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. 2014 Oct 15;9(10):e106907.
doi: 10.1371/journal.pone.0106907. eCollection 2014.

The association of depression and anxiety with pain: a study from NESDA

Eric W de Heer  1 , Marloes M J G Gerrits  2 , Aartjan T F Beekman  3 , Jack Dekker  4 , Harm W J van Marwijk  5 , Margot W M de Waal  6 , Philip Spinhoven  7 , Brenda W J H Penninx  2 , Christina M van der Feltz-Cornelis  8
Affiliations

The association of depression and anxiety with pain: a study from NESDA

Eric W de Heer et al. PLoS One. .

Erratum in

  • PLoS One. 2014;9(12):e115077

Abstract

Chronic pain is commonly co-morbid with a depressive or anxiety disorder. Objective of this study is to examine the influence of depression, along with anxiety, on pain-related disability, pain intensity, and pain location in a large sample of adults with and without a depressive and/or anxiety disorder. The study population consisted of 2981 participants with a depressive, anxiety, co-morbid depressive and anxiety disorder, remitted disorder or no current disorder (controls). Severity of depressive and anxiety symptoms was also assessed. In separate multinomial regression analyses, the association of presence of depressive or anxiety disorders and symptom severity with the Chronic Pain Grade and location of pain was explored. Presence of a depressive (OR = 6.67; P<.001), anxiety (OR = 4.84; P<.001), or co-morbid depressive and anxiety disorder (OR = 30.26; P<.001) was associated with the Chronic Pain Grade. Moreover, symptom severity was associated with more disabling and severely limiting pain. Also, a remitted depressive or anxiety disorder showed more disabling and severely limiting pain (OR = 3.53; P<.001) as compared to controls. A current anxiety disorder (OR = 2.96; p<.001) and a co-morbid depressive and anxiety disorder (OR = 5.15; P<.001) were more strongly associated with cardio-respiratory pain, than gastro-intestinal or musculoskeletal pain. These findings remain after adjustment for chronic cardio respiratory illness. Patients with a current and remitted depressive and/or anxiety disorder and those with more severe symptoms have more disabling pain and pain of cardio-respiratory nature, than persons without a depressive or anxiety disorder. This warrants further research.

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Conflict of interest statement

Competing Interests: The authors of this manuscript have read the journal's policy and have the following competing interests: ATFB reports grants from Eli Lilly, grants from Astra Zeneca, grants from Jansen, grants from Shire, personal fees (as a speaker) from Eli Lilly, and personal fees (as a speaker) from Lundbeck, outside the submitted work. JD and CMFC report grants from Eli Lilly, outside the submitted work. BWJHP reports grants from Dutch government, ministry of Health (ZonMw), during the conduct of the study. This does not alter their adherence to PLOS ONE policies on sharing data and materials, except those mentioned in the data availability statement.

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Publication types

Grants and funding

The infrastructure for the NESDA study is funded through the Geestkracht program of the Netherlands Organisation for Health Research and Development (Zon-MW, grant number 10-000-1002) and is supported by participating universities and mental health care organisations (VU University Medical Center, GGZ inGeest, Arkin, Leiden University Medical Center, GGZ Rivierduinen, University Medical Center Groningen, Lentis, GGZ Friesland, GGZ Drenthe, IQ Healthcare, Netherlands Institute for Health Services Research [NIVEL], and the Netherlands Institute of Mental Health and Addiction [Trimbos]. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.