Psychosocial stress and anxiety in musculoskeletal pain patients with and without depression

Ellen L. Poleshuck, Matthew Bair, Kurt Kroenke, Teresa Damush, Wanzhu Tu, Jingwei Wu, Erin E. Krebs, Donna E. Giles

Research output: Contribution to journalArticle

44 Citations (Scopus)

Abstract

Objective: The objective of this study was to determine if psychosocial stress and anxiety were associated with depression severity in primary care patients with chronic musculoskeletal pain. Methods: A cross-sectional sample of 500 primary care patients with musculoskeletal pain (250 with depression and 250 without depression) was assessed for anxiety, psychosocial stress, depression severity and demographics. The depressed and nondepressed participants were compared using t test and χ2 analyses. Multiple linear regression analyses were used to evaluate the respective associations of psychosocial stressors and anxiety with depression severity based on the 20-item Symptoms Check List across all 500 participants. Results: Compared with nondepressed patients, the depressed patients reported significantly more psychosocial stressors and more severe anxiety. Depressed patients reported a higher frequency of difficulties with every psychosocial stressor assessed. After controlling for covariates, both anxiety and psychosocial stressors were found to be associated with depression severity. Conclusions: Both anxiety and psychosocial stress should be considered in the assessment and treatment of patients with musculoskeletal pain and depression. Psychosocial stressors among patients with pain may have an impact on depression beyond that of anxiety. Tailored, integrated treatments that target the psychosocial needs of patients with pain and depression are needed. In addition to pharmacotherapy, psychotherapy and other behavioral treatments may be especially important for depression complicated by anxiety or psychosocial stress.

Original languageEnglish
Pages (from-to)116-122
Number of pages7
JournalGeneral Hospital Psychiatry
Volume31
Issue number2
DOIs
StatePublished - Mar 2009

Fingerprint

Musculoskeletal Pain
Anxiety
Depression
Primary Health Care
Pain
Psychotherapy
Chronic Pain
Linear Models
Therapeutics
Regression Analysis
Demography
Drug Therapy

Keywords

  • Anxiety
  • Depression
  • Pain
  • Psychosocial stress

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Psychosocial stress and anxiety in musculoskeletal pain patients with and without depression. / Poleshuck, Ellen L.; Bair, Matthew; Kroenke, Kurt; Damush, Teresa; Tu, Wanzhu; Wu, Jingwei; Krebs, Erin E.; Giles, Donna E.

In: General Hospital Psychiatry, Vol. 31, No. 2, 03.2009, p. 116-122.

Research output: Contribution to journalArticle

@article{70e0a9476c0f4bfb97d32faa267f84c7,
title = "Psychosocial stress and anxiety in musculoskeletal pain patients with and without depression",
abstract = "Objective: The objective of this study was to determine if psychosocial stress and anxiety were associated with depression severity in primary care patients with chronic musculoskeletal pain. Methods: A cross-sectional sample of 500 primary care patients with musculoskeletal pain (250 with depression and 250 without depression) was assessed for anxiety, psychosocial stress, depression severity and demographics. The depressed and nondepressed participants were compared using t test and χ2 analyses. Multiple linear regression analyses were used to evaluate the respective associations of psychosocial stressors and anxiety with depression severity based on the 20-item Symptoms Check List across all 500 participants. Results: Compared with nondepressed patients, the depressed patients reported significantly more psychosocial stressors and more severe anxiety. Depressed patients reported a higher frequency of difficulties with every psychosocial stressor assessed. After controlling for covariates, both anxiety and psychosocial stressors were found to be associated with depression severity. Conclusions: Both anxiety and psychosocial stress should be considered in the assessment and treatment of patients with musculoskeletal pain and depression. Psychosocial stressors among patients with pain may have an impact on depression beyond that of anxiety. Tailored, integrated treatments that target the psychosocial needs of patients with pain and depression are needed. In addition to pharmacotherapy, psychotherapy and other behavioral treatments may be especially important for depression complicated by anxiety or psychosocial stress.",
keywords = "Anxiety, Depression, Pain, Psychosocial stress",
author = "Poleshuck, {Ellen L.} and Matthew Bair and Kurt Kroenke and Teresa Damush and Wanzhu Tu and Jingwei Wu and Krebs, {Erin E.} and Giles, {Donna E.}",
year = "2009",
month = "3",
doi = "10.1016/j.genhosppsych.2008.10.003",
language = "English",
volume = "31",
pages = "116--122",
journal = "General Hospital Psychiatry",
issn = "0163-8343",
publisher = "Elsevier Inc.",
number = "2",

}

TY - JOUR

T1 - Psychosocial stress and anxiety in musculoskeletal pain patients with and without depression

AU - Poleshuck, Ellen L.

AU - Bair, Matthew

AU - Kroenke, Kurt

AU - Damush, Teresa

AU - Tu, Wanzhu

AU - Wu, Jingwei

AU - Krebs, Erin E.

AU - Giles, Donna E.

PY - 2009/3

Y1 - 2009/3

N2 - Objective: The objective of this study was to determine if psychosocial stress and anxiety were associated with depression severity in primary care patients with chronic musculoskeletal pain. Methods: A cross-sectional sample of 500 primary care patients with musculoskeletal pain (250 with depression and 250 without depression) was assessed for anxiety, psychosocial stress, depression severity and demographics. The depressed and nondepressed participants were compared using t test and χ2 analyses. Multiple linear regression analyses were used to evaluate the respective associations of psychosocial stressors and anxiety with depression severity based on the 20-item Symptoms Check List across all 500 participants. Results: Compared with nondepressed patients, the depressed patients reported significantly more psychosocial stressors and more severe anxiety. Depressed patients reported a higher frequency of difficulties with every psychosocial stressor assessed. After controlling for covariates, both anxiety and psychosocial stressors were found to be associated with depression severity. Conclusions: Both anxiety and psychosocial stress should be considered in the assessment and treatment of patients with musculoskeletal pain and depression. Psychosocial stressors among patients with pain may have an impact on depression beyond that of anxiety. Tailored, integrated treatments that target the psychosocial needs of patients with pain and depression are needed. In addition to pharmacotherapy, psychotherapy and other behavioral treatments may be especially important for depression complicated by anxiety or psychosocial stress.

AB - Objective: The objective of this study was to determine if psychosocial stress and anxiety were associated with depression severity in primary care patients with chronic musculoskeletal pain. Methods: A cross-sectional sample of 500 primary care patients with musculoskeletal pain (250 with depression and 250 without depression) was assessed for anxiety, psychosocial stress, depression severity and demographics. The depressed and nondepressed participants were compared using t test and χ2 analyses. Multiple linear regression analyses were used to evaluate the respective associations of psychosocial stressors and anxiety with depression severity based on the 20-item Symptoms Check List across all 500 participants. Results: Compared with nondepressed patients, the depressed patients reported significantly more psychosocial stressors and more severe anxiety. Depressed patients reported a higher frequency of difficulties with every psychosocial stressor assessed. After controlling for covariates, both anxiety and psychosocial stressors were found to be associated with depression severity. Conclusions: Both anxiety and psychosocial stress should be considered in the assessment and treatment of patients with musculoskeletal pain and depression. Psychosocial stressors among patients with pain may have an impact on depression beyond that of anxiety. Tailored, integrated treatments that target the psychosocial needs of patients with pain and depression are needed. In addition to pharmacotherapy, psychotherapy and other behavioral treatments may be especially important for depression complicated by anxiety or psychosocial stress.

KW - Anxiety

KW - Depression

KW - Pain

KW - Psychosocial stress

UR - http://www.scopus.com/inward/record.url?scp=61349173118&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=61349173118&partnerID=8YFLogxK

U2 - 10.1016/j.genhosppsych.2008.10.003

DO - 10.1016/j.genhosppsych.2008.10.003

M3 - Article

C2 - 19269531

AN - SCOPUS:61349173118

VL - 31

SP - 116

EP - 122

JO - General Hospital Psychiatry

JF - General Hospital Psychiatry

SN - 0163-8343

IS - 2

ER -