Depression, Depressive Somatic or Nonsomatic Symptoms, and Function in a Primarily Hispanic Chronic Pain Population

Area of Science:

• Pain Medicine
• Psychiatry
• Public Health

Background:

• Chronic pain and depression are leading causes of disability, often co-occurring.
• Comorbidity negatively affects psychosocial and physical functioning, increasing healthcare costs.
• The belief that Hispanics somaticize depression may impede diagnosis and treatment outcomes.

Purpose of the Study:

• To investigate the associations between depression (somatic and nonsomatic symptoms) and functional status in chronic pain patients.
• To examine these relationships within a population residing along the USA-Mexico border.
• To evaluate the impact of individualized, multimodal pain treatment on depression and pain.

Main Methods:

• Cross-sectional study of chronic pain patients receiving individualized, multimodal pain treatment.
• Assessment of depression levels, somatic and nonsomatic depressive symptoms, and functional status.
• Comparison of findings with previous research in similar populations.

Main Results:

• Increased depression correlated with increased pain intensity and decreased functioning.
• Nearly 25% of participants reported moderate-to-severe depression.
• Approximately 25% reported suicidal ideation, independent of depression or treatment status.
• Pain intensity and suicidal ideation were lower than in previous studies of similar populations.
• Antidepressant use as adjuvant therapy was a plausible factor in improved outcomes.

Conclusions:

• Chronic pain patients, irrespective of gender or ethnicity, will report depressive symptoms when assessed with appropriate tools.
• Individualized, multimodal pain management, potentially including antidepressants, may improve outcomes for chronic pain and depression.
• Findings have implications for clinical practice and future research on comorbid chronic pain and depression.