Self-management practices among primary care patients with musculoskeletal pain and depression

Teresa Damush, Jingwei Wu, Matthew Bair, Jason M. Sutherland, Kurt Kroenke

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

The objective of this study was to assess the effect of clinical depression on pain self-management practices. We employed a cross-sectional analysis of baseline data from the Stepped Care for Affective disorders and Musculoskeletal Pain (SCAMP) study. Participants included 250 patients with pain and comorbid depression and 250 patients with pain only and were enrolled from urban university and VA primary care clinics. Musculoskeletal pain was defined as low back, hip or knee pain present ≥3 months and with at least a moderate, Brief Pain Inventory severity score ≥5. Depression was defined as a PHQ-9 score ≥10. We used multiple logistic and Poisson regression to assess the relationship between individual and combined effects of depression and pain severity on two core pain self-management skills: exercise duration and cognitive strategies. Depressed patients exercised less per week than did nondepressed patients but showed a trend towards more frequent use of cognitive strategies. On multivariable analysis, depression severity substantially decreased the use of exercise as a pain self-management strategy. In contrast, depression and pain severity interacted to increase the use of cognitive strategies. Depression and pain severity have differential effects on self-management practices. Understanding the differences between preferential strategies of pain patients with and without depression may be useful in tailoring pain self-management programs.

Original languageEnglish
Pages (from-to)301-307
Number of pages7
JournalJournal of Behavioral Medicine
Volume31
Issue number4
DOIs
StatePublished - Aug 2008

Fingerprint

Musculoskeletal Pain
Self Care
Primary Health Care
Depression
Pain
Pain Management
Exercise
Mood Disorders
Hip
Knee
Cross-Sectional Studies
Logistic Models
Equipment and Supplies

Keywords

  • Cognitive strategies
  • Exercise
  • Mental stress relaxation

ASJC Scopus subject areas

  • Psychology(all)
  • Clinical Psychology

Cite this

Self-management practices among primary care patients with musculoskeletal pain and depression. / Damush, Teresa; Wu, Jingwei; Bair, Matthew; Sutherland, Jason M.; Kroenke, Kurt.

In: Journal of Behavioral Medicine, Vol. 31, No. 4, 08.2008, p. 301-307.

Research output: Contribution to journalArticle

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