Related Experiment Video
Updated: Jun 10, 2026
Association Between Sleep Quality and Cognitive Symptoms in Patients with Major Depressive Disorder
Published on: April 26, 2024
Depressive Symptoms as a Potential Mediator in the Association Between Pain and Cognitive Function: A Cross-Sectional
Sizhe Gao1, Mingkun Feng1, Haibin Zhou1
1Department of Pain Management, Beijing Jishuitan Hospital, Capital Medical University, Beijing, 100035, People's Republic of China.
Objective:
To investigate the association between pain intensity and cognitive function, and to explore the influence of demographic, clinical, and mood factors on this relationship.
Design:
Cross-sectional study.
Setting:
A tertiary comprehensive teaching hospital.
Subjects:
2661 inpatients admitted for pain management who completed cognitive function screening.
Methods:
Pain intensity was assessed using the Numeric Rating Scale (NRS). Cognitive function was evaluated with the Montreal Cognitive Assessment (MoCA). Anxiety and depressive symptoms were assessed using the Hamilton Anxiety Scale (HAMA) and the Hamilton Depression Scale (HAMD), respectively. Univariable and multivariable analyses were performed to examine the association between pain intensity and cognitive function, and mediation analysis was conducted to explore potential mediating effects.
Results:
The median pain duration was 3.0 months (IQR 0.6-12.0), and the median admission NRS score was 6 (IQR 4-6). Among the 2661 patients, 1502 (56.4%) had a MoCA score below 26, indicating mild cognitive impairment. Multiple linear regression model showed that higher pain intensity was significantly associated with higher MoCA (β = 0.22, 95% CI [0.12, 0.33], p < 0.001) after controlling for age, sex, education, pain duration, anxiety, and depression. Mediation analysis showed that baseline pain significantly predicted higher depressive symptoms (β = 0.41, p < 0.001), and depressive symptoms were negatively associated with cognitive performance (β = -0.16, p < 0.001).
Conclusion:
This large-scale cross-sectional study demonstrated a complex association between pain intensity and cognitive performance. While pain was directly associated with cognitive scores, depressive symptoms exerted a significant negative indirect effect, indicating partially opposing pathways. These findings suggest that mood-related mechanisms play a critical role in the pain-cognition relationship, highlighting the importance of integrating mood assessment into pain management.
Related Concept Videos
01:27Depressive Disorders: Etiology
Biological Factors in Depression
Biological predispositions significantly influence the risk of developing depressive disorders. Genetic studies highlight the role of variations in the serotonin transporter...
01:30Negative and Cognitive Symptoms of Schizophrenia
Negative Symptoms
Negative symptoms of schizophrenia manifest as deficits in normal emotional and behavioral functioning, profoundly impacting daily life. Individuals with schizophrenia often display a flat affect, characterized by a near-total absence of emotional expression,...
01:18Depression: Overview
01:27Depressive Disorders: MDD and Dysthymia
01:29The Influence of Cognition on Affect
01:29The Influence of Affect on Cognition