Does a history of depressionactuallymediate smoking-related pain? Findings from a cross-sectional general population-based study

van Hecke, O., Torrance, N., Cochrane, L., Cavanagh, J. , Donnan, P.T., Padmanabhan, S. , Porteous, D.J., Hocking, L. and Smith, B.H. (2014) Does a history of depressionactuallymediate smoking-related pain? Findings from a cross-sectional general population-based study. European Journal of Pain, 18(9), pp. 1223-1230. (doi: 10.1002/j.1532-2149.2014.00470.x)

Abstract

Background: Smokers report more pain and worse functioning. The evidence from pain clinics suggests that depression affects this relationship: The association between smoking and chronic pain is weakened when controlling for depression. This study explored the relationship between smoking, pain and depression in a large general population-based cohort (Generation Scotland: Scottish Family Health Study).<p></p> Methods Chronic pain measures (intensity, disability), self-reported smoking status and a history of major depressive disorder (MDD) were analysed. A multivariate analysis of covariance determined whether smoking status was associated with both pain measures and a history of depressive illness. Using a statistical mediation model any mediating effect of depression on the relationship between smoking and chronic pain was sought.<p></p> Results Of all 24,024 participants, 30% (n = 7162) reported any chronic pain. Within this chronic pain group, 16% (n = 1158) had a history of MDD; 7108 had valid smoking data: 20% (n = 1408) were current smokers, 33% (n = 2351) former and 47% (n = 3349) never smokers. Current smokers demonstrated higher pain intensity and pain-related disability scores compared with former and non-smokers (p < 0.001 for all analyses). From the mediation model, the effect on pain intensity decreased (p < 0.001), indicating that the relationship between smoking and a history of depression contributes significantly to the effect of smoking on pain intensity. When applied to smoking-related pain disability, there was no mediation effect.<p></p> Conclusions In contrast to smokers treated in pain clinics, a history of MDD mediated the relationship between smoking and pain intensity, but not pain-related disability in smokers in the community.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Cavanagh, Professor Jonathan and Padmanabhan, Professor Sandosh
• Authors: van Hecke, O., Torrance, N., Cochrane, L., Cavanagh, J., Donnan, P.T., Padmanabhan, S., Porteous, D.J., Hocking, L., and Smith, B.H.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Mental Health and Wellbeing; College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
• Journal Name: European Journal of Pain
• Publisher: John Wiley and Sons
• ISSN: 1090-3801
• ISSN (Online): 1532-2149