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Papers: 9 Jan 2021 - 15 Jan 2021


Human Studies

2021 Jan 05


Publish Ahead of Print

The impact of pain and catastrophizing on the long-term course of depression in the general population (the HUNT pain study).


Glette M, Stiles TC, Jensen MP, Nilsen T I L, Borchgrevink PC, Landmark T
Pain. 2021 Jan 05; Publish Ahead of Print.
PMID: 33416223.


Pain and depression are episodic conditions that might take a chronic course. They are clearly related, but information on how they influence each other in the process of chronification is limited. Pain catastrophizing is hypothesized to play a role in the development of depression and chronic pain, but few longitudinal studies have investigated their association over a longer-term. In this study, a random cohort from the general population (n = 4764) answered questions about pain, catastrophizing, and depression at five assessments in yearly intervals. Linear mixed models showed that within persons, increases in pain intensity and catastrophizing were independently associated with increases in depressive symptoms (mean change = -1.12, 95% CI [-1.32, -0.91]) and -1.29, 95% CI [-1.52, -1.05], respectively). In prospective analyses restricted to individuals without depression above cut-off at baseline, chronic pain increased the risk of endorsing depression over the following four years (OR =2.01, 95% CI [1.71, 2.37]). Seven percent showed a chronic course of depression, as indicated by scores above cut-off on at least three of five assessments. Number of years lived with chronic pain was associated with a chronic course of depression, with odds ratios increasing from 1.55 (95% CI [0.87, 2.91]) to 14.19 (95% CI [8.99, 22.41]) when reporting chronic pain on two versus five assessments compared to none. The results suggest that when pain intensity or catastrophizing change, depressive symptoms change in the same direction. When pain and catastrophizing become chronic, they appear to be mutually reinforcing determinants for chronic depression.