Effect of depression treatment on chronic pain outcomes.
OBJECTIVE
To examine the effect of depression treatment on medical and social outcomes for individuals with chronic pain and depression. People with chronic pain and depression have worse health outcomes than those with chronic pain alone. Little is known about the effectiveness of depression treatment for this population.


METHODS
Propensity score-weighted analyses, using both waves (1997-1998 and 2000-2001) of the National Survey of Alcohol, Drug, and Mental Health Problems, were used to examine the effect of a) any depression treatment and b) minimally adequate depression treatment on persistence of depression symptoms, depression severity, pain severity, overall health, mental health status, physical health status, social functioning, employment status, and number of workdays missed. Analyses were limited to those who met Composite International Diagnostic Interview Short-Form criteria for major depressive disorder, reported having at least one chronic pain condition, and completed both interviews (n = 553).


RESULTS
Receiving any depression treatment was associated with higher scores on the mental component summary of the Medical Outcomes Study Short Form-12, indicating better mental health (difference = 2.65 points, p = .002) and less interference of pain on work (odds ratio = 0.57, p = .02). Among those receiving treatment, minimal adequacy of treatment was not significantly associated with better outcomes.


CONCLUSIONS
Depression treatment improves mental health and reduces the effects of pain on work among those with chronic pain and depression. Understanding the effect of depression treatment on outcomes for this population is important for employers, healthcare providers treating this population, and policymakers working in this decade of pain control and research to improve care for chronic pain sufferers.
Teh
Carrie Farmer
CF
RAND Corporation, Pittsburgh, PA 15213, USA. cteh@rand.org
Zaslavsky
Alan M
AM
Reynolds
Charles F
CF
Cleary
Paul D
PD
D002908:Chronic Disease; D015897:Comorbidity; D017281:Cost of Illness; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D004651:Employment; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010146:Pain / Q000175:diagnosis / Q000453:epidemiology*; D059408:Pain Management; D057216:Propensity Score; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011787:Quality of Health Care; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires