Association Between Clinical Depression, Anxiety, and Chronic Pain in the Active Duty Army Personnel

Author:

Ee Juliana S1,Hing Matthew S1,Dogbey Godwin Y2,Cook Marc A3,Agnello Robert N4,Skelly Stephanie K1,Frost Landon S1

Affiliation:

1. Womack Army Medical Center, Department of Family Medicine , Fort Bragg, NC 28310, USA

2. Department of Research and Medical Education, Campbell University, Jerry M. Wallace School of Osteopathic Medicine , Lillington, NC 27546, USA

3. Department of Primary Care, Weed Army Community Hospital , Fort Irwin, CA 92310, USA

4. Department of Family Medicine, Campbell University, Jerry M. Wallace School of Osteopathic Medicine , Lillington, NC 27546, USA

Abstract

ABSTRACT Introduction Chronic pain is highly prevalent among soldiers leading to costly impacts on disability and readiness. Depression and anxiety (D&A) are frequently comorbid with chronic pain, but previous studies tend to focus on reporting the odds of co-occurrence. The aim of this study was to examine the association of properly diagnosed D&A disorders on chronic pain indicators among active duty soldiers. Materials and Methods Data were drawn from the intake assessments of 203 soldiers seen at an Interdisciplinary Pain Management Center. The Diagnostic and Statistical Manual of Mental Disorders-5 diagnostic criteria and the D&A subscales of the Patient Health Questionnaire were used to identify patients who met criteria for clinical depression or anxiety. Of the 203 patients, 129 met neither depression nor anxiety criteria (No D&A), 12 met clinical depression criteria only, 16 met clinical anxiety only, and 46 showed coexisting D&A disorders. The D&A and No D&A groups were compared using validated measures to assess the pain intensity rating and pain effect on well-being, physical functioning, and catastrophizing tendency. Data were analyzed using descriptive statistics and independent samples t-test analyses. Results Significant differences were found between the D&A and No D&A groups on all pain-related measures (all Ps < .001). Patients in the D&A group reported higher average intensity of pain (6.11 versus 5.05) and greater effect of pain on activity (6.91 versus 5.37), sleep (7.20 versus 4.90), emotional state (7.74 versus 4.47), and stress (8.13 versus 4.78). Depression and anxiety patients also reported higher pain-catastrophizing tendency (38.56 versus 18.50) and greater physical disability (18.20 versus 12.22). Conclusions Soldiers who have chronic pain with coexisting D&A disorders experience a greater degree of perceived negative impacts. Consequently, attentiveness to proper diagnosis and treatment of coexisting clinical mood disorders is an essential step in fully addressing chronic pain management.

Publisher

Oxford University Press (OUP)

Subject

Public Health, Environmental and Occupational Health,General Medicine

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