The Journal of Pain Summary

Highlight from The Journal of Pain (Volume 20, No. 4, April 2019)

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Incident Chronics Spinal Pain and Depressive Disorders: Data from the National Comorbidity Survey

Karen B. Schmaling, Zachary A. Nounou

Chronic spinal pain and depression are common conditions. In addition, both are associated with significant morbidity and healthcare utilization. In the United States, low back pain, neck pain, and major depressive disorder comprise three of the top four leading causes of disability. 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 were used, including a stratified sample of 5,001 participants who were evaluated in 1990-1992 and again in 2000-2001.

The authors’ hypothesis regarding antecedent chronic spinal pain increasing the risk for development of depressive disorders was partially supported: the data suggested that those with antecedent chronic spinal pain were more likely to develop subsequent depression than those without chronic pain. However, although antecedent chronic spinal pain did predict the subsequent development of dysthymic disorder, antecedent chronic spinal pain did not predict subsequent major depressive disorder.

Few studies have examined the development of depression in the context of chronic pain, and as with this study, the findings regarding the temporal precedence of chronic pain on subsequent depression have been equivocal. 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.