title: The association of depression and anxiety with pain: a study from NESDA.
abstract: Chronic pain is commonly co-morbid with a depressive or anxiety disorder. Objective of this study is to examine the influence of depression, along with anxiety, on pain-related disability, pain intensity, and pain location in a large sample of adults with and without a depressive and/or anxiety disorder. The study population consisted of 2981 participants with a depressive, anxiety, co-morbid depressive and anxiety disorder, remitted disorder or no current disorder (controls). Severity of depressive and anxiety symptoms was also assessed. In separate multinomial regression analyses, the association of presence of depressive or anxiety disorders and symptom severity with the Chronic Pain Grade and location of pain was explored. Presence of a depressive (OR = 6.67; P<.001), anxiety (OR = 4.84; P<.001), or co-morbid depressive and anxiety disorder (OR = 30.26; P<.001) was associated with the Chronic Pain Grade. Moreover, symptom severity was associated with more disabling and severely limiting pain. Also, a remitted depressive or anxiety disorder showed more disabling and severely limiting pain (OR = 3.53; P<.001) as compared to controls. A current anxiety disorder (OR = 2.96; p<.001) and a co-morbid depressive and anxiety disorder (OR = 5.15; P<.001) were more strongly associated with cardio-respiratory pain, than gastro-intestinal or musculoskeletal pain. These findings remain after adjustment for chronic cardio respiratory illness. Patients with a current and remitted depressive and/or anxiety disorder and those with more severe symptoms have more disabling pain and pain of cardio-respiratory nature, than persons without a depressive or anxiety disorder. This warrants further research.
authors.affiliation: TopClinical Center for Body, Mind, and Health, GGz Breburg Tilburg, Tilburg, The Netherlands; Tilburg School of Behavioral and Social Sciences, Tranzo Department, University of Tilburg, Tilburg, The Netherlands.
authors.forename: Eric W
authors.initials: EW
authors.lastname: de Heer
authors.affiliation: Department of Psychiatry, EMGO Institute for Health and Care research, VU University Medical Centre, Amsterdam, The Netherlands.
authors.forename: Marloes M J G
authors.initials: MM
authors.lastname: Gerrits
authors.affiliation: Department of Psychiatry, EMGO Institute for Health and Care research, VU University Medical Centre, Amsterdam, The Netherlands; GGZ inGeest, Mental Health Institute, Amsterdam, The Netherlands.
authors.forename: Aartjan T F
authors.initials: AT
authors.lastname: Beekman
authors.affiliation: Arkin, Mental Health Institute, Amsterdam, The Netherlands; Department of Clinical Psychology, VU University, Amsterdam, The Netherlands.
authors.forename: Jack
authors.initials: J
authors.lastname: Dekker
authors.affiliation: Department of General Practice, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands.
authors.forename: Harm W J
authors.initials: HW
authors.lastname: van Marwijk
authors.affiliation: Department of Public Health and Primary Care, Leiden university Medical Centre, Leiden, The Netherlands.
authors.forename: Margot W M
authors.initials: MW
authors.lastname: de Waal
authors.affiliation: Institute of Psychology, Leiden University, Leiden, The Netherlands; Department of Psychiatry, Leiden University Medical Centre, Leiden, The Netherlands.
authors.forename: Philip
authors.initials: P
authors.lastname: Spinhoven
authors.affiliation: Department of Psychiatry, EMGO Institute for Health and Care research, VU University Medical Centre, Amsterdam, The Netherlands.
authors.forename: Brenda W J H
authors.initials: BW
authors.lastname: Penninx
authors.affiliation: TopClinical Center for Body, Mind, and Health, GGz Breburg Tilburg, Tilburg, The Netherlands; Tilburg School of Behavioral and Social Sciences, Tranzo Department, University of Tilburg, Tilburg, The Netherlands; Trimbos Institute, Utrecht, the Netherlands.
authors.forename: Christina M
authors.initials: CM
authors.lastname: van der Feltz-Cornelis
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000453:epidemiology* / Q000209:etiology; D059350:Chronic Pain / Q000150:complications / Q000453:epidemiology*; D015897:Comorbidity; D003866:Depressive Disorder / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires