It is well known that chronic pain and clinical depression go together, but a study in The Journal of Pain, published by the American Pain Society, shows that the connection between pain and depression is strongest in middle-age women and African Americans.
Researchers at Wayne State University studied a representative community sample of 1,100 Michigan residents and found that the incidence of chronic pain, defined as pain persisting for six months, was 22 percent. Approximately 35 percent of those with chronic pain said they had depression, but mood problems were not associated with a particular pain condition or pain site. Researchers evaluated several demographic factors and found that older age was generally related to chronic pain but with comorbid depression. They noted that depression tends to decrease with age while pain tends to increase.
From the data, the authors concluded that in middle-age women chronic pain might not be the cause of depression but preexisting mood problems could be associated with development of chronic pain. They further concluded that depression can increase vulnerability to experiencing persistent pain.
The study also showed that African Americans were more likely to have chronic pain with depression than Caucasians. Further analysis showed that racial differences were not attributable to possible socioeconomic factors but might be associated with differences in the use of pain coping strategies. Though income was not a significant risk factor for the study, the authors indicated that occupational factors, such as physically demanding work and poor or no health insurance coverage, may account for the link between lower socioeconomic status and pain, and that financial strain and stress are closely linked with depression.
From their findings, the authors recommend that clinicians screen pain patients for depression and pay close attention to middle-age women and African Americans for whom risk for comorbid depression is the highest.
Source: American Pain Society