Illness perceptions are the main predictors of depression and anxiety symptoms in patients with chronic pain

Abstract

Depression and anxiety symptoms in chronic pain are associated with adverse clinical outcomes, and appear highly related to patient's illness perceptions as well as with marital adjustment. This study aimed to investigate the predictive value of pain variables, marital adjustment and illness perceptions on depression and anxiety in patients with chronic pain. Two hundred patients were recruited from a pain unit in a public hospital in the north of Portugal. Patients completed a questionnaire that assessed illness perceptions (IPQ-Brief), marital adjustment (revised dyadic adjustment scale), depression and anxiety symptoms (hospital anxiety depression scale) and pain variables (pain intensity and pain disability index). Depression and anxiety symptoms were associated with pain intensity, pain-related disability, marital adjustment and illness perceptions. Results from hierarchical regression showed that illness perceptions contributed significantly to depression and anxiety symptoms over and above the effects of pain intensity, pain-related disability and marital adjustment, after controlling for gender. In multivariate analyses, pain intensity, pain-related disability and marital adjustment were uniquely related to depression and anxiety symptoms, whereas specific illness perceptions were uniquely related to depression symptoms (identity, treatment control, emotional response and coherence) and to anxiety symptoms (identity, emotional response and concern). Perceptions of greater symptomatology (identity) and of emotional impact, and lesser perceptions of treatment control and understanding of chronic pain (illness comprehensibility) were significantly associated with increased depression symptoms. Perceptions of greater symptomatology (identity), emotional impact and greater concern were associated with anxiety symptoms. These findings indicate that the contribution of illness perceptions was greater than that made by traditional covariates, and may therefore be a useful basis for future psychological interventions.

Patients’ Self-Reported Disability Weights of Top-Ranking Diseases in Thailand: Do They Differ by Socio-Demographic and Illness Characteristics?

“…As seen in other studies [11][12][13], patients with mental diseases, especially major depression, had higher disability weights than those with osteoarthritis, a physical disease. The perception of patients affects their judgement of their disability associated with an illness.…”

“…Osteoarthritis patients were stratified into three groups based on their clinical treatment stated in the medical records; treated with surgery, treated with medication or therapy (physical or occupational), and untreated (waiting for surgery). The AUD patients were interviewed with the Alcohol Use Disorder Identification Test (AUDIT) [19], the results of which were used to classify them into mild (score < 7), moderate (score [8][9][10][11][12][13][14][15][16][17][18][19], and severe (score >20) level.…”

“…Patients with a certain disease of interest can be a good source of information to derive disability weights of that disease as they have experienced the illness both physically and psychologically. Studies have shown that patients' perceptions of the disability affected by their illness differ between those with mental and physical illnesses [11][12][13]. Patients generally attribute more disability to mental disorders than to physical disorders and the higher disability of mental than physical illness is expressed in terms of social and personal relationships than in functional roles [9].…”

Illness Perception and Job Satisfaction in Patients Suffering from Migraine Headaches: Trait Anxiety and Depressive Symptoms as Potential Mediators

“…Specifically, the label someone gives to his/her illness (Identity), the control perceived over his/her treatment, how much the illness is understood, and the emotional impact of the disease seem to be predictors of depressive symptoms. 51 Further studies have shown that other dimensions of illness perception can predict the onset of depressive symptoms: 49 duration and negative consequences of the illness. 52 Moreover, in another study on chronic heart failure, results indicated that patients who perceive their illness to be burdensome and threatening and experience low personal control over it contribute to increased depressive symptoms and anxiety.…”

Will peripherally restricted kappa-opioid receptor agonists (pKORAs) relieve pain with less opioid adverse effects and abuse potential?

“…Pain, if not adequately treated, can have a significant negative impact on quality of life, such as disruption of sleep, mood and functional capacity. These can lead to anxiety, depression and other mental health issues . For example, a World Health Organization (WHO) study reported a 4‐fold increase in the prevalence of psychological disorders in people who suffer from persistent pain .…”