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| PMID |
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| TITLE |
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| Comorbid Chronic Pain and Depression: Shared Risk Factors and Differential Antidepressant Effectiveness. |
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| ABSTRACT |
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| 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 ( = 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. |
| Copyright © 2021 Roughan, Campos, García-Marín, Cuéllar-Partida, Lupton, Hickie, Medland, Wray, Byrne, Ngo, Martin and Rentería. |
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| DATE PUBLISHED |
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| HISTORY |
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| PUBSTATUS |
PUBSTATUSDATE |
| received |
2020/12/18 |
| accepted |
2021/03/12 |
| entrez |
2021/04/29 06:25 |
| pubmed |
2021/04/30 06:00 |
| medline |
2021/04/30 06:01 |
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| AUTHORS |
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| NAME |
COLLECTIVENAME |
LASTNAME |
FORENAME |
INITIALS |
AFFILIATION |
AFFILIATIONINFO |
| Roughan WH |
|
Roughan |
William H |
WH |
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Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia. |
| Campos AI |
|
Campos |
Adrián I |
AI |
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Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia. |
| García-Marín LM |
|
García-Marín |
Luis M |
LM |
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Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia. |
| Cuéllar-Partida G |
|
Cuéllar-Partida |
Gabriel |
G |
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UQ Diamantina Institute, The University of Queensland and Translational Research Institute, Brisbane, QLD, Australia. |
| Lupton MK |
|
Lupton |
Michelle K |
MK |
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Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia. |
| Hickie IB |
|
Hickie |
Ian B |
IB |
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Brain and Mind Centre, University of Sydney, Camperdown, NSW, Australia. |
| Medland SE |
|
Medland |
Sarah E |
SE |
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Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia. |
| Wray NR |
|
Wray |
Naomi R |
NR |
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Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia. |
| Byrne EM |
|
Byrne |
Enda M |
EM |
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Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD, Australia. |
| Ngo TT |
|
Ngo |
Trung Thanh |
TT |
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UQ Diamantina Institute, The University of Queensland and Translational Research Institute, Brisbane, QLD, Australia. |
| Martin NG |
|
Martin |
Nicholas G |
NG |
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Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia. |
| Rentería ME |
|
Rentería |
Miguel E |
ME |
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Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia. |
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| INVESTIGATORS |
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| JOURNAL |
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| VOLUME: 12 |
| ISSUE: |
| TITLE: Frontiers in psychiatry |
| ISOABBREVIATION: Front Psychiatry |
| YEAR: 2021 |
| MONTH: |
| DAY: |
| MEDLINEDATE: |
| SEASON: |
| CITEDMEDIUM: Print |
| ISSN: 1664-0640 |
| ISSNTYPE: Print |
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| MEDLINE JOURNAL |
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| MEDLINETA: Front Psychiatry |
| COUNTRY: Switzerland |
| ISSNLINKING: 1664-0640 |
| NLMUNIQUEID: 101545006 |
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| PUBLICATION TYPE |
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| PUBLICATIONTYPE TEXT |
| Journal Article |
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| COMMENTS AND CORRECTIONS |
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| GRANTS |
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| GENERAL NOTE |
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| KEYWORDS |
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| KEYWORD |
| antidepressant |
| chronic pain |
| comorbidity |
| depression |
| suicide |
| treatment response |
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| MESH HEADINGS |
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| SUPPLEMENTARY MESH |
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| GENE SYMBOLS |
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| CHEMICALS |
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