Association Between Depressive Symptoms and Pain Intensity in Patients With Arthritis

Arthritis manifests with joint pain and stiffness that impair physical function and significantly elevate depression risk. However, the magnitude of pain's impact on depressive symptoms and related factors in arthritis patients warrants further investigation. Clarifying this association and its mechanisms is important for improving mental health and quality of life in this population.

This study analyzed data from the China Health and Retirement Longitudinal Study (CHARLS) in 2020, focusing on 1020 patients with arthritis.

Depressive symptoms were assessed using the 10-item Center for Epidemiologic Studies Depression Scale (CESD-10), with a score ≥10 defining the presence of clinically significant depressive symptoms. Univariate analysis was performed using the Chi-square test. A binary logistic regression model was employed to examine the association between pain intensity (binary: present/absent) and depressive symptoms, while controlling for multiple covariates, including demographics, health behaviors, and functional status.

Among the 1020 arthritis patients, the presence of pain significantly increased the risk of depressive symptoms (OR = 1.743, p = 0.002). Older age (OR = 0.982, p = 0.042), a higher educational level (e.g., high school or above: OR = 0.446, p = 0.005), better self-rated health (OR = 0.408, p < 0.001), possessing internet use skills (OR = 0.625, p = 0.004), and retaining housework ability (OR = 0.466, p < 0.001) were identified as protective factors against depressive symptoms. Stratified analyses further revealed that the association between pain and depression was more pronounced among males, patients aged <65 years, and those with lower educational attainment.

This study confirms that pain is an independent risk factor for depressive symptoms in arthritis patients, and this association exhibits heterogeneity across demographic subgroups. Higher educational attainment, positive self-rated health, and maintenance of daily functional and social connectivity serve as psychological protective resources. Clinical practice should identify high-risk patients and implement personalized strategies integrating pain management, psychological support, and functional promotion to alleviate depressive symptoms and enhance health.