Pain interference impacts response to treatment for anxiety disorder

Carrie Farmer Teh, Natalia E. Morone, Jordan F. Karp, Bea Herbeck Belnap, Fang Zhu, Debra K. Weiner, Bruce L. Rollman

Research output: Contribution to journalArticlepeer-review

38 Scopus citations

Abstract

Background: Anxiety disorders and pain are commonly comorbid, though little is known about the effect of pain on the course and treatment of anxiety. Methods: This is a secondary analysis of a randomized controlled trial for anxiety treatment in primary care. Participants with panic disorder (PD) and/ or generalized anxiety disorder (GAD) (N = 191; 81% female, mean age 44) were randomized to either their primary-care physician's usual care or a 12- month course of telephone-based collaborative care. Anxiety severity, pain interference, health-related quality of life, health services use, and employment status were assessed at baseline, and at 2-, 4-, 8-, and 12-month follow-up. We defined response to anxiety treatment as a 40% or greater improvement from baseline on anxiety severity scales at 12-month follow-up. Results: The 39% who reported high pain interference at baseline had more severe anxiety (mean SIGH-A score: 21.8 versus 18.0, P<.001), greater limitations in activities of daily living, and more work days missed in the previous month (5.8 versus 4.0 days, P =.01) than those with low pain interference. At 12-month follow-up, high pain interference was associated with a lower likelihood ofresponding to anxiety treatment (OR =.28; 95% CI =.12-.63) and higher health services use (26.1% with ≥1 hospitalization versus 12.0%, P<.001). Conclusions: Pain that interferes with daily activities is prevalent among primary care patients with PD/GAD and associated with more severe anxiety, worse daily functioning, higher health services use, and a lower likelihood ofresponding to treatment for PD/GAD.

Original languageEnglish (US)
Pages (from-to)222-228
Number of pages7
JournalDepression and Anxiety
Volume26
Issue number3
DOIs
StatePublished - Mar 2009
Externally publishedYes

Keywords

  • Activities of daily living
  • Anxiety disorders
  • Pain
  • Primary care

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health

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