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The Association of Depression and Anxiety with Pain: A Study from NESDA
Open accessAbstract
Chronic pain is commonly co-morbid with a depressive or anxiety disorder. Objective of this study is to examine the influence of depression, along with anxiety, on pain-related disability, pain intensity, and pain location in a large sample of adults with and without a depressive and/or anxiety disorder. The study population consisted of 2981 participants with a depressive, anxiety, co-morbid depressive and anxiety disorder, remitted disorder or no current disorder (controls). Severity of depressive and anxiety symptoms was also assessed. In separate multinomial regression analyses, the association of presence of depressive or anxiety disorders and symptom severity with the Chronic Pain Grade and location of pain was explored. Presence of a depressive (OR = 6.67; P<.001), anxiety (OR = 4.84; P<.001), or co-morbid depressive and anxiety disorder (OR = 30.26; P<.001) was associated with the Chronic Pain Grade. Moreover, symptom severity was associated with more disabling and severely limiting pain. Also, a remitted depressive or anxiety disorder showed more disabling and severely limiting pain (OR = 3.53; P<.001) as compared to controls. A current anxiety disorder (OR = 2.96; p<.001) and a co-morbid depressive and anxiety disorder (OR = 5.15; P<.001) were more strongly associated with cardio-respiratory pain, than gastro-intestinal or musculoskeletal pain. These findings remain after adjustment for chronic cardio respiratory illness. Patients with a current and remitted depressive and/or anxiety disorder and those with more severe symptoms have more disabling pain and pain of cardio-respiratory nature, than persons without a depressive or anxiety disorder. This warrants further research.
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“there is also considerable evidence on the comorbidity of chronic pain and mood disorders [84].”
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“Previous studies have consistently found that patients with high levels of anxiety and depression receiving opioid treatment for chronic pain are at increased risk of developing opioid misuse [80,81,82,83,84,85,86,87,88,89,90].”
From Pain acceptance creates an emotional context that protects against the misuse of prescription opioids: A study in a sample of patients with chronic noncancer pain (2021) · cites this paper as [84]
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Metadata
- Authors
- de Heer, E. W., Gerrits, M. M. J. G., Beekman, A. T. F., Dekker, J., van Marwijk, H. W. J., de Waal, M. W. M., Spinhoven, P., Penninx, B. W. J. H., & van der Feltz-Cornelis, C. M.
- Affiliations
- Amsterdam Public Health (NL)
- Arkin (NL)
- Leiden University (NL)
- ORCID
- Venue
- PLoS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2014-10-15
- Volume
- 9
- Issue
- 10
- Pages
- e106907
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC4198088
- OpenAlex
- W2015721095
- Cited by
- 363
- References
- 70
- Citations by year
- 2026: 20 · 2025: 34 · 2024: 33 · 2023: 39 · 2022: 37 · 2021: 57 · 2020: 37 · 2019: 22 · 2018: 32 · 2017: 15 · 2016: 25 · 2015: 11 · 2014: 1
- FWCI
- 12.59
- Type
- journal article
- Language
- en
- Update notices
- correction (2014-12-01)
- Open access
- gold
- doi.org
- Locations
- PLoS ONE (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- Research portal (Tilburg University) (publishedVersion, other-oa)
- PubMed (publishedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Leiden Repository (Leiden University) (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Pure Amsterdam UMC (submittedVersion)
- Research Explorer (The University of Manchester) (submittedVersion)
- VU Research Portal (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Funders
- Eli Lilly and Company
- College of Family Physicians of Canada
- Universiteit Leiden (10‐000‐1002)
- ZonMw (10‐000‐1002)
- Vrije Universiteit Amsterdam
- GGZ inGeest
- Rivierduinen
- GGZ Friesland
- GGZ Drenthe
- Nederlands Instituut voor Onderzoek van de Gezondheidszorg (10-000-1002)
- Leids Universitair Medisch Centrum
- Universitair Medisch Centrum Groningen
- H. Lundbeck A/S
- 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
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- depression, anxiety, chronic pain, pain-related disability, pain intensity, pain localization, remitted depression, symptom severity, gastrointestinal pain, musculoskeletal pain, NESDA
- MeSH terms
- Adult, Anxiety Disorders, Depressive Disorder, Female, Humans, Male, Middle Aged, Pain Measurement, Surveys and Questionnaires, Severity of Illness Index, Comorbidity, Chronic Pain
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