title: Evaluation of How Depression and Anxiety Mediate the Relationship  Between Pain Catastrophizing and Prescription Opioid Misuse in a  Chronic Pain Population.
abstract: OBJECTIVE
  We investigated the extent to which anxiety and depression mediate the relationship between pain catastrophizing and the risk of prescription opioid misuse in chronic pain patients.
  
  
  METHODS
  215 patients with chronic occupational musculoskeletal disorders completed self-report measures upon admission to a functional restorational program. A bootstrap multivariate regression analysis was conducted to assess how depression and anxiety mediated the relationship between pain catastrophizing and prescription opioid misuse.
  
  
  RESULTS
  Catastrophizing, anxiety, and depression predicted higher risk for prescription opioid misuse. Furthermore, anxiety and depression acted as mediators while controlling for the effects of gender and age. Finally, it was found that the effects of catastrophizing on risk for prescription opioid misuse were completely eliminated by those of depression.
  
  
  CONCLUSIONS
  Due to the partially independent relationship of anxiety and catastrophizing, it is recommended that treatments for chronic pain patients employ techniques addressing both behaviors. The relationship between depression and catastrophizing requires more research since it was observed that their effects were confounded.
authors.forename: Javier
authors.initials: J
authors.lastname: Arteta
authors.forename: Briana
authors.initials: B
authors.lastname: Cobos
authors.forename: Yueqin
authors.initials: Y
authors.lastname: Hu
authors.forename: Krista
authors.initials: K
authors.lastname: Jordan
authors.forename: Krista
authors.initials: K
authors.lastname: Howard
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000009:adverse effects*; D001007:Anxiety / Q000175:diagnosis / Q000188:drug therapy / Q000523:psychology*; D058443:Catastrophization / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology*; D059350:Chronic Pain / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology*; D003430:Cross-Sectional Studies; D003863:Depression / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D063487:Prescription Drug Misuse / Q000523:psychology*; D057566:Self Report; D016320:Substance Abuse Treatment Centers / Q000379:methods
chemical_list: D000701:Analgesics, Opioid