DEPRESSION AND THE EXPERIENCE OF CHRONIC BACK PAIN - A STUDY OF RELATED VARIABLES AND AGE-DIFFERENCES

Objective: To document the prevalence of depression an examine the rel ationship between depression and selected pain-related variables assoc iated with chronic back pain among elderly and nonelderly samples. Des ign: Survey with mailed questionnaire. Setting: Patients seeking treat ment at a spine diagnostic and treatment center. Patients: Consecutive sample of elderly subjects (n = 69). Nonelderly subjects (n = 59) wer e randomly selected to achieve a sample size comparable to the elderly . Evaluation of depressed mood was determined by Beck Depression Inven tory. Main Outcome Measures: Multidimensional Pain Inventory, Pain Dis ability Index, Pain Duration, Work-Related Disability, Medication Use, and Pain Severity. Results: A high prevalence of dysphoria was found in both age groups. No significant differences were found between age and depressed mood. The only significant association between depressed mood and age occurred with pain duration, with the elderly experienci ng fewer total hours per day in pain. Combining age groups, multivaria te analysis of variance revealed that dysphoric chronic pain patients reported more antidepressant use, greater pain intensity, greater inte rference due to pain, and less life control than the nondepressed pati ents. Interference in activities demonstrated the strongest relationsh ip with depressed mood in both age groups. Conclusions: There is a hig h prevalence of dysphoria in both the elderly and nonelderly with chro nic back pain. The relationships between pain-related constructs and d epressed mood in chronic back pain patients are similar in the elderly and nonelderly. The impact of the pain experience on the individual's activities, functioning, and feelings of life control should be consi dered in theoretical and clinical explanations of the association betw een pain and depression.