The adverse effects of comorbid pain on depression outcomes in primary care patients: Results from the artist trial

Angela M. DeVeaugh-Geiss, Suzanne L. West, William C. Miller, Betsy Sleath, Bradley N. Gaynes, Kurt Kroenke

Research output: Contribution to journalArticle

34 Scopus citations

Abstract

Objectives.: To explore the effect of pain symptoms and improvements in pain on depression outcomes. Methods.: We analyzed data from A Randomized Trial Investigating SSRI Treatment (ARTIST), a randomized longitudinal effectiveness study comparing selective serotonin reuptake inhibitors (SSRIs) for the treatment of depression in primary care (n = 573). Depression outcome at month 6, defined as remission, partial response, and nonresponse using the Symptom Checklist-20, was the primary outcome. Results.: Compared to patients with no pain at baseline, those with severe pain were less likely to achieve remission (OR = 0.11, 95% CI 0.05-0.25) and partial response (OR = 0.24, 95% CI 0.10-0.59) vs nonresponse. Patients with moderate pain were less likely to achieve remission vs nonresponse (OR = 0.25, 95% CI 0.13-0.48). Patients with early improvement in pain were more likely to achieve remission (OR = 1.90, 95% CI 1.03-3.49). Accounting for missing data with last observation carried forward or multiple imputation yielded similar results. Conclusion.: Pain symptoms are present in the majority of depressed primary care patients beginning antidepressant therapy. Pain symptoms are associated with worse depression outcomes, while improvement in pain is associated with significantly better depression outcomes. Attention to comorbid pain may be important in enhancing depression care. Wiley Periodicals, Inc.

Original languageEnglish (US)
Pages (from-to)732-741
Number of pages10
JournalPain Medicine
Volume11
Issue number5
DOIs
StatePublished - May 2010

ASJC Scopus subject areas

  • Clinical Neurology
  • Anesthesiology and Pain Medicine

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