic Musculoskeletal Pain in Primary Care Patients
Open accessAbstract
Objective: To assess the relationship between depression and anxiety comorbidity on pain intensity, pain-related disability, and health-related quality of life (HRQL). Methods: Analysis of baseline data from the Stepped Care for Affective Disorders and Musculoskeletal Pain (SCAMP) study. All patients (n = 500) had chronic pain (≥3-month duration) of the low back, hip, or knee. Patients with depression were oversampled for the clinical trial component of SCAMP and thus represented 50% of the study population. Patients were categorized according to pain comorbid with depression, anxiety, or both. We used analysis of variance and multivariate analysis of variance models to assess the relationships between independent and dependent variables. Results: Participants had a mean age of 59 years; they were 55% women, 56% White, and 40% Black. Fifty-four percent (n = 271) reported pain only, 20% (n = 98) had pain and depression, 3% (n = 15) had pain and anxiety, and 23% (n = 116) had pain, depression, and anxiety. Patients with pain and both depression and anxiety experienced the greatest pain severity (p < .0001) and pain-related disability (p < .0001). Psychiatric comorbidity was strongly associated with disability days in the past 3 months (p < .0001), with 18.1 days reported by patients with pain only, 32.2 days by those with pain and anxiety, 38.0 days by those with pain and depression, and 42.6 days in those with all three conditions. We found a similar pattern of poorer HRQL (p < .0001) in those with pain, depression, and anxiety. Conclusions: The added morbidity of depression and anxiety with chronic pain is strongly associated with more severe pain, greater disability, and poorer HRQL. ANOVA = analysis of variance; BPI = Brief Pain Inventory; GAD-7 = Generalized Anxiety Disorder 7-item scale; HRQL = health-related quality of life; ICD-9 = International Statistical Classification of Diseases and Related Health Problems, 9th Edition; IU = Indiana University; MANOVA = multivariate analysis of variance; MRI = magnetic resonance imaging; PA = pain and anxiety; PD = pain and depression; PDA = pain, depression, and anxiety; PHQ-9 = Patient Health Questionnaire-9; PO = pain only; SCAMP = stepped care for affective disorders and musculoskeletal pain; SCL-20 = Hopkins Symptom Checklist-20; SF-36 = Medical Outcomes Study Short Form-36; VA = Veterans Affairs.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
The PHQ-9: Validity of a brief depression severity measure
Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2001) · Journal of General Internal Medicine · doi:10.1046/j.1525-1497.2001.016009606.x · Cited by 44,910
Self-citationA Brief Measure for Assessing Generalized Anxiety Disorder: The GAD-7
Spitzer, R. L., Kroenke, K., Williams, J. B. W., & Löwe, B. (2006) · Archives of Internal Medicine · doi:10.1001/archinte.166.10.1092 · Cited by 31,765
Self-citationLovibond, P. F., & Lovibond, S. H. (1995) · Behaviour Research and Therapy · doi:10.1016/0005-7967(94)00075-u · Cited by 14,523
Spitzer, R. L. (1999) · JAMA · doi:10.1001/jama.282.18.1737 · Cited by 9,802
MCHORNEY, C. A., JOHNE, W., & ANASTASIAE, R. (1993) · Medical Care · doi:10.1097/00005650-199303000-00006 · Cited by 6,681
Pain assessment: global use of the Brief Pain Inventory.
Cs, C., & Km, R. (1994) · PubMed · Cited by 5,178
Anxiety disorders in primary care: prevalence, impairment, comorbidity, and detection
Kroenke, K., Spitzer, R. L., Williams, J. B. W., Monahan, P. O., & Löwe, B. (2007) · Annals of Internal Medicine · doi:10.7326/0003-4819-146-5-200703060-00004 · Cited by 4,741
Self-citationGlobal mortality, disability, and the contribution of risk factors: Global Burden of Disease Study
Murray, C. J., & Lopez, A. D. (1997) · The Lancet · doi:10.1016/s0140-6736(96)07495-8 · Cited by 4,492 · cited 1×
“Major depression is the fourth leading cause of disease burden worldwide and projected to move into second place by 2020 (13).”
BackgroundAn Ultra-Brief Screening Scale for Anxiety and Depression: The PHQ–4
Kroenke, K., Spitzer, R. L., Williams, J. B. W., & Löwe, B. (2009) · Psychosomatics · doi:10.1016/s0033-3182(09)70864-3 · Cited by 4,261
Self-citation(1994) · Medical Entomology and Zoology · Cited by 4,156
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
Self-citationA Study of the Natural History of Back Pain: Part I
ROLAND, M., & MORRIS, R. (1983) · Spine · doi:10.1097/00007632-198303000-00004 · Cited by 3,395
Grading the severity of chronic pain
Von Korff, M., Ormel, J., Keefe, F. J., & Dworkin, S. F. (1992) · Pain · doi:10.1016/0304-3959(92)90154-4 · Cited by 3,022
(1985) · Cited by 2,882
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
Unützer, J., Katon, W., Callahan, C. M., Williams, Jr., Hunkeler, E., Harpole, L., Hoffing, M., Della Penna, R. D., Noël, P. H., Lin, E. H. B., et al. (2002) · JAMA · doi:10.1001/jama.288.22.2836 · Cited by 2,405
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
A review of psychological risk factors in back and neck pain
Linton, S. J. (2000) · Spine · doi:10.1097/00007632-200005010-00017 · Cited by 1,776
Regier, D. A. (1988) · Archives of General Psychiatry · doi:10.1001/archpsyc.1988.01800350011002 · Cited by 1,737
Anxiety Disorders and Phobias: A Cognitive Perspective
Dietch, J. T. (1986) · Psychosomatics · doi:10.1016/s0033-3182(86)72726-6 · Cited by 1,514
Six-item screener to identify cognitive impairment among potential subjects for clinical research
Callahan, C. M., Unverzagt, F. W., Hui, S. L., Perkins, A. J., & Hendrie, H. C. (2002) · Medical Care · doi:10.1097/00005650-200209000-00007 · Cited by 1,499 · cited 1×
“cognitive screener (34); c) had bipolar disorder or schizophrenia; d) had a”
BackgroundCost of Lost Productive Work Time Among US Workers With Depression
Stewart, W. F. (2003) · JAMA · doi:10.1001/jama.289.23.3135 · Cited by 1,421
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 2×
“We assessed pain outcomes with the BPI-Short Form, an 11-item multidimensional pain scale with demonstrated reliability in patients with cancer, and nonmalignant chronic pain, such as arthritis and other painful conditions (30,36,37).”
MethodThe Economic Burden of Depression in the United States: How Did It Change Between 1990 and 2000?
Greenberg, P. E., Kessler, R. C., Birnbaum, H. G., Leong, S. A., Lowe, S. W., Berglund, P. A., & Corey-Lisle, P. K. (2003) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v64n1211 · Cited by 1,280
The economic burden of anxiety disorders in the 1990s
Greenberg, P. E., Sisitsky, T., Kessler, R. C., Finkelstein, S. N., Berndt, E. R., Davidson, J. R. T., Ballenger, J. C., & Fyer, A. J. (1999) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v60n0702 · Cited by 1,242 · cited 1×
“Anxiety disorders afflict 30 million Americans in their lifetime (16), and cost the US an estimated $42 billion per year in direct and indirect costs (17).”
BackgroundDworkin, R. H., Bačkonja, M., Rowbotham, M. C., Allen, R. R., Argoff, C., Bennett, G. J., Bushnell, M. C., Farrar, J. T., Galer, B. S., Haythornthwaite, J. A., et al. (2003) · Archives of Neurology · doi:10.1001/archneur.60.11.1524 · Cited by 1,213
An epidemiologic comparison of pain complaints
Korff, M. V., Dworkin, S. F., LeResche, L., & Kruger, A. (1988) · Pain · doi:10.1016/0304-3959(88)90066-8 · Cited by 966
McWilliams, L. A., Cox, B. J., & Enns, M. W. (2003) · Pain · doi:10.1016/s0304-3959(03)00301-4 · Cited by 951
Common symptoms in ambulatory care: incidence, evaluation, therapy, and outcome
Kroenke, K., & Mangelsdorff, A. D. (1989) · The American Journal of Medicine · doi:10.1016/0002-9343(89)90293-3 · Cited by 947
Burt, C. W., & Schappert, S. M. (1997) · PubMed · Cited by 944
A Multifaceted Intervention to Improve Treatment of Depression in Primary Care
Katon, W. (1996) · Archives of General Psychiatry · doi:10.1001/archpsyc.1996.01830100072009 · Cited by 835
Spitzer, R. L. (1995) · JAMA · doi:10.1001/jama.274.19.1511 · Cited by 771
Pain Catastrophizing and Kinesiophobia: Predictors of Chronic Low Back Pain
Picavet, H. S. J. (2002) · American Journal of Epidemiology · doi:10.1093/aje/kwf136 · Cited by 744
Osborn, R. L., Demoncada, A. C., & Feuerstein, M. (2006) · The International Journal of Psychiatry in Medicine · doi:10.2190/eufn-rv1k-y3tr-fk0l · Cited by 621
Symptoms in the community. Prevalence, classification, and psychiatric comorbidity
Kroenke, K. (1993) · Archives of Internal Medicine · doi:10.1001/archinte.153.21.2474 · Cited by 574
Self-citationMale and female chronic pain patients categorized by DSM-III psychiatric diagnostic criteria
Fishbain, D. A., GOLDBERG, M. L., Meagher, R. B., Steele, R., & Rosomoff, H. L. (1986) · Pain · doi:10.1016/0304-3959(86)90074-6 · Cited by 560
The impact of chronic pain in the community.
Smith, B. H., Elliott, A. M., Chambers, W. A., Smith, W. C., Hannaford, P. C., & Penny, K. (2001) · Family Practice · doi:10.1093/fampra/18.3.292 · Cited by 540
Health-Related Quality of Life in Primary Care Patients With Mental Disorders
Spitzer, R. L., Kroenke, K., Linzer, M., Hahn, S. R., Williams, J. B. W., deGruy, F. V., Brody, D. S., & Davies, M. (1995) · JAMA · doi:10.1001/jama.1995.03530190025030 · Cited by 505
Self-citationKroenke, K., & Swindle, R. (2000) · Psychotherapy and Psychosomatics · doi:10.1159/000012395 · Cited by 478
Self-citationAdvances in Pain Research and Therapy.
Lamer, T. J. (1990) · Clinical Journal of Pain · doi:10.1097/00002508-199006000-00024 · Cited by 445
McCracken, L. M., & Turk, D. C. (2002) · Spine · doi:10.1097/00007632-200211150-00033 · Cited by 439
Pain modulation: expectation, opioid analgesia and virtual pain
Fields, H. L. (2000) · Progress in brain research · doi:10.1016/s0079-6123(08)62143-3 · Cited by 436
Association Between Mental Health Disorders, Problem Drug Use, and Regular Prescription Opioid Use
Sullivan, M. D., Edlund, M. J., Zhang, L., Unützer, J., & Wells, K. B. (2006) · Archives of Internal Medicine · doi:10.1001/archinte.166.19.2087 · Cited by 436
Kroenke, K. (1993) · Archives of Internal Medicine · doi:10.1001/archinte.1993.00410210102011 · Cited by 408
Self-citationMental Disorders and Disability Among Patients in a Primary Care Group Practice
Olfson, M., FIREMAN, B. H., Weissman, M. M., Leon, A. C., Sheehan, D. V., Kathol, R. G., Hoven, C. W., & Farber, L. H. (1997) · American Journal of Psychiatry · doi:10.1176/ajp.154.12.1734 · Cited by 404
Kessler, D. S., Lloyd, K. R., Lewis, G., Gray, D. P., & Heath, I. (1999) · BMJ · doi:10.1136/bmj.318.7181.436 · Cited by 385
Impact of pain on depression treatment response in primary care
Bair, M. J., Robinson, R. L., Eckert, G. J., Stang, P. E., Croghan, T. W., & Kroenke, K. (2004) · Psychosomatic Medicine · doi:10.1097/01.psy.0000106883.94059.c5 · Cited by 371
Self-citationCommon comorbidity scales were similar in their ability to predict health care costs and mortality
Perkins, A. J., Kroenke, K., Unützer, J., Katon, W. J., Williams, J. W., Hope, C. J., & Callahan, C. M. (2004) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2004.03.002 · Cited by 343
Self-citationChronic Pain and Poor Self-rated Health
Mäntyselkä, P. T. (2003) · JAMA · doi:10.1001/jama.290.18.2435 · Cited by 340
Spitzer, R. L., Kroenke, K., Linzer, M., Hahn, S. R., Williams, J. B. W., deGruy, F. V., Brody, D. S., & Davies, M. (1995) · PubMed · Cited by 323
Self-citationSimilar Effectiveness of Paroxetine, Fluoxetine, and Sertraline in Primary Care
Kroenke, K., West, S. L., Swindle, R. W., Gilsenan, A., Eckert, G. J., Dolor, R. J., Stang, P., Zhou, X., Hays, R. D., & Weinberger, M. (2001) · JAMA · doi:10.1001/jama.286.23.2947 · Cited by 310
Self-citationNeuroanatomical circuits modulating fear and anxiety behaviors
Charney, D. S. (2003) · Acta Psychiatrica Scandinavica · doi:10.1034/j.1600-0447.108.s417.3.x · Cited by 293
Schonfeld, W. H., Verboncoeur, C. J., Fifer, S., Lipschutz, R. C., Lubeck, D. P., & Buesching, D. P. (1997) · Journal of Affective Disorders · doi:10.1016/s0165-0327(96)01416-4 · Cited by 250
Antidepressants as analgesics: a review of randomized controlled trials.
Lynch, M. E. (2001) · PubMed · Cited by 242
Jensen, M. P., Strom, S. E., Turner, J. A., & Romano, J. M. (1992) · Pain · doi:10.1016/0304-3959(92)90156-6 · Cited by 187
Depressive, anxiety, and somatoform disorders in primary care: prevalence and recognition
Mergl, R., Seidscheck, I., Allgaier, A., Möller, H., Hegerl, U., & Henkel, V. (2006) · Depression and Anxiety · doi:10.1002/da.20192 · Cited by 172
Effects of Duloxetine on Painful Physical Symptoms Associated With Depression
GOLDSTEIN, D. J., Lu, Y., Detke, M. J., Hudson, J. I., Iyengar, S., & Demitrack, M. A. (2004) · Psychosomatics · doi:10.1176/appi.psy.45.1.17 · Cited by 154
Chronic Pain and Emotional Distress in Children and Adolescents
Varni, J. W., Rapoff, M. A., Waldron, S. A., Gragg, R. A., Bernstein, B., & Lindsley, C. B. (1996) · Journal of Developmental & Behavioral Pediatrics · doi:10.1097/00004703-199606000-00003 · Cited by 141
Managing pain and comorbid depression: A public health challenge.
Gallagher, R. M., & Verma, S. (1999) · PubMed · Cited by 133
Prevalence and impact of depression and pain in neurology outpatients
Williams, L. S. (2003) · Journal of Neurology Neurosurgery & Psychiatry · doi:10.1136/jnnp.74.11.1587 · Cited by 132
Functional imaging and pain: behavior, perception, and modulation.
Porro, C. A. (2003) · The Neuroscientist · doi:10.1177/1073858403253660 · Cited by 132
Fishbain, D. A. (1999) · Medical Clinics of North America · doi:10.1016/s0025-7125(05)70132-2 · Cited by 128
Krishnan, R. R., France, R. D., Pelton, S., McCann, U. D., Davidson, J. R. T., & Urban, B. J. (1985) · Pain · doi:10.1016/0304-3959(85)90029-6 · Cited by 120
Prevalence of mental disorders in primary care. Implications for screening
Leon, A. C. (1995) · Archives of Family Medicine · doi:10.1001/archfami.4.10.857 · Cited by 115
McLaughlin, T. P., Khandker, R. K., Kruzikas, D. T., & Tummala, R. (2006) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v67n0803 · Cited by 105
Stepped Care for Affective Disorders and Musculoskeletal Pain (SCAMP) study
Kroenke, K., Bair, M. J., Damush, T. M., Hoke, S., Nicholas, G., Kempf, C., Huffman, M. A., Wu, J., & Sutherland, J. M. (2007) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2007.08.005 · Cited by 96
Self-citationDuloxetine in treatment of anxiety symptoms associated with depression
Dünner, D. L., GOLDSTEIN, D. J., Mallinckrodt, C. H., Lu, Y., & Detke, M. J. (2003) · Depression and Anxiety · doi:10.1002/da.10122 · Cited by 73
Coping with Chronic Pain: A Guide to Patient Self-management
Hanson, R. W., & Gerber, K. E. (1989) · Medical Entomology and Zoology · Cited by 71
Beecher, H. K. (1969) · JAMA · doi:10.1001/jama.1969.03160200044014 · Cited by 60
Verhaak, P. F. M., Schellevis, F., Nuijen, J., & Volkers, A. (2006) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2005.11.001 · Cited by 56
Private body consciousness, anxiety and pain symptom reports of chronic pain patients
Ferguson, R. J., & Ahles, T. A. (1998) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(98)00048-5 · Cited by 55
Psychopathology in Medical Inpatients and its Relationship to Length of Hospital Stay: A Pilot Study
Levenson, J. L., Hamer, R. M., Silverman, J. J., & Rossiter, L. F. (1987) · The International Journal of Psychiatry in Medicine · doi:10.2190/k51b-h0vh-cf2k-d0wj · Cited by 34
ADVANCES IN COMPREHENSIVE PAIN MANAGEMENT
Koenig, T. W., & Clark, M. R. (1996) · Psychiatric Clinics of North America · doi:10.1016/s0193-953x(05)70307-5 · Cited by 28
Collaborative Management to Achieve Treatment Guidelines: Impact on Depression in Primary Care
Katon, W. (1995) · JAMA · doi:10.1001/jama.1995.03520370068039 · Cited by 6
Flagged first, then by citations
1 of the 75 references couldn’t be matched to a known paper.
Cited by
Sorted by citations
Kroenke, K., Spitzer, R. L., Williams, J. B. W., & Löwe, B. (2010) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2010.03.006 · Cited by 4,057
Self-citationRELIEVING PAIN IN AMERICA: A BLUEPRINT FOR TRANSFORMING PREVENTION, CARE, EDUCATION, AND RESEARCH
Simon, L. S. (2012) · Journal of Pain & Palliative Care Pharmacotherapy · doi:10.3109/15360288.2012.678473 · Cited by 2,200
Descending pain modulation and chronification of pain
Ossipov, M. H., Morimura, K., & Porreca, F. (2014) · Current Opinion in Supportive and Palliative Care · doi:10.1097/spc.0000000000000055 · Cited by 875
Neuroinflammation and comorbidity of pain and depression
Walker, A. K., Kavelaars, A., Heijnen, C. J., & Dantzer, R. (2014) · Pharmacological Reviews · doi:10.1124/pr.113.008144 · Cited by 460
Lerman, S. F., Rudich, Z., Brill, S., Shalev, H., & Shahar, G. (2015) · Psychosomatic Medicine · doi:10.1097/psy.0000000000000158 · Cited by 408
Metadata
- Authors
- Bair, M. J., Wu, J., Damush, T. M., Sutherland, J. M., & Kroenke, K.
- Affiliations
- Richard L. Roudebush VA Medical Center (US)
- Dartmouth College (US)
- Corresponding author
- Bair, Matthew J.
- Venue
- Psychosomatic Medicine
- Published
- 2008-10
- Volume
- 70
- Issue
- 8
- Pages
- 890-897
- ISSN
- 0033-3174 (ISSN-L)
- PMC
- PMC2902727
- OpenAlex
- W2049101564
- Cited by
- 572
- References
- 75
- Citations by year
- 2026: 25 · 2025: 25 · 2024: 36 · 2023: 26 · 2022: 33 · 2021: 48 · 2020: 42 · 2019: 42 · 2018: 37 · 2017: 32 · 2016: 28 · 2015: 43 · 2014: 35 · 2013: 29 · 2012: 22
- FWCI
- 15.94
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Psychosomatic Medicine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- IUScholarWorks (Indiana University) (submittedVersion)
- Funders
- 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 › Fibromyalgia and Chronic Fatigue Syndrome Research
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Keywords
- depression, anxiety, psychiatric comorbidity, pain intensity, pain-related disability, health-related quality of life, low back pain, hip pain, knee pain, primary care
- MeSH terms
- Absenteeism, Adult, Aged, Antidepressive Agents, Anxiety Disorders, Behavior Therapy, Chronic Disease, Combined Modality Therapy, Cross-Sectional Studies, Depressive Disorder, Disability Evaluation, Female, Humans, Male, Middle Aged, Pain, Pain Measurement, Primary Health Care, Prospective Studies, Quality of Life, Self Care, Sick Role, Social Behavior, Cohort Studies, Comorbidity, Self Efficacy, Pain Management
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
