The role of psychological variables in explaining depression in older people with chronic pain

Abstract

OBJECTIVES: Depression is commonly associated with chronic pain, and is also a common condition in the elderly. However research in the area of depression and pain is scarce. The aim of the present work was to analyse how cognitive-behavioural and perceptual variables help to explain the presence or absence of depression in older people with chronic pain caused by osteoarthritis. METHOD: A total of 104 older adults were evaluated using a protocol that measured depression, perceptual characteristics of pain (intensity, frequency and duration), beliefs about pain, self-efficacy beliefs, coping style, coping strategies and pain behaviours. RESULTS: Using Student's t-tests and discriminant analysis, we found that psychological variables such as catastrophizing, passive coping, complaint behaviour, avoidance, coping self-statements, ignoring pain sensations and stability and mystery beliefs help to explain depressive symptomatology. CONCLUSION: The present study confirms the important role of cognitive-behavioural variables in the discrimination between older adults who suffer pain with and without symptoms of depression. Moreover, certain variables that in young adults had been seen to play a non-adaptive role, such as ignoring pain sensations, were seen to have an adaptive function in the elderly. Also, our results are in support of depression models - such as Abramson's Hopelessness Model - proposing that depression in chronic pain patients, unlike in other groups of depressed people, is characterized by absence of self-blame feelings.