Longitudinal Associations Between Depression, Anxiety, Pain, and Pain-Related Disability in Chronic Pain Patients

Lerman, Sheera F.; Rudich, Zvia; Brill, Silviu; Shalev, Hadar; Shahar, Golan

doi:10.1097/psy.0000000000000158

Cited by 305 publications

(216 citation statements)

References 90 publications

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“…Chronic pain is a debilitating condition affecting over 100 million Americans (1), with more thanhalf showing comorbid depression and anxiety (2–4). Several recent studies using rodent models of chronic pain reveal adaptations in mood and stress-related brain regions with corresponding effects in nociceptive, motivation, anxiety, and depression related behaviors, as well as analgesic efficacy (5–11).…”

Section: Introductionmentioning

confidence: 99%

Neuropathic pain promotes adaptive changes in gene expression in brain networks involved in stress and depression

et al. 2017

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Neuropathic pain is a complex chronic condition characterized by a wide range of sensory, cognitive, and affective symptoms. A large percentage of neuropathic pain patients are also afflicted with depression and anxiety disorders – a pattern that is reliably replicated in animal models. Furthermore, clinical and preclinical studies indicate that chronic pain corresponds with adaptations in several brain networks involved in mood, motivation, and reward. Chronic stress is also a major risk factor for depression. We investigated whether chronic pain and stress affect similar mechanisms, and whether chronic pain can affect gene expression patterns known to be involved in depression. Using two mouse models for neuropathic pain and depression (spared nerve injury (SNI) and chronic unpredictable stress (CUS)) we performed next generation RNA-sequencing and pathway analysis to monitor changes in gene expression in the nucleus accumbens (NAc), the medial prefrontal cortex (mPFC), and the periaqueductal grey (PAG). These three brain regions are implicated in the pathophysiology of depression and in the modulation of pain. In addition to finding unique transcriptome profiles across the three brain regions,.we identified a substantial number of signaling pathway-associated genes with similar changes in expression in both SNI and CUS mice. Many of these genes have been implicated in depression, anxiety and chronic pain in patients. Our study provides a resource of the changes in gene expression induced by long-term neuropathic pain in three distinct brain regions and reveals molecular connections between pain and chronic stress.

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Section: Introductionmentioning

confidence: 99%

Neuropathic pain promotes adaptive changes in gene expression in brain networks involved in stress and depression

et al. 2017

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“…The prevalence of anxiety in ALS is less studied but has been reported to range between 8% and 26% (9). There appears to be a link between pain, depression, and anxiety (11,12). Thus, pain has the potential to be a major contributor to mood disturbances in patients with ALS.…”

Section: Introductionmentioning

confidence: 99%

The role of mental health and self-efficacy in the pain experience of patients with amyotrophic lateral sclerosis

Stephens

Lehman

Raheja

et al. 2016

Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration

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Complex interactions between pain, depression, and anxiety impact quality of life in patients with ALS. Psychological approaches to pain control may be useful. This study explored the role of self-efficacy in mitigating pain. Individuals registered with the Agency for Toxic Substances and Disease Registry National ALS Registry and who experienced pain were invited to participate in an online survey. Subjects completed the Brief Pain Inventory-Short Form, Hospital Anxiety and Depression Scale, and Chronic Pain Self-Efficacy Scale. Correlations between variables were determined. Multiple linear regression models assessed relationships between depression, anxiety and self-efficacy predictions, and pain severity, interference, and relief. Results recorded that there were 197 participants (58% males, mean age 59 AE 10 years). Cases or borderline cases of depression or anxiety were common. Mean levels of pain were moderate. Higher pain self-efficacy scores predicted lower pain severity, lower pain interference, and higher pain relief with treatment. As depression scores increased, pain interference with daily life was higher. In conclusion, anxiety and depression are common in patients with ALS and pain. Self-efficacy appears to mitigate pain. A multifactorial approach to pain management should be considered in these patients, addressing mental health and self-efficacy to augment pharmacologic pain treatments.

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“…This was done via a confirmatory factor analysis in an SEM framework. Testing an SEM that focuses on the role of the three DPV variables in Time 1 levels of anxious depression, pain, disability, and catastrophizing. The latter four outcomes were assessed as latent factors, as described in Lerman et al () and Noyman‐Veksler et al (). In this model, anxious depression served as a mediator of the links between DPV dimensions and the four pain outcomes.…”

Section: Methodsmentioning

confidence: 99%

Depressive personality vulnerability in chronic physical pain: Centrality of sociotropy

Shahar

Lerman

Topaz

et al. 2018

Journal of Personality

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Longitudinal Associations Between Depression, Anxiety, Pain, and Pain-Related Disability in Chronic Pain Patients

Abstract: Among adult patients with chronic pain treated at specialty pain clinics, high levels of depression and anxiety may worsen pain and pain-related disability.

Cited by 305 publications

References 90 publications

Neuropathic pain promotes adaptive changes in gene expression in brain networks involved in stress and depression

Neuropathic pain promotes adaptive changes in gene expression in brain networks involved in stress and depression

The role of mental health and self-efficacy in the pain experience of patients with amyotrophic lateral sclerosis

Depressive personality vulnerability in chronic physical pain: Centrality of sociotropy

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