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Papers: 10 Feb 2024 - 16 Feb 2024

2024 Feb 08

J Pain


Is there an association between lateralization of chronic pain in the body and depression?


Edwards KA, Lii T, Schouten TD, Kearney KM, Ziadni MS, Darnall BD, Mackey SC, Gilam G


Depression commonly co-occurs with chronic pain and can worsen pain outcomes. Recent theoretical work has hypothesized that pain localized to the left hemibody is a risk factor for worse depression due to overlap in underlying neural substrates. This hypothesis has not been tested a priori. Using a large sample of treatment-seeking adults with mixed-etiology chronic pain (N=1,185), our cross-sectional study tested whether patients with left-sided pain endorse worse depressive symptoms. We also examined differences in other pain-related functioning measures. We tested four comparisons based on painful body areas using the CHOIR bodymap: 1) only left-sided (OL) vs. any right-sided pain; 2) only right-sided (OR) vs. any left-sided pain; 3) OL vs. OR vs. bilateral pain; and 4) more left-sided vs. more right-sided vs. equal-sided pain. ANOVA models showed OL pain was not associated with worse depression (F=5.50, p=.019). Any left-sided pain was associated with worse depression, though the effect was small (F=8.58, p=.003, Cohens d=.29). Bilateral pain was associated with worse depression (F=8.05, p<.001, Cohens d=.24-.33). Regardless of pain location, more body areas endorsed was associated with greater depression. Although a more rigorous assessment of pain laterality is needed, our findings do not support the hypothesis that left lateralized pain is associated with worse depression. PERSPECTIVE: Pain lateralized to the left side of the body has been hypothesized as a risk factor for worse depression in chronic pain, despite never being tested in a large, real-world sample of patients with chronic pain. Findings showed that more widespread pain, not pain laterality, was associated with worse depression.