Depression predicts disability in long-term chronic pain patients

Area of Science:

• Medical rehabilitation
• Psychiatry
• Pain management

Background:

• Chronic pain significantly impacts patients' lives, affecting their disability status.
• Previous studies on predictors of treatment outcomes and disability in chronic pain patients have yielded inconsistent results regarding psychopathology and personality.
• Understanding factors predicting long-term disability is crucial for effective rehabilitation strategies.

Purpose of the Study:

• To investigate the predictive utility of personality characteristics, depression, and personality disorders for disability status in chronic pain patients.
• To evaluate these factors in a long-term follow-up setting.
• To provide insights for improving disability assessments and interventions in chronic pain management.

Main Methods:

• A cohort of 184 chronic pain patients with limited prior sick leave was evaluated at baseline.
• Psychiatric evaluation included the Structured Clinical Interview for DSM-IV Screen Questionnaire (SCID-II), Montgomery-Asberg Depression Rating Scale (MADRS), and Karolinska Scales of Personality (KSP).
• Disability status was assessed via insurance records at a minimum of two-and-a-half years post-baseline evaluation.

Main Results:

• Age and the number of prior sick leave days were significant predictors of subsequent disability status.
• A baseline diagnosis of depression strongly predicted long-term disability (OR = 7.04, p = 0.034).
• Baseline personality traits and the presence of personality disorders did not significantly predict disability status in this sample.

Conclusions:

• Depression is a key predictor of disability status in chronic pain patients over an extended follow-up period.
• Personality disorders and traits were not found to be significant predictors of disability in this study.
• These findings highlight the importance of addressing depression in the management of chronic pain to mitigate long-term disability.