Combined effects of major depression, pain and somatic disorders on general functioning in the general adult population

Abstract

This study was carried out to assess the prevalence of major depressive disorder (MDD) in persons suffering from pain symptoms in various locations, both with and without comorbid somatic disorders and to analyze the single and combined effects of MDD, pain symptoms and somatic disorders on general functioning in the community. The 12-month prevalence of MDD, somatic disorders and pain symptoms, grouped according to location, were determined among 4181 participants from a community sample. Depression was assessed utilising the Composite International Diagnostic Interview. Pain symptoms were self-reported by participants whereas medical diagnoses were validated by medical examinations. General functioning was evaluated utilising the established MOS-SF-36 scale. The prevalence of MDD was significantly increased for persons with pain in any location. In the absence of a somatic disorder, MDD prevalence was highest in persons with abdominal/chest pain (9.3%) and arm or leg pain (7.9%) and lowest in persons with back pain (6.2%). Mental and physical well-being were lowest for persons with both MDD and a somatic disorder, irrespective of pain locations. Increasing numbers of pain locations impaired mental and physical well-being across all groups, but the effect on mental well-being was most marked in participants with MDD and comorbid somatic disorders. The presence of pain increases risk of associated MDD. The number of pain locations experienced, rather than the specific location of pain, has the greatest impact on general functioning. Not only chronic pain, but pain of any type may be an indicator of MDD and decreased general functioning.

Depressive Symptoms and Pain Complaints as Predictors of Later Development of Depression in Portuguese Middle-Aged Women

“…These body locations had already been mentioned by the authors of other studies on the relationship between pain and depression. That is the case for stomach or abdomen pains and for headaches (Baune et al, 2008;Means-Christensen et al, 2008). We could not confirm the significant correlation, however, between back or arm and leg pains and the development of depression in the following year, as found by other authors (Barkow et al, 2001(Barkow et al, , 2004Baune et al, 2008).…”

“…Along these lines, a study by Baune, Caniato, Garcia-Alcaraz, and Berger (2008) presented results showing that, regardless of the precise area of the body (head, neck, shoulders, chest, abdomen, back, arms, and legs), pain is related to a greater prevalence of depression. It is possible that any kind of pain may be associated with depressive symptoms and that its precise location is not a determinant factor in this relation.…”

Understanding the influence of stigma and discrimination for the functional limitation severity – psychological distress relationship: A stress and coping perspective

“…Bodily pain, for example, is considered an obstacle to one’s ability or motivation to engage in activities conducive to well-being (Gayman, Brown & Cui, 2011), and it is associated with depressive symptoms among people with functional limitations (Baune et al, 2008; Gayman et al, 2011). Additional tests (not presented) assessing the mediating role of bodily pain using a multiplicative pain inventory (Gayman et al, 2011) found no support for its inclusion as a mediator of the functional limitation severity—depressive symptoms relationship.…”

Functional Limitation, Pain, and Alcohol Use: Exploring Gender Differences in the Mediating Role of Depressive Symptoms

“…Bodily pain, which varies considerably in its magnitude and chronicity, is described as a form of stressor exposure because it may present an obstacle to one's ability or motivation to engage in activities that are conducive to well-being (Gayman et al, 2011). Functional limitation and bodily pain are also both consistently linked with depressive symptoms (Baune et al, 2008;Breslin et al 2006;Brown & Turner, 2010;Gayman et al, 2011;Yang, 2006), which provides grounds for anticipating that they may be linked with alcohol use vis-à-vis its tension-reducing functions.…”