Effect of depression treatment on depressive symptoms in older adulthood: The moderating role of pain

Shahrzad Mavandadi, Thomas R. Ten Have, Ira R. Katz, U. Nalla B. Durai, Dean D. Krahn, Maria D. Llorente, Joann E. Kirchner, Edwin J. Olsen, William W. Van Stone, Susan L. Cooley, David W. Oslin

Research output: Contribution to journalArticle

39 Scopus citations

Abstract

OBJECTIVES: To investigate whether pain severity and interference with normal work activities moderate the effects of depression treatment on changes in depressive symptoms over time in older adults in primary care. DESIGN: Patient-randomized, clinical trial. SETTING: Multisite: three clinics located in Veterans Affairs Medical Centers. PARTICIPANTS: Adults aged 60 and older (n=524) who screened positive for depression and participated in the Primary Care Research in Substance Abuse and Mental Health for the Elderly Study. INTERVENTION: Integrated care versus enhanced specialty referral care. MEASUREMENTS: Pain severity, the degree to which pain interferes with work inside and outside of the home, and depressive symptoms were examined at baseline and 3, 6, and 12 months. RESULTS: Intention-to-treat analyses revealed that both treatment groups showed reduced depressive symptoms over time, although self-reported pain moderated reductions in depressive symptoms. At higher levels of pain severity and interference with work activities, improvements in depressive symptoms were blunted. Furthermore, pain interference appeared to have a greater effect on depressive symptoms than did pain severity; in individuals with major depression, pain interference fully accounted for the moderating effects of pain severity on changes in depressive symptoms over time. CONCLUSION: Pain and its interference with functioning interfere with recovery from depression. Findings highlight the importance of addressing multiple domains of functioning (e.g., physical and social disability) and the degree to which pain and other forms of physical comorbidity may hinder or minimize treatment-related improvements in depressive symptoms.

Original languageEnglish (US)
Pages (from-to)202-211
Number of pages10
JournalJournal of the American Geriatrics Society
Volume55
Issue number2
DOIs
StatePublished - Feb 1 2007

Keywords

  • Depression treatment
  • Depressive symptoms
  • Pain
  • Primary care

ASJC Scopus subject areas

  • Geriatrics and Gerontology

Fingerprint Dive into the research topics of 'Effect of depression treatment on depressive symptoms in older adulthood: The moderating role of pain'. Together they form a unique fingerprint.

  • Cite this

    Mavandadi, S., Ten Have, T. R., Katz, I. R., Durai, U. N. B., Krahn, D. D., Llorente, M. D., Kirchner, J. E., Olsen, E. J., Van Stone, W. W., Cooley, S. L., & Oslin, D. W. (2007). Effect of depression treatment on depressive symptoms in older adulthood: The moderating role of pain. Journal of the American Geriatrics Society, 55(2), 202-211. https://doi.org/10.1111/j.1532-5415.2007.01042.x