Factors associated with depression in patients undergoing rehabilitation for chronic pain: a cross-sectional analytical study at a referral hospital in Peru

Abstract

Despite the well-known impact of depression on patients with chronic pain and its association, few studies have evaluated its related factors in Physical Medicine and Rehabilitation settings. The objective of the present study was to assess the factors associated with depression in adult patients undergoing rehabilitation for chronic pain at Hospital Rebagliati (HNERM) in Peru. A cross-sectional analytical study was conducted between June and August 2023, involving 212 adult patients with chronic pain undergoing rehabilitation at HNERM. Data were collected through a survey, including sociodemographic information, pain characteristics, and depression assessment using the Patient Health Questionnaire-9 (PHQ-9). Statistical analysis included descriptive statistics and generalized linear models to identify factors associated with depression. Among 212 participants, 17.9% had a depression diagnosis based on the PHQ-9 (cutoff score: 10 points). Factors associated with a higher frequency of depression included a time since pain diagnosis of 3–6 months [adjusted prevalence ratios (aPR): 1.15, 95% confidence interval (CI): 1.04–1.27], severe pain (aPR: 1.17, 95% CI: 1.04–1.32), comorbidities (for 1: aPR: 1.21, 95% CI: 1.08–1.35; for 2: aPR: 1.17, 95% CI: 1.06–1.29; for ≥3: aPR: 1.27, 95% CI: 1.10–1.47), use of ≥2 medications for pain management (aPR: 1.27, 95% CI: 1.13–1.42), and receipt of psychological therapy (aPR: 1.26, 95% CI: 1.09–1.46). Nonpharmacological interventions did not show an association with an increased prevalence of depression. These findings underscore the significance of adopting a comprehensive approach to chronic pain management, including the screening, assessment, and treatment of associated depression.