Abstract
This study examined pre-existing depression as a risk factor for the development of
chronic spinal pain, and pre-existing chronic spinal pain as a risk factor for the
development of depression. Data from the National Comorbidity Survey, a stratified
sample of 5,001 participants evaluated in 1990 to 1992 (NCS-1) and again in 2000 to
2001 (NCS-2) were used to address these associations. Cox regression was used to estimate
hazard ratios and time-to-incidence after NCS-1. Participants with antecedent acute
or chronic depressive disorders at NCS-1 were more likely to develop chronic spinal
pain in the ensuing 10 years compared with participants without depressive disorders.
Those with antecedent chronic spinal pain at NCS-1 were more likely to develop dysthymic
disorder than subjects without chronic spinal pain at NCS-1; however, antecedent chronic
spinal pain was not associated the subsequent development of major depressive disorder.
These results suggest that both pain and depression are associated with the development
of the other condition. In particular, chronic depression is more strongly linked
to chronic spinal pain than is acute depression. The results are discussed in terms
of the need to assess the presence of both disorders given the presence of one.
Perspective
Chronic spinal pain and depressive disorders, especially chronic depression, increase
the likelihood for the subsequent development of the other condition. The results
underscore the need to routinely assess for the presence of both disorders given the
presence of one to mitigate the effects of developing comorbid conditions.
Key words
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Article info
Publication history
Published online: November 21, 2018
Accepted:
November 9,
2018
Received in revised form:
July 25,
2018
Received:
May 29,
2018
Footnotes
The National Comorbidity Survey is funded by the National Institute of Mental Health (grants R01 MH/DA46376 and R01 MH49098), the National Institute of Drug Abuse (through a supplement to R01 MH/DA46376), and the W.T. Grant Foundation (grant 90135190).
The authors have no conflicts of interest to declare.
Supplementary data accompanying this article are available online at www.jpain.org and www.sciencedirect.com.
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© 2018 by the American Pain Society
