title: Pain and depression in a cohort of underserved, community-dwelling primary care patients.
abstract: OBJECTIVE
  Almost 17% of the US population exhibits a major depressive disorder in their lifetimes. Prevalence data show that whites experience depression earlier than African Americans, and women have a higher prevalence than men. Less is known regarding depression among underserved minority populations. The goal of our study was to examine the relationship of depression and associated self-reported conditions in participants enrolled in a community-based research registry, a substantial number of whom were underrepresented minorities.
  
  
  METHODS
  This study used a research registry of community members who had expressed interest in participating in health education projects conducted by the Center for Primary Care Community-Based Research. The patients received care at 10 family health centers. Participants were surveyed regarding family history of depression/anxiety and associated symptoms. Descriptive analyses, univariate analyses, and logistic regressions were used.
  
  
  RESULTS
  The population (N = 2421) included women (72.2%), African Americans (54.9%), and reported good or very good general health (68.9%). Comorbid pain was found, with headache as the predominant complaint. Compared with nonwhites, whites had a significantly higher prevalence of current depression (26.3% vs. 23.8%; P = .01), current anxiety (25.5% vs. 16.6%), and current headache (14.2% vs. 11.2%). Whites also had a higher prevalence of a family history of depression (38.4% vs. 32.1%) and anxiety (8.9% vs. 7.7%) and of taking depression (22.4% vs. 14.8%) and anxiety (15.8% vs. 7.8%) medications. However, nonwhites had a higher prevalence of leg pain (18.8% vs. 14.9%) but a lower prevalence of headache (11.2% vs. 14.2%).
  
  
  CONCLUSIONS
  Pain was common in patients with comorbid behavioral conditions. Headache was more common in whites, whereas leg pain was more common in nonwhites. Physicians should screen for depression and anxiety in patients with headache and other pain symptoms.
authors.affiliation: Center for Clinical and Community Health Improvement, Austen BioInnovation Institute in Akron, Akron, OH, USA.
authors.forename: Janine E
authors.initials: JE
authors.lastname: Janosky
authors.forename: Jeannette E
authors.initials: JE
authors.lastname: South-Paul
authors.forename: Chyongchiou J
authors.initials: CJ
authors.lastname: Lin
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D015331:Cohort Studies; D003153:Community Health Services / Q000379:methods* / Q000458:organization & administration; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology; D005260:Female; D006266:Health Education; D006801:Humans; D016015:Logistic Models; D008297:Male; D008507:Medically Underserved Area; D008875:Middle Aged; D010146:Pain / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology; D015995:Prevalence; D011320:Primary Health Care / Q000379:methods* / Q000458:organization & administration; D011594:Psychometrics; D012372:ROC Curve; D012042:Registries; D057566:Self Report; D014481:United States / Q000453:epidemiology; D044465:White People; D055815:Young Adult