Pain and depressive symptoms among financially disadvantaged women's health patients.

OBJECTIVES: Women are at greater risk than men for both pain and depression, yet little is known about the frequency and implications of comorbid pain and depression among women in women's health settings. This study aimed to determine the frequency of comorbid depressive symptoms and pain among a sample of gynecology outpatients and to evaluate the associations of comorbid pain and depressive symptoms with physical, emotional, and social functioning and abuse experiences.
METHODS: A total of 242 low-income, primarily African American women presenting at an urban women's health clinic for routine gynecological care consented to participate. Subjects completed the Beck Depression Inventory, Brief Symptom Inventory, Graded Chronic Pain Scale, SF-36, Physical and Sexual Abuse Questionnaire, and Duke Social Support Index. Multivariate analyses were used to test pain and depressive symptoms in their associations with emotional, physical, and social functioning and abuse experience. Age, race, income, and education were controlled in all analyses.
RESULTS: Nearly 20% of participants reported comorbid high depressive symptoms and pain. Both depressive symptoms and pain were independently associated with emotional, physical, and social functioning domains. Depressive symptoms, but not pain, were associated with increased likelihood of history of abuse.
CONCLUSIONS: Comorbid depressive symptoms and pain are a substantial problem, with pervasive implications among financially disadvantaged women seeking routine gynecological care. Subsequent research will determine if psychosocial treatment can be adapted effectively to the needs of this patient population.