Pain and Depression

An article published a few months ago reminds us that depressive symptoms are a common comorbidity that occur in approximately 20% of persons experiencing osteoarthritis (OA), which is more than double the prevalence in the general population in the United States.

Consequences of depressive symptoms in OA patients include reduced quality of life, greater use of health care resources, and even an increased mortality rate. However, while studies have shown that pain is associated with the onset and severity of depressive symptoms, and conversely, the presence of depressed mood predicts more intense OA pain, these prior studies have failed to show that the presence of depressive symptoms may cumulatively affect OA pain, where greater depression persistence could lead to more severe pain.

So, to analyze how depression can affect OA knee pain, the researchers examined the dynamic associations between the symptoms of depression and pain in 2,287 adults included in the Osteoarthritis Initiative, a longitudinal study of knee health, over a period of 48 months.

Researchers documented a statistically significant dose-response relationship between the depression persistence and severity of pain related to OA of the knee.

Now, if depression can be controlled, then maybe so can, at least to some extent, knee pain. It is not surprising that newer treatment guidelines for patients recommend treating depression in what may be an older population, but unfortunately, prior studies indicate that depressive symptoms are under-recognized and under-treated in this group. Ultimately, these findings highlight the need for alternative disease management strategies for OA patients that incorporate effective interventions for depression that can be implemented in routine clinical practice.

While the structural disease decline in OA is progressive and irreversible, the results of this study underscore the necessity for developing alternative disease management strategies that try to target factors that contribute to pain that can be modified.

Such as depression.