The effect of depressive symptoms on pain in a substance-using population with persistent pain: a cross-sectional cohort study

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Abstract

Background

In light of the ongoing opioid overdose crisis, there is an urgent need for research on the impacts of mental health among people presenting with concurrent pain and substance use. This study examined the effect of depressive symptoms on pain severity and functional interference among people who use drugs (PWUD) during a community-wide overdose crisis.

Methods

From December 1st 2016 to December 31st 2018, 288 participants in two cohort studies of PWUD in Vancouver, Canada completed interviewer-administered questionnaires that included the Brief Pain Inventory and PROMIS Emotional Distress–Depression instruments. Generalized linear regression modelling (GLM) was used to examine the cross-sectional effect of depressive symptoms and other confounding factors on pain severity and interference.

Results

Moderate to severe depressive symptoms were significantly associated with greater pain-related functional interference (adjusted β = 1.24, 95% confidence interval [CI] = 0.33–2.15), but not significantly associated with greater average pain severity (adjusted β = 0.22, 95% CI = − 0.3 – 0.82), when controlling for confounding variables. Reported daily heroin use (adjusted β = 1.26, 95% CI = 0.47–2.05) and non-fatal overdose (adjusted β = 1.02, 95% CI = 0.08–1.96) were also significantly associated with greater pain-related functional interference.

Conclusions

In a substance-using population, greater pain-related functional interference was positively associated with depressive symptoms as well as overdose and daily heroin use. These findings emphasize the need to address the functional impact of pain, mental health comorbidity, and high-risk substance use that may contribute to overdose and other harms.

Related collections

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Author and article information

Contributors

Pauline Voon: pauline.voon@bccsu.ubc.ca

Journal

Journal ID (nlm-ta): BMC Psychiatry

Journal ID (iso-abbrev): BMC Psychiatry

Title: BMC Psychiatry

Publisher: BioMed Central (London )

ISSN (Electronic): 1471-244X

Publication date (Electronic): 20 August 2021

Publication date PMC-release: 20 August 2021

Publication date Collection: 2021

Volume: 21

Electronic Location Identifier: 416

Affiliations

[1 ]GRID grid.511486.f, ISNI 0000 0004 8021 645X, British Columbia Centre on Substance Use, ; 400-1045 Howe Street, Vancouver, BC V6Z 2A9 Canada

[2 ]GRID grid.17091.3e, ISNI 0000 0001 2288 9830, School of Population and Public Health, , University of British Columbia, ; 5804 Fairview Avenue, Vancouver, BC V6T 1Z3 Canada

[3 ]GRID grid.61971.38, ISNI 0000 0004 1936 7494, Faculty of Health Sciences, , Simon Fraser University, ; 8888 University Drive, Burnaby, BC V5A 1S6 Canada

[4 ]GRID grid.17091.3e, ISNI 0000 0001 2288 9830, Department of Medicine, , University of British Columbia, ; 400-1045 Howe Street, Vancouver, BC V6Z 2A9 Canada

Article

Publisher ID: 3424

DOI: 10.1186/s12888-021-03424-7

PMC ID: 8379773

PubMed ID: 34416868

SO-VID: 43425395-5e3a-42a5-95f2-cd13a36a3146

License:

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