Correlation between pain severity and levels of anxiety and depression in osteoarthritis patients: a systematic review and meta-analysis

Abstract

Objectives Osteoarthritis (OA) is a chronic degenerative musculoskeletal disease that causes articular damage and chronic pain, with a prevalence of up to 50% in individuals >60 years of age. Patients suffering from chronic painful conditions, including OA, also frequently report anxiety or depression. A systematic review and meta-analysis were performed to assess the correlation between pain severity and depressive and anxious symptomatology in OA patients. Methods A systematic search was conducted using four databases (PubMed, Medline, Scopus, and Web of Science) from inception up to 14th January of 2020. We included original articles evaluating pain severity and anxiety and/or depression severity in OA-diagnosed patients. Detailed data were extracted from each study, including patients’ characteristics and pain, anxiety, and depression severity. When available, the Pearson correlation coefficient between pain and depression severity and pain and anxiety severity was collected and a meta-analysis of random effects was applied. Results This systematic review included 121 studies, with a total of 38085 participants. The mean age was 64.3 years old and subjects were predominantly female (63%). The most used scale to evaluate pain severity was the Western Ontario and the McMaster Universities Osteoarthritis Index, while for anxiety and depression, the Hospital Anxiety and Depression Scale was the most used. The meta-analysis showed a moderate positive correlation between pain severity and both anxious (r = 0.31, p < 0.001) and depressive symptomatology (r = 0.36, p < 0.001). Conclusions Our results demonstrate a significant correlation between pain and depression/anxiety severity in OA patients, highlighting the need for its routine evaluation by clinicians.

Clinical outcomes one year after a digital musculoskeletal (MSK) program: an observational, longitudinal study with nonparticipant comparison group

“…Chronic MSK pain may hinder activities of daily living, including walking, getting up from sitting, opening a jar, or reaching overhead. Furthermore, chronic MSK pain often occurs with and exacerbates depression and anxiety [5]. Depression and anxiety can also influence pain severity and duration [6][7][8][9].…”

Older Adult Use and Outcomes in a Digital Musculoskeletal (MSK) Program, by Generation

“…In 2018, 134.5 million adults in the United States reported MSK conditions with older adults experiencing higher prevalence rates of MSK conditions and limitations compared to younger adults (2,3). Furthermore, chronic MSK pain often occurs together with depression and anxiety (4). Pain makes it more challenging to identify depression and anxiety and can exacerbate depression and anxiety symptoms.…”

Dexmedetomidine alleviates anxiety-like behavior in mice following peripheral nerve injury by reducing the hyperactivity of glutamatergic neurons in the anterior cingulate cortex

“…This tends to create a cycle of pain and anxiety symptoms that is di cult to break, making the treatment of such patients challenging. For example, concomitant anxiety and/or depression is estimated to affect approximately one in three patients with osteoarthritis-related pain [38,39]. Anxiety may result from chronic pain, but anxiety also predicts subsequent pain outcomes before or after surgical arthroplasty [40,41].…”