title: The impact of pain and depression on recovery after coronary artery bypass grafting.
abstract: OBJECTIVE
  To describe the relationship between pain and depression on recovery after coronary artery bypass grafting (CABG).
  
  
  METHODS
  A secondary data analysis on 453 depressed and nondepressed post-CABG patients enrolled in a randomized, controlled, effectiveness trial of telephone-delivered collaborative care for depression. Outcome measures were collected from March 2004 to September 2007 and included pain, physical function, and mood symptoms.
  
  
  RESULTS
  Depressed patients (baseline Patient Health Questionnaire-9 score ≥10) versus those without depression reported significantly worse pain scores on the 36-Item Short Form Health Survey Bodily Pain Scale at baseline and up to 12 months post-CABG, p < .05. Among patients with depression, those who received collaborative care reported significantly better pain scores at each time point between 2 and 12 months post-CABG versus depressed patients randomized to the usual care control group, p < .05. Regardless of intervention status, depressed participants with at least moderate pain at baseline reported significantly lower functional status (measured by the Duke Activity Status Index) at 8 and 12 months versus depressed patients with none or mild pain, p < .05. Depressed patients with at least moderate pain at baseline were also significantly less likely to show improvement of depressive symptoms throughout the course of follow-up versus depressed patients with little or no pain, p < .05. These findings controlled for age, gender, education, race, comorbid conditions, and baseline pain diagnosis.
  
  
  CONCLUSIONS
  Depression and pain seem to influence functional recovery post-CABG. The relationship between these two conditions and 12-month outcomes should be considered by clinicians when planning treatment.
authors.affiliation: Division of General Internal Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA. moronene@upmc.edu
authors.forename: Natalia E
authors.initials: NE
authors.lastname: Morone
authors.forename: Debra K
authors.initials: DK
authors.lastname: Weiner
authors.forename: Bea Herbeck
authors.initials: BH
authors.lastname: Belnap
authors.forename: Jordan F
authors.initials: JF
authors.lastname: Karp
authors.forename: Sati
authors.initials: S
authors.lastname: Mazumdar
authors.forename: Patricia R
authors.initials: PR
authors.lastname: Houck
authors.forename: Fanyin
authors.initials: F
authors.lastname: He
authors.forename: Bruce L
authors.initials: BL
authors.lastname: Rollman
mesh_terms: D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D015897:Comorbidity; D001026:Coronary Artery Bypass / Q000523:psychology*; D003866:Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010146:Pain / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D010147:Pain Measurement / Q000706:statistics & numerical data; D010149:Postoperative Pain / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D010348:Patient Care Team; D011183:Postoperative Complications / Q000188:drug therapy* / Q000453:epidemiology; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal