title: Symptoms of depression predict the trajectory of pain among patients with early inflammatory arthritis: a path analysis approach to assessing change.
abstract: OBJECTIVE
  To assess the longitudinal relationships, including directionality, among chronic pain, symptoms of depression, and disease activity in patients with early inflammatory arthritis (EIA).
  
  
  METHODS
  One hundred eighty patients with EIA completed an examination, including swollen joint count, and were administered the Center for Epidemiological Studies Depression Scale (CES-D) and the McGill Pain Questionnaire (MPQ) at 2 timepoints 6 months apart. Cross-lagged panel path analysis was used to simultaneously assess concurrent and longitudinal relationships among pain, symptoms of depression, and number of swollen joints.
  
  
  RESULTS
  Pain, symptoms of depression, and number of swollen joints decreased over time (p < 0.001) and were prospectively linked to pain, symptoms of depression, and number of swollen joints, respectively, at 6 months. Symptoms of depression and pain were correlated with each other at baseline (0.47) and at 6-month followup assessments (0.28). Baseline symptoms of depression significantly predicted pain symptoms at 6 months (standardized regression coefficient = 0.28, p = 0.001), whereas pain and disease activity did not predict the course of any other variable after controlling for baseline values.
  
  
  CONCLUSIONS
  Symptoms of depression predicted the trajectory of pain from baseline to 6 months. In addition, there were reciprocal/bidirectional associations between pain and symptoms of depression over time. More research is needed to better understand the relationship between pain and depressive symptoms and how to best manage patients with EIA who have high levels of both.
authors.affiliation: SMBD-Jewish General Hospital, 4333 Cote Ste Catherine Road, Montreal, Quebec H3T 1E4.
authors.forename: Orit
authors.initials: O
authors.lastname: Schieir
authors.forename: Brett D
authors.initials: BD
authors.lastname: Thombs
authors.forename: Marie
authors.initials: M
authors.lastname: Hudson
authors.forename: Suzanne
authors.initials: S
authors.lastname: Taillefer
authors.forename: Russell
authors.initials: R
authors.lastname: Steele
authors.forename: Laeora
authors.initials: L
authors.lastname: Berkson
authors.forename: Carole
authors.initials: C
authors.lastname: Bertrand
authors.forename: Francois
authors.initials: F
authors.lastname: Couture
authors.forename: Mary-Ann
authors.initials: MA
authors.lastname: Fitzcharles
authors.forename: Michel
authors.initials: M
authors.lastname: Gagné
authors.forename: Bruce
authors.initials: B
authors.lastname: Garfield
authors.forename: Andrzej
authors.initials: A
authors.lastname: Gutkowski
authors.forename: Harb
authors.initials: H
authors.lastname: Kang
authors.forename: Morton
authors.initials: M
authors.lastname: Kapusta
authors.forename: Sophie
authors.initials: S
authors.lastname: Ligier
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Mathieu
authors.forename: Henri
authors.initials: H
authors.lastname: Ménard
authors.forename: Suzanne
authors.initials: S
authors.lastname: Mercille
authors.forename: Michael
authors.initials: M
authors.lastname: Starr
authors.forename: Michael
authors.initials: M
authors.lastname: Stein
authors.forename: Michel
authors.initials: M
authors.lastname: Zummer
authors.forename: Murray
authors.initials: M
authors.lastname: Baron
mesh_terms: D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000503:physiopathology / Q000523:psychology*; D015984:Causality; D002908:Chronic Disease / Q000523:psychology; D003866:Depressive Disorder / Q000175:diagnosis* / Q000209:etiology; D004185:Disability Evaluation; D018450:Disease Progression; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010147:Pain Measurement / Q000379:methods*; D010148:Intractable Pain / Q000150:complications* / Q000503:physiopathology / Q000523:psychology*; D011446:Prospective Studies; D012720:Severity of Illness Index; D013223:Statistics as Topic