Melissa H Adams1, Travis I Lovejoy1, Dennis C Turk2, Steven K Dobscha1, Peter Hauser3, Benjamin J Morasco4. 1. Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR, USA; Department of Psychiatry, Oregon Health & Science University, Portland, OR, USA. 2. Department of Anesthesiology and Pain Medicine and Center for Pain Research on Impact, Measurement, & Effectiveness, University of Washington, Seattle, WA, USA. 3. VISN 22 Network Office and Division of Mental Health, Long Beach VA Medical Center, Long Beach, CA, USA; Department of Psychiatry, University of California San Diego & Department of Psychiatry and Human Behavior, University of California-Irvine, Irvine, CA, USA. 4. Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR, USA; Department of Psychiatry, Oregon Health & Science University, Portland, OR, USA. Electronic address: benjamin.morasco@va.gov.
Abstract
OBJECTIVE: Depression and chronic pain are common in persons chronically infected with the hepatitis C virus (HCV), although little is known about the rate of co-occurrence or mechanisms by which they are associated. We evaluated whether pain-related anxiety mediates the relationship between depressive symptoms and pain-related physical functioning in patients with HCV. METHODS: Patients with HCV (n=175) completed self-report measures assessing demographic characteristics, pain-related function and mental health. Path analyses examined direct effects of cognitive-affective and somatic symptoms of depression on pain interference and indirect effects of these relationships via four subscales of the Pain Anxiety Symptoms Scale-20. RESULTS: Cognitive-affective and somatic symptoms of depression were positively and significantly related to pain interference. Pain-related anxiety mediated the relationship between both cognitive-affective and somatic symptoms of depression, and this mediation was predominantly accounted for by the escape-avoidance component of pain-related anxiety. CONCLUSIONS: Findings indicate a potential mediating role of pain-related anxiety, particularly escape-avoidance anxiety, on the relationship between depression and pain interference in patients with HCV. These findings suggest that escape-avoidance anxiety may be a particularly germane target for treatment in patients with HCV and chronic pain, particularly when depression, with characteristic features of withdrawal and inhibition, is a comorbid condition. Published by Elsevier Inc.
OBJECTIVE:Depression and chronic pain are common in persons chronically infected with the hepatitis C virus (HCV), although little is known about the rate of co-occurrence or mechanisms by which they are associated. We evaluated whether pain-related anxiety mediates the relationship between depressive symptoms and pain-related physical functioning in patients with HCV. METHODS:Patients with HCV (n=175) completed self-report measures assessing demographic characteristics, pain-related function and mental health. Path analyses examined direct effects of cognitive-affective and somatic symptoms of depression on pain interference and indirect effects of these relationships via four subscales of the PainAnxiety Symptoms Scale-20. RESULTS: Cognitive-affective and somatic symptoms of depression were positively and significantly related to pain interference. Pain-related anxiety mediated the relationship between both cognitive-affective and somatic symptoms of depression, and this mediation was predominantly accounted for by the escape-avoidance component of pain-related anxiety. CONCLUSIONS: Findings indicate a potential mediating role of pain-related anxiety, particularly escape-avoidance anxiety, on the relationship between depression and pain interference in patients with HCV. These findings suggest that escape-avoidance anxiety may be a particularly germane target for treatment in patients with HCV and chronic pain, particularly when depression, with characteristic features of withdrawal and inhibition, is a comorbid condition. Published by Elsevier Inc.
Entities:
Keywords:
Chronic pain; Comorbidity; Depression; Hepatitis C virus; Pain-related anxiety
Authors: Samuel Yeung-Shan Wong; Frank Wan-Kin Chan; Rebecca Lai-Ping Wong; Ming-Chi Chu; Yu-Yuk Kitty Lam; Stewart W Mercer; S Helen Ma Journal: Clin J Pain Date: 2011-10 Impact factor: 3.442
Authors: Jeannette Golden; Ronán Michael Conroy; Ann Marie O'Dwyer; Daniel Golden; Jean-Benoit Hardouin Journal: Soc Sci Med Date: 2006-09-28 Impact factor: 4.634
Authors: Julie Loebach Wetherell; Niloofar Afari; Thomas Rutledge; John T Sorrell; Jill A Stoddard; Andrew J Petkus; Brittany C Solomon; David H Lehman; Lin Liu; Ariel J Lang; J Hampton Atkinson Journal: Pain Date: 2011-06-17 Impact factor: 6.961
Authors: Amy A Dan; Lisa M Martin; Cathy Crone; Janus P Ong; Denise W Farmer; Thomas Wise; Sean C Robbins; Zobair M Younossi Journal: J Hepatol Date: 2005-12-27 Impact factor: 25.083
Authors: Jennifer M Loftis; Marilyn Huckans; Samantha Ruimy; David J Hinrichs; Peter Hauser Journal: Neurosci Lett Date: 2007-11-06 Impact factor: 3.046
Authors: Benjamin J Morasco; David W Greaves; Travis I Lovejoy; Dennis C Turk; Steven K Dobscha; Peter Hauser Journal: Pain Med Date: 2016-06-27 Impact factor: 3.750