Comorbid Chronic Pain and Depression: Shared Risk Factors and Differential Antidepressant Effectiveness
The bidirectional relationship between depression and chronic pain is well-recognized, but their clinical management remains challenging. Here we characterize the shared risk factors and outcomes for their comorbidity in the Australian Genetics of Depression cohort study (N = 13,839). Participants c...
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Frontiers Media S.A.
2021-04-01
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Series: | Frontiers in Psychiatry |
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Online Access: | https://www.frontiersin.org/articles/10.3389/fpsyt.2021.643609/full |
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record_format |
Article |
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DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
William H. Roughan William H. Roughan Adrián I. Campos Adrián I. Campos Luis M. García-Marín Luis M. García-Marín Gabriel Cuéllar-Partida Gabriel Cuéllar-Partida Michelle K. Lupton Ian B. Hickie Sarah E. Medland Naomi R. Wray Naomi R. Wray Enda M. Byrne Trung Thanh Ngo Trung Thanh Ngo Nicholas G. Martin Miguel E. Rentería Miguel E. Rentería |
spellingShingle |
William H. Roughan William H. Roughan Adrián I. Campos Adrián I. Campos Luis M. García-Marín Luis M. García-Marín Gabriel Cuéllar-Partida Gabriel Cuéllar-Partida Michelle K. Lupton Ian B. Hickie Sarah E. Medland Naomi R. Wray Naomi R. Wray Enda M. Byrne Trung Thanh Ngo Trung Thanh Ngo Nicholas G. Martin Miguel E. Rentería Miguel E. Rentería Comorbid Chronic Pain and Depression: Shared Risk Factors and Differential Antidepressant Effectiveness Frontiers in Psychiatry depression chronic pain suicide treatment response comorbidity antidepressant |
author_facet |
William H. Roughan William H. Roughan Adrián I. Campos Adrián I. Campos Luis M. García-Marín Luis M. García-Marín Gabriel Cuéllar-Partida Gabriel Cuéllar-Partida Michelle K. Lupton Ian B. Hickie Sarah E. Medland Naomi R. Wray Naomi R. Wray Enda M. Byrne Trung Thanh Ngo Trung Thanh Ngo Nicholas G. Martin Miguel E. Rentería Miguel E. Rentería |
author_sort |
William H. Roughan |
title |
Comorbid Chronic Pain and Depression: Shared Risk Factors and Differential Antidepressant Effectiveness |
title_short |
Comorbid Chronic Pain and Depression: Shared Risk Factors and Differential Antidepressant Effectiveness |
title_full |
Comorbid Chronic Pain and Depression: Shared Risk Factors and Differential Antidepressant Effectiveness |
title_fullStr |
Comorbid Chronic Pain and Depression: Shared Risk Factors and Differential Antidepressant Effectiveness |
title_full_unstemmed |
Comorbid Chronic Pain and Depression: Shared Risk Factors and Differential Antidepressant Effectiveness |
title_sort |
comorbid chronic pain and depression: shared risk factors and differential antidepressant effectiveness |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Psychiatry |
issn |
1664-0640 |
publishDate |
2021-04-01 |
description |
The bidirectional relationship between depression and chronic pain is well-recognized, but their clinical management remains challenging. Here we characterize the shared risk factors and outcomes for their comorbidity in the Australian Genetics of Depression cohort study (N = 13,839). Participants completed online questionnaires about chronic pain, psychiatric symptoms, comorbidities, treatment response and general health. Logistic regression models were used to examine the relationship between chronic pain and clinical and demographic factors. Cumulative linked logistic regressions assessed the effect of chronic pain on treatment response for 10 different antidepressants. Chronic pain was associated with an increased risk of depression (OR = 1.86 [1.37–2.54]), recent suicide attempt (OR = 1.88 [1.14–3.09]), higher use of tobacco (OR = 1.05 [1.02–1.09]) and misuse of painkillers (e.g., opioids; OR = 1.31 [1.06–1.62]). Participants with comorbid chronic pain and depression reported fewer functional benefits from antidepressant use and lower benefits from sertraline (OR = 0.75 [0.68–0.83]), escitalopram (OR = 0.75 [0.67–0.85]) and venlafaxine (OR = 0.78 [0.68–0.88]) when compared to participants without chronic pain. Furthermore, participants taking sertraline (OR = 0.45 [0.30–0.67]), escitalopram (OR = 0.45 [0.27–0.74]) and citalopram (OR = 0.32 [0.15–0.67]) specifically for chronic pain (among other indications) reported lower benefits compared to other participants taking these same medications but not for chronic pain. These findings reveal novel insights into the complex relationship between chronic pain and depression. Treatment response analyses indicate differential effectiveness between particular antidepressants and poorer functional outcomes for these comorbid conditions. Further examination is warranted in targeted interventional clinical trials, which also include neuroimaging genetics and pharmacogenomics protocols. This work will advance the delineation of disease risk indicators and novel aetiological pathways for therapeutic intervention in comorbid pain and depression as well as other psychiatric comorbidities. |
topic |
depression chronic pain suicide treatment response comorbidity antidepressant |
url |
https://www.frontiersin.org/articles/10.3389/fpsyt.2021.643609/full |
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doaj-64bfcaeb03c74cef9609619ef5be277b2021-04-12T05:04:09ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402021-04-011210.3389/fpsyt.2021.643609643609Comorbid Chronic Pain and Depression: Shared Risk Factors and Differential Antidepressant EffectivenessWilliam H. Roughan0William H. Roughan1Adrián I. Campos2Adrián I. Campos3Luis M. García-Marín4Luis M. García-Marín5Gabriel Cuéllar-Partida6Gabriel Cuéllar-Partida7Michelle K. Lupton8Ian B. Hickie9Sarah E. Medland10Naomi R. Wray11Naomi R. Wray12Enda M. Byrne13Trung Thanh Ngo14Trung Thanh Ngo15Nicholas G. Martin16Miguel E. Rentería17Miguel E. Rentería18Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, AustraliaFaculty of Medicine, The University of Queensland, Brisbane, QLD, AustraliaDepartment of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, AustraliaFaculty of Medicine, The University of Queensland, Brisbane, QLD, AustraliaDepartment of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, AustraliaFaculty of Medicine, The University of Queensland, Brisbane, QLD, AustraliaFaculty of Medicine, The University of Queensland, Brisbane, QLD, AustraliaUQ Diamantina Institute, The University of Queensland and Translational Research Institute, Brisbane, QLD, AustraliaDepartment of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, AustraliaBrain and Mind Centre, University of Sydney, Camperdown, NSW, AustraliaDepartment of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, AustraliaInstitute for Molecular Bioscience, The University of Queensland, Brisbane, QLD, AustraliaQueensland Brain Institute, The University of Queensland, Brisbane, QLD, AustraliaInstitute for Molecular Bioscience, The University of Queensland, Brisbane, QLD, AustraliaFaculty of Medicine, The University of Queensland, Brisbane, QLD, AustraliaUQ Diamantina Institute, The University of Queensland and Translational Research Institute, Brisbane, QLD, AustraliaDepartment of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, AustraliaDepartment of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, AustraliaFaculty of Medicine, The University of Queensland, Brisbane, QLD, AustraliaThe bidirectional relationship between depression and chronic pain is well-recognized, but their clinical management remains challenging. Here we characterize the shared risk factors and outcomes for their comorbidity in the Australian Genetics of Depression cohort study (N = 13,839). Participants completed online questionnaires about chronic pain, psychiatric symptoms, comorbidities, treatment response and general health. Logistic regression models were used to examine the relationship between chronic pain and clinical and demographic factors. Cumulative linked logistic regressions assessed the effect of chronic pain on treatment response for 10 different antidepressants. Chronic pain was associated with an increased risk of depression (OR = 1.86 [1.37–2.54]), recent suicide attempt (OR = 1.88 [1.14–3.09]), higher use of tobacco (OR = 1.05 [1.02–1.09]) and misuse of painkillers (e.g., opioids; OR = 1.31 [1.06–1.62]). Participants with comorbid chronic pain and depression reported fewer functional benefits from antidepressant use and lower benefits from sertraline (OR = 0.75 [0.68–0.83]), escitalopram (OR = 0.75 [0.67–0.85]) and venlafaxine (OR = 0.78 [0.68–0.88]) when compared to participants without chronic pain. Furthermore, participants taking sertraline (OR = 0.45 [0.30–0.67]), escitalopram (OR = 0.45 [0.27–0.74]) and citalopram (OR = 0.32 [0.15–0.67]) specifically for chronic pain (among other indications) reported lower benefits compared to other participants taking these same medications but not for chronic pain. These findings reveal novel insights into the complex relationship between chronic pain and depression. Treatment response analyses indicate differential effectiveness between particular antidepressants and poorer functional outcomes for these comorbid conditions. Further examination is warranted in targeted interventional clinical trials, which also include neuroimaging genetics and pharmacogenomics protocols. This work will advance the delineation of disease risk indicators and novel aetiological pathways for therapeutic intervention in comorbid pain and depression as well as other psychiatric comorbidities.https://www.frontiersin.org/articles/10.3389/fpsyt.2021.643609/fulldepressionchronic painsuicidetreatment responsecomorbidityantidepressant |