Depressive symptoms and health-related quality of life in a heterogeneous psychiatric sample: conditional indirect effects of pain severity and interference

Abstract

Background Few studies have examined clinically relevant mechanisms that underlie the association between two important indices of recovery— depression severity and health-related quality of life (HRQOL) in psychiatric outpatients. This study aimed to explicate the roles of pain interference and pain severity as mediating and moderating mechanisms in the relationship between depressive symptoms and HRQOL. Methods Data from 290 outpatients diagnosed with schizophrenia (n = 102), depressive (n = 98), and anxiety (n = 90) disorders were examined. Participants completed a set of questionnaires that queried their sociodemographic statuses, current pain severity and interference levels, depression severity levels, and HRQOL. Subsequently, mediation and moderation analyses were conducted. Results Analyses revealed that pain interference fully mediated the relationship between depressive symptoms and physical (34% of the total effect) but not mental HRQOL. At high pain levels (+ 1 SD from mean), depressive symptoms may interfere with physical quality of life through pain interference, but this was not present at low pain levels (− 1 SD from mean). Conclusions Prolonged pain symptoms could negatively influence psychiatric recovery beyond the physical aspect of HRQOL. These results thus imply a need to detect and manage severe physical pain complaints at the acute stage in psychiatric outpatients.

Effect of elevated depressive symptoms during adolescence on health-related quality of life in young adulthood—a six-year cohort study with repeated exposure measurements

“…Numerous studies have shown that elevated depressive symptoms are associated with lower health-related quality of life. However, many of these studies have recruited adult ( 14 – 29 ), clinical ( 16 , 18 – 23 , 25 – 28 , 30 – 38 ), or community samples ( 14 , 15 , 24 , 29 , 39 , 40 ), with limited generalizability. Rarely studies have included children and adolescents from the general population ( 41 ).…”

Brain Functional Alteration at Different Stages of Neuropathic Pain With Allodynia and Emotional Disorders

“…In addition to hyperalgesia, allodynia, and spontaneous pain, NeuP is also accompanied by the manifestation of emotional disorders including anxiety and depression ( 1 , 5 ). Notably, emotional disbalance further exacerbates NeuP ( 6 , 7 ). Although NeuP has become a major worldwide public health concern ( 8 ), the mechanisms underlying its pathogenesis remain unclear, and thus its treatment remains challenging.…”