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BMC Psychiatry
Published in: BMC Psychiatry 1/2014

Open Access 01-12-2014 | Research article

Pain, not chronic disease, is associated with the recurrence of depressive and anxiety disorders

Authors: Marloes MJG Gerrits, Patricia van Oppen, Stephanie S Leone, Harm WJ van Marwijk, Henriëtte E van der Horst, Brenda W Penninx

Published in: BMC Psychiatry | Issue 1/2014

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Abstract

Background

Studies suggest that poor physical health might be associated with increased depression and anxiety recurrence. The objectives of this study were to determine whether specific chronic diseases and pain characteristics are associated with depression and anxiety recurrence and to examine whether such associations are mediated by subthreshold depressive or anxiety symptoms.

Methods

1122 individuals with remitted depressive or anxiety disorder (Netherlands Study of Depression and Anxiety) were followed up for a period of four years. The impact of specific chronic diseases and pain characteristics on recurrence was assessed using Cox regression and mediation analyses.

Results

Chronic diseases were not associated with recurrence. Neck (HR 1.45, p < .01), chest (HR 1.65, p < .01), abdominal (HR 1.52, p < .01) pain, an increase in the number of pain locations (HR 1.10, p < .01) and pain severity (HR 1.18, p = .01) were associated with an increased risk of depression recurrence but not anxiety. Subthreshold depressive symptoms mediated the associations between pain and depression recurrence.

Conclusions

Pain, not chronic disease, increases the likelihood of depression recurrence, largely through its association with aggravated subthreshold depressive symptoms. These findings support the idea of the existence of a mutually reinforcing mechanism between pain and depression and are indicative of the importance of shedding light on neurobiological links in order to optimize pain and depression management.
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Metadata
Title
Pain, not chronic disease, is associated with the recurrence of depressive and anxiety disorders
Authors
Marloes MJG Gerrits
Patricia van Oppen
Stephanie S Leone
Harm WJ van Marwijk
Henriëtte E van der Horst
Brenda W Penninx
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2014
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/1471-244X-14-187

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