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)

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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).

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.

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.

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 > Institute of Health and Wellbeing > Mental Health and Wellbeing
College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
Journal Name:European Journal of Pain
Publisher:John Wiley and Sons
ISSN:1090-3801
ISSN (Online):1532-2149

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