Greater Depressive Symptom Severity is Associated with Increased Odds of Analgesic Use

Although pain and depression frequently co-occur, the relationship between depressive symptom severity and both the odds and duration of analgesic use remains underexplored. This study investigated the relationship between depressive symptoms and analgesic use, with particular attention to the duration of use.

A cross-sectional analysis was conducted using data from the 2005-2018 National Health and Nutrition Examination Survey. Depressive symptoms were assessed using the Patient Health Questionnaire-9.

A total of 36,023 participants (51.14% women) were included. Each 1-point increase in the Patient Health Questionnaire-9 score was associated with a higher likelihood of analgesic use (adjusted odds ratio=1.08 and 95% confidence interval: 1.07-1.09). Compared to individuals with minimal depressive symptoms, those with mild (adjusted odds ratio=1.66 and 95% confidence interval: 1.45-1.90), moderate (adjusted odds ratio=2.17 and 95% confidence interval: 1.77-2.67), and severe symptoms (adjusted odds ratio=2.97, 95% confidence interval: 2.41-3.67) had progressively higher odds of analgesic use. Overall, depressive symptoms were associated with more than twice the odds of analgesic use (adjusted odds ratio=2.13 and 95% confidence interval: 1.82-2.48). Higher Patient Health Questionnaire-9 scores were associated with increased odds of longer analgesic use (>15 d; adjusted odds ratio=1.05 and 95% confidence interval: 1.02-1.08), as was the presence of depressive symptoms (adjusted odds ratio=1.73 and 95% confidence interval: 1.21-2.48). This association was most pronounced among individuals with severe depressive symptoms (adjusted odds ratio=2.58 and 95% confidence interval: 1.46-4.57).

Depressive symptoms were significantly associated with both increased likelihood and longer duration of analgesic use. These findings highlight the complex and potentially bidirectional relationship between pain and mental health, suggesting the need for integrated approaches to pain management and psychiatric care.