Study links depression in women with chronic pain to greater incidence of disability

Women with higher levels of depression when suffering with long-term pain report greater disability than men in the same situation, according to new research published in the latest edition of the European Journal of Pain.

This suggests that by targeting their depression, doctors could help reduce disability in female patients with chronic conditions such as arthritis and back pain.

The study, which involved 260 chronic pain patients from Royal National Hospital for Rheumatic Diseases (RNHRD), builds on growing evidence that "psychosocial" factors can have an effect on a person's health and behavior.

"It is now accepted that pain is more than just a sensory experience, and that factors like a person's gender, their emotional condition or their interactions with others, can contribute to their pain experiences," said Dr. Ed Keogh from the Pain Management Unit at the University of Bath and RNHRD.

"This research shows that pain-related emotions are associated with pain-related behaviour, such as the number of visits to the GP, the number of medications taken, the amount of sleep lost, and disability, but it also highlights a significant discrepancy between the behaviours of men and women.

"For women in particular, targeting depression may help reduce disability associated with chronic pain."

Women are already known to report higher levels of depression than men, and are generally found to report greater levels of pain, with greater frequency and greater intensity when compared to men.

Evidence is emerging that suggests men and women also respond differently to the drugs and other treatments, such as psychology-based interventions, used to treat pain.

"We found that within men with chronic pain, higher levels of depression were related to a greater of number of medications being used than women," said Dr. Keogh.

"Why this should be is not clear, but the social gender roles we adopt throughout our lives may have some important part to play.

"Alongside drugs, other therapies that focus on the behaviours and tendencies associated with depression, such as avoidance and withdrawal, may also be effective in these situations for some people."

http://dx.doi.org/10.1016/j.ejpain.2005.05.007 and http://www.bath.ac.uk