A 20-Year Study of the Bidirectional Relationship Between Anxious and Depressive Symptomology and Pain Medication Usage

Abstract

Aim: To investigate the 20-year relationship between anxiety, depression and pain medication use. Patients: A total of 521 individuals reporting chronic pain from the National Survey of Midlife Development in the USA (MIDUS) study. Methods: Structural equation modeling of 20-year longitudinal survey data. Results: Over 20 years, a bidirectional relationship between depression and anxiety in individuals with chronic pain was indicated. Pain medication utilization predicted later use at 10 years. Pain medication use was not strongly related to later anxiety; however, heightened anxiety was associated with later use. Conclusion: Depression and anxiety show an extensive long-term bidirectional relationship. While there was little indication of a relationship between pain medication use and later negative mood, anxiety was associated with subsequent pain medication use.

Keywords::

• anxiety
• chronic pain
• depression
• opioids
• pharmacological management of pain

Acknowledgments

The authors wish to thank K Gordon (The University of Tennessee) for comments on the manuscript. We thank the John D and Catherine T MacArthur Foundation Research Network and the National Institute on Aging for support.

Financial & competing interests disclosure

The MIDUS 1 study (National Survey of Midlife Development in the USA) was supported by the John D and Catherine T MacArthur Foundation Research Network on Successful Midlife Development. MIDUS 2 and 3 research was supported by a grant from the National Institute on Aging (P01-AG020166) to conduct a longitudinal follow-up of the MIDUS 1 investigation. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Additional information

Funding

The MIDUS 1 study (National Survey of Midlife Development in the USA) was supported by the John D and Catherine T MacArthur Foundation Research Network on Successful Midlife Development. MIDUS 2 and 3 research was supported by a grant from the National Institute on Aging (P01-AG020166) to conduct a longitudinal follow-up of the MIDUS 1 investigation. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. No writing assistance was utilized in the production of this manuscript.