• Eur J Pain · Aug 2013

    Reciprocal longitudinal associations between pain and depressive symptoms in adolescents.

    • A Lewandowski Holley, E F Law, C Zhou, L Murphy, G Clarke, and T M Palermo.
    • Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine, Seattle, USA. Amy.lewandowski@seattlechildrens.org
    • Eur J Pain. 2013 Aug 1;17(7):1058-67.

    BackgroundElevated depressive symptoms are common in youth with chronic pain, and pain symptoms are frequent in adolescents with depressive disorders. While studies have identified concurrent associations between pain and depression over time in youth, it is unclear how change in one symptom impacts change in the other symptom.MethodsThis three-time point 12-month longitudinal study examined reciprocal associations among pain and depression in a clinical sample of adolescents (12-18) diagnosed with chronic pain (n = 55) or a depressive disorder (n = 40). Mixed-effects multivariate models were used to test if changes over a preceding time interval predicted symptom severity at subsequent time points. Study group, age, sex, race, baseline pain intensity and baseline depressive symptoms were included as covariates.ResultsGeneralized estimating equations revealed that pain and depressive symptoms were significantly associated over time (β = 1.54; p < 0.001). As hypothesized, changes in pain were associated with subsequent depressive symptoms (β = 1.16; p < 0.001). Conversely, changes in depressive symptoms predicted subsequent pain (β = 0.026; p < 0.05), but with a weaker association. In the model predicting pain, an interaction between depressive symptoms and study group emerged (β = -0.02; p < 0.05), with change in depressive symptoms having the greatest impact on pain in the depressed sample.ConclusionsFindings extend previous adult research to an adolescent sample showing changes in pain intensity are predictive of subsequent depressive symptoms. In comparison to adult data, changes in depressive symptoms had less impact on subsequent pain in youth. Future research can examine how targeting persistent pain may also aid the treatment of depressive symptoms in adolescents.© 2012 European Federation of International Association for the Study of Pain Chapters.

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