title: Factors associated with the development of depression in chronic non-cancer pain patients following the onset of opioid treatment for pain.
abstract: OBJECTIVE
  Pharmaceutical opioid prescription rates are increasing globally, however knowledge of their long-term effects on mental health, in particular depression remains limited. This study aimed to identify factors associated with the onset of depression post-opioid use that differ to factors associated with depression post-pain.
  
  
  METHODS
  Participants (N = 1418) were a national sample prescribed opioids for chronic non-cancer pain. Age at onset of depression, pain and commencement of opioid medications were collected via structured interview.
  
  
  RESULTS
  Six in 10 (61%) reported lifetime depression; of those, almost half developed depression after pain and after they started opioid medications (48%). Variables associated with post-opioid depression included lower pain self-efficacy and poorer social support, younger onset of opioid use, and difficulties and concerns with opioid medications.
  
  
  CONCLUSIONS
  The findings highlight the importance of monitoring for the emergence of mood dysfunction, particularly for those starting opioids for pain at a younger age, and consideration of psychological treatments that address self-efficacy that appears to be associated with post-opioid depression.
authors.affiliation: National Drug and Alcohol Research Centre, UNSW, Sydney, NSW 2052, Australia.
authors.forename: Kimberley
authors.initials: K
authors.lastname: Smith
authors.affiliation: National Drug and Alcohol Research Centre, UNSW, Sydney, NSW 2052, Australia.
authors.forename: Richard P
authors.initials: RP
authors.lastname: Mattick
authors.affiliation: School of Medicine, University of Tasmania, Australia.
authors.forename: Raimondo
authors.initials: R
authors.lastname: Bruno
authors.affiliation: National Drug and Alcohol Research Centre, UNSW, Sydney, NSW 2052, Australia.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Nielsen
authors.affiliation: St Vincent's Clinical School, UNSW Medicine, UNSW, Australia.
authors.forename: Milton
authors.initials: M
authors.lastname: Cohen
authors.affiliation: National Drug and Alcohol Research Centre, UNSW, Sydney, NSW 2052, Australia. Electronic address: g.campbell@unsw.edu.au.
authors.forename: Gabrielle
authors.initials: G
authors.lastname: Campbell
authors.affiliation: National Drug and Alcohol Research Centre, UNSW, Sydney, NSW 2052, Australia.
authors.forename: Briony
authors.initials: B
authors.lastname: Larance
authors.affiliation: National Drug and Alcohol Research Centre, UNSW, Sydney, NSW 2052, Australia.
authors.forename: Michael
authors.initials: M
authors.lastname: Farrell
authors.affiliation: National Drug and Alcohol Research Centre, UNSW, Sydney, NSW 2052, Australia; School of Population and Global Health, University of Melbourne, Australia; Murdoch Children's Research Institute, Australia; Department of Global Health, School of Public Health, University of Washington, USA.
authors.forename: Louisa
authors.initials: L
authors.lastname: Degenhardt
mesh_terms: D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000009:adverse effects*; D059350:Chronic Pain / Q000188:drug therapy* / Q000523:psychology; D003863:Depression / Q000139:chemically induced / Q000209:etiology*; D003866:Depressive Disorder / Q000139:chemically induced / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D012307:Risk Factors
chemical_list: D000701:Analgesics, Opioid
keywords: Chronic pain; Depression; Pharmaceutical opioids; Self-efficacy