Comorbid symptoms of depression and musculoskeletal pain and risk of long term sickness absence

Abstract

BackgroundSymptoms of depression and musculoskeletal pain have both been found to be associated with increased risk of long term sickness absence (LTSA). The comorbidity between depression and pain i.e. simultaneous presence of both symptoms, is well established in the literature. The aim for the current investigation was to investigate whether the presence of comorbid pain influences the associations between depressive symptoms and LTSA or if the presence of comorbid depressive symptoms influences associations between musculoskeletal pain and LTSA.MethodsA sample of 6572 Danish female health care workers responding to a questionnaire about health and working conditions were followed up in a national register of social transfer payments (DREAM) for 550 days. We estimated the risk for LTSA of four weeks or more, associated with depressive symptoms and number of musculoskeletal pain locations using a Cox proportional hazards model allowing multiple observations per individual. We conducted a test for multiplicative interaction between musculoskeletal pain locations and depressive symptoms, and presented stratified regression models to facilitate the interpretation of the results.ResultsThe severity of depressive symptoms was correlated with the number of pain locations reported (Spearman’s rho = .24, p < 0.001). We found a significant multiplicative interaction between depressive symptoms and musculoskeletal pain in predicting the risk of LTSA. Depressive symptoms and number of musculoskeletal pain locations were associated with increased risk of LTSA for individuals who did not have comorbid symptoms. However, we found no significant associations between the two predictors and LTSA among participants who reported comorbid symptoms.ConclusionsThe risk of LTSA associated with depressive symptoms and musculoskeletal pain appears to be moderated by the presence of comorbid symptoms. The modified risk for LTSA among workers with comorbid symptoms requires further investigation.

Trajectories of multisite musculoskeletal pain in midlife: Associations with common mental disorders

“…A 10‐year (5 plus 5 year) follow‐up of metal industry employees found reciprocal longitudinal associations between distress symptoms and musculoskeletal pain, whereas depressive symptoms were predictive of pain in men but not in women (Leino & Magni, ). In predicting long‐term sickness absences, an interaction between depressive symptoms and musculoskeletal pain was found among female Danish employees (Melkevik et al, ). Among Finnish employees, the risk of disability retirement was fourfold in those with co‐occurring mental and musculoskeletal disorders compared to participants with neither, while having either disorder alone was associated with a twofold risk (Kaila‐Kangas et al, ).…”

“…Low back pain and neck pain are the most prevalent and affect people of all age groups (GBD 2017 Disease and Injury Incidence and Prevalence Collaborators, ). Musculoskeletal pain occurs in several body sites concurrently more often than in a single site only in the general population (Carnes et al, ; Schmidt & Baumeister, ), among the occupationally active (Melkevik et al, ; Saastamoinen, Leino‐Arjas, Laaksonen, Martikainen, & Lahelma, ) and among older adults (Butera et al, ). While musculoskeletal pain in adolescence often persists to midlife (Leino‐Arjas et al, ) and midlife pain to old age (Neupane et al, ), the widespreadness of pain may decrease with retirement from work (Neupane et al, ).…”

Decline of depressive symptoms in Europe: differential trends across the lifespan

“…It is estimated that about 264 million people worldwide are affected [32]. Besides being a serious disorder itself, depression is also a major predictor of other healthrelated outcomes like cardiovascular events, treatment noncompliance, musculoskeletal pain, absenteeism, dementia, and suicide [16,20,21,45]. Accordingly, the Global Burden of Disease Study of the World Health Organization estimates that depression is one of the leading causes of disability [34,54].…”

The Comorbidity of Musculoskeletal Disorders and Depression: Associations with Working Conditions Among Hospital Nurses

“…The prevalence of the comorbidity of MSDs and depression was 14.5% in the study sample. A previous study with over 6,500 Danish female health care workers reported an 18% comorbidity including one or more musculoskeletal pain locations and medium or higher levels of depressive symptoms (Melkevik et al, 2018). The comorbid pain and depression have been widely reported in the patient population (Goesling et al, 2013).…”