title: The co-occurrence of pain and depression in adults with multiple sclerosis.
abstract: OBJECTIVE
  To define the rates of pain, depression, and their co-occurrence in persons with multiple sclerosis (MS).
  
  
  METHODS
  Participants were 161 persons with MS who previously participated in research and indicated a willingness to be contacted for future studies. Data were collected via postal survey and included the Patient Health Questionnaire-9 for depressive symptoms and a numerical rating scale (0-10) for pain. Descriptive statistics, chi-square analyses, and odds ratios were calculated to describe the prevalence, difference, and likelihood of depression, pain, and their comorbidity.
  
  
  RESULTS
  Some level of pain was experienced by 73% of the sample, with 40% of the entire sample reporting moderate or worse pain severity. Clinically significant levels of depressive symptoms were reported by 22% of the sample, and 8% reported sufficient symptoms to meet major depressive episode diagnostic criteria. Of persons meeting depression criteria, 86-100% reported experiencing any pain; 67-77% of persons meeting depression criteria reported experiencing pain of at least moderate severity. Of persons experiencing any pain, 11-34% met depression criteria; 15-37% of persons experiencing pain of at least moderate severity met depression criteria.
  
  
  CONCLUSIONS
  Pain and depression co-occur frequently in persons with MS. However, it is more common for individuals with depression to report pain than for individuals with pain to endorse symptoms of depression. Future studies should explore the implications of this co-occurrence, such as whether these individuals experience greater levels of disability, higher medical costs, or fewer benefits from treatment than persons with either condition alone.
authors.affiliation: Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA 98133, USA. kalschul@uw.edu
authors.forename: Kevin N
authors.initials: KN
authors.lastname: Alschuler
authors.forename: Dawn M
authors.initials: DM
authors.lastname: Ehde
authors.forename: Mark P
authors.initials: MP
authors.lastname: Jensen
mesh_terms: D000328:Adult; D015897:Comorbidity; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D009103:Multiple Sclerosis / Q000453:epidemiology* / Q000523:psychology*; D016017:Odds Ratio; D010146:Pain / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D010147:Pain Measurement / Q000379:methods / Q000706:statistics & numerical data; D015995:Prevalence; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014861:Washington / Q000453:epidemiology