6533b834fe1ef96bd129d661

RESEARCH PRODUCT

Depression and pain: primary data and meta-analysis among 237 952 people across 47 low- and middle-income countries

Brendon StubbsMarco SolmiTrevor ThompsonMichele FornaroNicola VeronesePatricia SchofieldAndré F. CarvalhoDavy VancampfortJames MugishaAi Koyanagi

subject

AdultMalemedicine.medical_specialtyAdolescentComorbidityAnxietyLogistic regressionGlobal HealthSeverity of Illness IndexComorbidity; depression; depressive symptoms; pain; Applied Psychology; Psychiatry and Mental HealthAngina03 medical and health sciencesYoung Adult0302 clinical medicinedepressive symptomsInternal medicinePrevalenceMedicineHumanspainPsychiatrydepressive symptomDeveloping CountriesApplied PsychologyDepression (differential diagnoses)AgedAged 80 and overDepressive Disorderbusiness.industryPain scaleOdds ratioMiddle Agedmedicine.diseaseHealth SurveysConfidence interval030227 psychiatryPsychiatry and Mental healthMeta-analysisChronic DiseasedepressionAnxietyFemalemedicine.symptombusinessComorbidity depression depressive symptoms pain030217 neurology & neurosurgery

description

BackgroundDepression and pain are leading causes of global disability. However, there is a paucity of multinational population data assessing the association between depression and pain, particularly among low- and middle-income countries (LMICs) where both are common. Therefore, we investigated this association across 47 LMICs.MethodsCommunity-based data on 273 952 individuals from 47 LMICs were analysed. Multivariable logistic and linear regression analyses were performed to assess the association between the International Classification of Diseases, 10th Revision depression/depression subtypes (over the past 12 months) and pain in the previous 30 days based on self-reported data. Country-wide meta-analysis adjusting for age and sex was also conducted.ResultsThe prevalence of severe pain was 8.0, 28.2, 20.2, and 34.0% for no depression, subsyndromal depression, brief depressive episode, and depressive episode, respectively. Logistic regression adjusted for socio-demographic variables, anxiety and chronic medical conditions (arthritis, diabetes, angina, asthma) demonstrated that compared with no depression, subsyndromal depression, brief depressive episode, and depressive episode were associated with a 2.16 [95% confidence interval (CI) 1.83–2.55], 1.45 (95% CI 1.22–1.73), and 2.11 (95% CI 1.87–2.39) increase in odds of severe pain, respectively. Similar results were obtained when a continuous pain scale was used as the outcome. Depression was significantly associated with severe pain in 44/47 countries with a pooled odds ratio of 3.93 (95% CI 3.54–4.37).ConclusionDepression and severe pain are highly comorbid across LMICs, independent of anxiety and chronic medical conditions. Whether depression treatment or pain management in patients with comorbid pain and depression leads to better clinical outcome is an area for future research.

yearjournalcountryeditionlanguage
2017-06-22