Is shoulder pain for three months or longer correlated with depression, anxiety, and sleep disturbance?
BACKGROUND
Recent studies have found a high prevalence of depression, anxiety, and sleep disturbance in patients with chronic musculoskeletal pain. We conducted a study to determine whether shoulder pain for 3 months or longer is correlated with depression, anxiety, and sleep disturbance.


METHODS
We prospectively evaluated 130 patients who had had shoulder pain for 3 months or longer (group I) and 60 healthy controls (group II). We obtained visual analog scale (VAS) pain score, and scores for the American Shoulder and Elbow Surgeons (ASES), Korean Shoulder Scale (KSS), Hospital Anxiety and Depression Scale (HADS), and Pittsburgh Sleep Quality Index (PSQI).


RESULTS
The mean VAS pain score, ASES score, and KSS score in group I were 6.2, 46.6, and 51.5, respectively. In that group, 22.3% had depression, 19.2% had anxiety, and 81.5% had sleep disturbance. The prevalences were higher in group I than in group II. There were no differences in depression, anxiety, or sleep disturbance by age, sex, type of disease, or duration of symptoms in group I. VAS pain scores positively correlated with PSQI scores (P = .01). ASES and KSS scores negatively correlated with HADS depression and anxiety subscale and PSQI scores (P < .001). Shoulder pain for 3 months or longer was the strongest predictor of sleep disturbance (P < .001).


CONCLUSIONS
Our study demonstrated high prevalence and close relationships of depression, anxiety, and sleep disturbance in patients with shoulder pain for 3 months or longer. These results may indicate importance of the psychologic approach as well as adequate pain control.
Pain Research Center, Department of Orthopedic Surgery, Dongsan Medical Center, School of Medicine, Keimyung University, Daegu, South Korea.
Chul-Hyun
CH
Cho
Sung-Won
SW
Jung
Jin-Young
JY
Park
Kwang-Soon
KS
Song
Kyeong-Im
KI
Yu
D001007:Anxiety / Q000453:epidemiology* / Q000209:etiology; D059350:Chronic Pain; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D020069:Shoulder Pain / Q000150:complications / Q000523:psychology*; D012893:Sleep Wake Disorders / Q000453:epidemiology* / Q000209:etiology; D013997:Time Factors