title: Longitudinal association between pain, and depression and anxiety over four years.
abstract: OBJECTIVE
  Many patients with depression and/or anxiety (D/A) persistently report pain. However, it is not clear how the course of D/A is associated with pain over time. The present study assessed longitudinal associations between D/A and pain, and compared pain over time between D/A and healthy controls.
  
  
  METHODS
  2676 participants of the Netherlands Study of Depression and Anxiety were followed-up for four years. At three waves (baseline, 2, 4years) we assessed depressive and anxiety symptom severity. Using DSM-IV criteria, we also assessed four different D/A disorder courses over time (n=2093): incident, remitted, chronic, and no D/A (reference group). Pain was assessed at the three waves by severity and number of locations.
  
  
  RESULTS
  Change in D/A symptoms was positively associated with change in pain symptoms. Compared to healthy controls (n=519), D/A subjects - incident (n=333), remitted (n=548) or chronic (n=693) - reported more severe pain (b=0.4-0.7, p<0.001) and more pain locations (b=0.8-1.4, p<.001) at all waves, with the highest ratings in chronic D/A. Remission of D/A during follow-up was associated with a significant decline in pain (severity; p=0.002, number of locations; p<.001), but pain levels remained significantly higher compared to healthy controls. Findings were similar for separate depression or anxiety course.
  
  
  CONCLUSIONS
  This study largely confirms synchrony of change between depression, anxiety and pain. However, even after depression and anxiety remission, subjects report higher pain ratings over time. Individuals with D/A (history) seem to be at increased risk of chronic pain.
authors.affiliation: Department of Psychiatry, EMGO Institute for Health and Care Research, VU University Medical Center and Academic Outpatient Clinic for Affective Disorders, GGZ inGeest, Amsterdam, The Netherlands; Department of General Practice and Elderly Care Medicine, EMGO institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands. Electronic address: mj.gerrits@vumc.nl.
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 Center and Academic Outpatient Clinic for Affective Disorders, GGZ inGeest, Amsterdam, The Netherlands; Department of General Practice and Elderly Care Medicine, EMGO institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Harm W J
authors.initials: HW
authors.lastname: van Marwijk
authors.affiliation: Department of Psychiatry, EMGO Institute for Health and Care Research, VU University Medical Center and Academic Outpatient Clinic for Affective Disorders, GGZ inGeest, Amsterdam, The Netherlands; Department of General Practice and Elderly Care Medicine, EMGO institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Patricia
authors.initials: P
authors.lastname: van Oppen
authors.affiliation: Department of General Practice and Elderly Care Medicine, EMGO institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Henriëtte
authors.initials: H
authors.lastname: van der Horst
authors.affiliation: Department of Psychiatry, EMGO Institute for Health and Care Research, VU University Medical Center and Academic Outpatient Clinic for Affective Disorders, GGZ inGeest, Amsterdam, The Netherlands.
authors.forename: Brenda W J H
authors.initials: BW
authors.lastname: Penninx
mesh_terms: D000328:Adult; D001007:Anxiety / Q000209:etiology*; D059350:Chronic Pain / Q000523:psychology; D003863:Depression / Q000209:etiology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010146:Pain / Q000175:diagnosis / Q000523:psychology*; D010147:Pain Measurement
keywords: Anxiety disorder; Course; Depressive disorder; Multilevel model; Pain