OBJECTIVE: To examine in a nationally representative sample (a) the differential association of specific anxiety and depressive disorders defined according to DSM-IV with pain disorder (PD) and pain symptoms, and (b) whether pain-associated anxiety and depressive disorders and their comorbidity have different implications in terms of impairment, disability, health care utilization, and substance use. METHOD: A nationally representative community study was conducted in Germany. Symptoms, syndromes and diagnoses of mental disorders, and pain were assessed in N = 4,181 participants aged 18-65 years using the DSM-IV/M-CIDI. RESULTS: Logistic regressions revealed that pain is associated with both specific anxiety and depressive disorders, with increasing significant odds ratios (OR) for medically explained pain symptoms (EPS; OR range: 1.9-2.0), to unexplained pain symptoms (UPS; OR range: 2.4-7.3), to PD (OR range: 3.3-14.8). PD and UPS persistently showed associations after adjusting for comorbid other anxiety and depressive disorders and physical illnesses. All types of pain, particularly PD/UPS, are associated with decreased quality of life, greater impairment in role functioning, disability, health care utilization, and substance use. Depressive disorders, even more so anxiety disorders and their comorbidity account for a substantial proportion of variance in these functional correlates. CONCLUSIONS: Pain is strongly associated with specific anxiety and depressive disorders. In light of the individual and societal burden due to pain, and the demonstrated role of comorbid anxiety or/and depression, our results call for further investigation of the underlying mechanisms for this association as well as targeted treatments for these comorbidities.
OBJECTIVE: To examine in a nationally representative sample (a) the differential association of specific anxiety and depressive disorders defined according to DSM-IV with pain disorder (PD) and pain symptoms, and (b) whether pain-associated anxiety and depressive disorders and their comorbidity have different implications in terms of impairment, disability, health care utilization, and substance use. METHOD: A nationally representative community study was conducted in Germany. Symptoms, syndromes and diagnoses of mental disorders, and pain were assessed in N = 4,181 participants aged 18-65 years using the DSM-IV/M-CIDI. RESULTS: Logistic regressions revealed that pain is associated with both specific anxiety and depressive disorders, with increasing significant odds ratios (OR) for medically explained pain symptoms (EPS; OR range: 1.9-2.0), to unexplained pain symptoms (UPS; OR range: 2.4-7.3), to PD (OR range: 3.3-14.8). PD and UPS persistently showed associations after adjusting for comorbid other anxiety and depressive disorders and physical illnesses. All types of pain, particularly PD/UPS, are associated with decreased quality of life, greater impairment in role functioning, disability, health care utilization, and substance use. Depressive disorders, even more so anxiety disorders and their comorbidity account for a substantial proportion of variance in these functional correlates. CONCLUSIONS:Pain is strongly associated with specific anxiety and depressive disorders. In light of the individual and societal burden due to pain, and the demonstrated role of comorbid anxiety or/and depression, our results call for further investigation of the underlying mechanisms for this association as well as targeted treatments for these comorbidities.
Authors: Johan Ormel; Maria Petukhova; Somnath Chatterji; Sergio Aguilar-Gaxiola; Jordi Alonso; Matthias C Angermeyer; Evelyn J Bromet; Huibert Burger; Koen Demyttenaere; Giovanni de Girolamo; Josep Maria Haro; Irving Hwang; Elie Karam; Norito Kawakami; Jean Pierre Lépine; María Elena Medina-Mora; José Posada-Villa; Nancy Sampson; Kate Scott; T Bedirhan Ustün; Michael Von Korff; David R Williams; Mingyuan Zhang; Ronald C Kessler Journal: Br J Psychiatry Date: 2008-05 Impact factor: 9.319
Authors: J E Ware; M Kosinski; B Gandek; N K Aaronson; G Apolone; P Bech; J Brazier; M Bullinger; S Kaasa; A Leplège; L Prieto; M Sullivan Journal: J Clin Epidemiol Date: 1998-11 Impact factor: 6.437
Authors: Michael Von Korff; Paul Crane; Michael Lane; Diana L Miglioretti; Greg Simon; Kathleen Saunders; Paul Stang; Nancy Brandenburg; Ronald Kessler Journal: Pain Date: 2005-02 Impact factor: 6.961
Authors: Ronald C Kessler; Patricia Berglund; Olga Demler; Robert Jin; Kathleen R Merikangas; Ellen E Walters Journal: Arch Gen Psychiatry Date: 2005-06
Authors: W M Hopman; T Towheed; T Anastassiades; A Tenenhouse; S Poliquin; C Berger; L Joseph; J P Brown; T M Murray; J D Adachi; D A Hanley; E Papadimitropoulos Journal: CMAJ Date: 2000-08-08 Impact factor: 8.262
Authors: Hans-Ulrich Wittchen; Katja Beesdo-Baum; Andrew T Gloster; Michael Höfler; Jens Klotsche; Roselind Lieb; André Beauducel; Markus Bühner; Ronald C Kessler Journal: Int J Methods Psychiatr Res Date: 2009-12 Impact factor: 4.035
Authors: Katja Beesdo-Baum; Michael Höfler; Andrew T Gloster; Jens Klotsche; Roselind Lieb; André Beauducel; Markus Bühner; Ronald C Kessler; Hans-Ulrich Wittchen Journal: Int J Methods Psychiatr Res Date: 2009-12 Impact factor: 4.035
Authors: Laura L Quentin; Cecelia I Nelson; Casey D Wright; Matthew C Arias; Manasi M Mittinty; Daniel W McNeil Journal: Eur J Pain Date: 2021-04-13 Impact factor: 3.931