• Zeping Yan, Zhiwei Wang, Qian Liang, Jian Liu, Shicai Wu, and Xiaorong Luan.
• School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China; University of Health and Rehabilitation Sciences, Qingdao, China; Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing, China.
• Pain Manag Nurs. 2023 Apr 1; 24 (2): 151156151-156.

BackgroundPain is the primary symptom of knee osteoarthritis (KOA), significantly associated with depressive symptoms. Whether the early pain intensity could distinguish different trajectories of depressive symptoms is not well understood among patients with KOA.AimsTo identify heterogeneous depressive symptoms trajectories among patients with KOA, and investigate the association between depressive symptoms subgroups and pain intensity.DesignSecondary analysis of a cohort sample.SettingThree waves of data from the China Health and Retirement Longitudinal Study was collected in 28 provinces across China.Participants702 patients with KOA aged ≥ 45 years completed the Center for Epidemiologic Studies Depression Scale biennially from 2011 to 2015.MethodsLatent class growth analysis was performed to identify the optimal trajectory shape and number of classes. Multinomial logistic regression analysis was conducted to compare pain intensity across the trajectories.ResultsFour distinct trajectories were identified as follows: no depressive symptoms, highly stable, decreasing, and increasing. In multivariate analysis, compared with the "no depressive symptoms" class, patients in the "highly stable" class and "increasing" class were more likely to report moderate pain (p < 0.05) and severe pain (p < 0.05). In addition, there was no significant difference in pain intensity between "no depressive symptoms" class and "decreasing" class (p > 0.05).ConclusionsThese results suggest important heterogeneity in depressive symptom trajectories among patients with KOA. Pain intensity could predict different depressive symptom trajectories in patients with KOA. Efforts to improve the depressive symptoms in patients with KOA must incorporate strategies to address pain.Copyright © 2022 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

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