Pain-related anxiety mediates the relationship between depressive symptoms and pain interference in veterans with hepatitis C.

Adams MH, Lovejoy TI, Turk DC, Dobscha SK, Hauser P, Morasco BJ. Pain-related anxiety mediates the relationship between depressive symptoms and pain interference in veterans with hepatitis C. General hospital psychiatry. 2015 Nov 1; 37(6):533-7.

Related HSR&D Project(s)

• CDA 13-268 – Chronic Pain Management in Veterans with Co-occurring Substance Use Disorders

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Abstract:

OBJECTIVE: Depression and chronic pain are common in persons chronically infected with the hepatitis C virus (HCV), although little is known about the rate of co-occurrence or mechanisms by which they are associated. We evaluated whether pain-related anxiety mediates the relationship between depressive symptoms and pain-related physical functioning in patients with HCV. METHODS: Patients with HCV (n = 175) completed self-report measures assessing demographic characteristics, pain-related function and mental health. Path analyses examined direct effects of cognitive-affective and somatic symptoms of depression on pain interference and indirect effects of these relationships via four subscales of the Pain Anxiety Symptoms Scale-20. RESULTS: Cognitive-affective and somatic symptoms of depression were positively and significantly related to pain interference. Pain-related anxiety mediated the relationship between both cognitive-affective and somatic symptoms of depression, and this mediation was predominantly accounted for by the escape-avoidance component of pain-related anxiety. CONCLUSIONS: Findings indicate a potential mediating role of pain-related anxiety, particularly escape-avoidance anxiety, on the relationship between depression and pain interference in patients with HCV. These findings suggest that escape-avoidance anxiety may be a particularly germane target for treatment in patients with HCV and chronic pain, particularly when depression, with characteristic features of withdrawal and inhibition, is a comorbid condition.