Advertisement

Depression and Opioid Misuse in Elderly Individuals With Chronic Pain: A Latent Class Analysis

Published:March 10, 2022DOI:https://doi.org/10.1016/j.pmn.2022.02.003

      Abstract

      Background

      Chronic pain patients tend to have comorbid depressive symptoms, and empirical data investigating differences related to depressive symptoms classes and opioid misuse are scant.

      Aims

      The aim of this study was to identify heterogeneous depressive symptoms trajectories in elderly individuals with chronic pain who take opioids, and investigate the association between depressive symptoms subgroups and opioid misuse.

      Design

      Secondary data analysis of a cross-sectional study.

      Settings

      Twelve communities were selected from a city in Shandong Province, China, using multi-stage cluster sampling.

      Participants/Subjects

      Individuals aged ≥60 years with self-reported chronic pain lasting more than one year and who took opioids under prescription were screened.

      Methods

      Latent class analysis was used to identify homogeneous depressive symptoms groups within the elderly population with chronic pain. Multinomial logistic regression, and one-way analysis of variance were also performed.

      Results

      The best-fitted model suggested three depressive symptoms subgroups: “Impaired Memory,” “Perceived Stress in Life and Work,” and “Low Mood.” Age, education level, and marital status were depression risk factors. The odds of opioid misuse varied among the depressive symptoms subgroups.

      Conclusions

      These findings may help improve depressive symptoms and chronic pain management by identifying high-risk elderly individuals for early intervention and personalizing treatment according to the depressive symptoms subgroup and severity of opioid misuse.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Pain Management Nursing
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Braden J.B.
        • Sullivan M.D.
        • Ray G.T.
        • Saunders K.
        • Merrill J.
        • Silverberg M.J.
        • Von Korff M.
        Trends in long-term opioid therapy for noncancer pain among persons with a history of depression.
        General Hospital Psychiatry. 2009; 31: 564-570
        • Brady K.T.
        • McCauley J.L.
        • Back S.E.
        Prescription opioid misuse, abuse, and treatment in the United States: An update.
        American Journal of Psychiatry. 2016; 173: 18-26
        • Bulloch A.G.
        • Williams J.V.
        • Lavorato D.H.
        • Patten S.B.
        The relationship between major depression and marital disruption is bidirectional.
        Depression and Anxiety. 2009; 26: 1172-1177
        • Burns R.A.
        • Butterworth P.
        • Luszcz M.
        • Anstey K.J.
        Stability and change in level of probable depression and depressive symptoms in a sample of middle and older-aged adults.
        International Psychogeriatrics. 2013; 25: 303-309
        • Butler S.F.
        • Budman S.H.
        • Fernandez K.C.
        • Houle B.
        • Benoit C.
        • Katz N.
        • Jamison R.N.
        Development and validation of the current opioid misuse measure.
        Pain. 2007; 130: 144-156
        • Carragher N.
        • Adamson G.
        • Bunting B.
        • McCann S.
        Subtypes of depression in a nationally representative sample.
        Journal of Affective Disorders. 2009; 113: 88-99
        • Chojnacka-Szawłowska G.
        • Kloc W.
        • Zdun-Ryżewska A.
        • Basiński K.
        • Majkowicz M.
        • Leppert W.
        • Libionka W.
        Impact of different illness perceptions and emotions associated with chronic back pain on anxiety and depression in patients qualified for surgery.
        Pain Management Nursing. 2019; 20: 599-603
        • Disu T.R.
        • Anne N.J.
        • Griffiths M.D.
        • Mamun M.A.
        Risk factors of geriatric depression among elderly Bangladeshi people: A pilot interview study.
        Asian Journal of Psychiatry. 2019; 44: 163-169
        • Djelantik A.
        • Smid G.E.
        • Kleber R.J.
        • Boelen P.A.
        Symptoms of prolonged grief, post-traumatic stress, and depression after loss in a Dutch community sample: A latent class analysis.
        Psychiatry Research. 2017; 247: 276-281
        • Feingold D.
        • Brill S.
        • Goor-Aryeh I.
        • Delayahu Y.
        • Lev-Ran S.
        The association between severity of depression and prescription opioid misuse among chronic pain patients with and without anxiety: A cross-sectional study.
        Journal of Affective Disorders. 2018; 235: 293-302
        • Jang S.N.
        • Kawachi I.
        • Chang J.
        • Boo K.
        • Shin H.G.
        • Lee H.
        • Cho S.I.
        Marital status, gender, and depression: analysis of the baseline survey of the Korean Longitudinal Study of Ageing (KLoSA).
        Social Science and Medicine. 2009; 69: 1608-1615
        • Jauregui P.
        • Estévez A.
        • Urbiola I.
        Pathological gambling and associated drug and alcohol abuse, emotion regulation, and anxious-depressive symptomatology.
        J Behav Addict. 2016; 5: 251-260
        • Kang Y.
        • Meghani S.H.
        • Bruner D.W.
        • Yeager K.A.
        Factors associated with depression in African American patients being treated for cancer pain.
        Pain Management Nursing. 2020; 21: 410-415
        • Khantzian E.J.
        The self-medication hypothesis of addictive disorders: Focus on heroin and cocaine dependence.
        American Journal of Psychiatry. 1985; 142: 1259-1264
        • Liu H.
        • Byles J.E.
        • Xu X.
        • Zhang M.
        • Wu X.
        • Hall J.J.
        Evaluation of successful aging among older people in China: Results from China health and retirement longitudinal study.
        Geriatrics & Gerontology International. 2017; 17: 1183-1190
        • Maree R.D.
        • Marcum Z.A.
        • Saghafi E.
        • Weiner D.K.
        • Karp J.F.
        A systematic review of opioid and benzodiazepine misuse in older adults.
        American Journal of Geriatric Psychiatry. 2016; 24: 949-963
        • Merrill J.O.
        • Von Korff M.
        • Banta-Green C.J.
        • Sullivan M.D.
        • Saunders K.W.
        • Campbell C.I.
        • Weisner C.
        Prescribed opioid difficulties, depression and opioid dose among chronic opioid therapy patients.
        General Hospital Psychiatry. 2012; 34: 581-587
        • Mohamed Zaki L.R.,
        • Hairi N.N
        A systematic review of the prevalence and measurement of chronic pain in Asian adults.
        Pain Management Nursing. 2015; 16: 440-452
        • Mumba M.N.
        • Nacarrow A.F.
        • Cody S.
        • Key B.A.
        • Wang H.
        • Robb M.
        • Allen R.S.
        Intensity and type of physical activity predicts depression in older adults.
        Aging & Mental Health. 2021; 25: 664-671
        • Rong J.
        • Chen G.
        • Wang X.
        • Ge Y.
        • Meng N.
        • Xie T.
        • Ding H.
        Correlation between depressive symptoms and quality of life, and associated factors for depressive symptoms among rural elderly in Anhui, China.
        Clinical Interventions in Aging. 2019; 14: 1901-1910
        • Sheng J.
        • Liu S.
        • Wang Y.
        • Cui R.
        • Zhang X.
        The link between depression and chronic pain: Neural mechanisms in the brain.
        Neural Plasticity. 2017; 20179724371
        • Treede R.D.
        • Rief W.
        • Barke A.
        • Aziz Q.
        • Bennett M.I.
        • Benoliel R.
        • Wang S.J.
        Chronic pain as a symptom or a disease: The IASP Classification of Chronic Pain for the International Classification of Diseases (ICD-11).
        Pain. 2019; 160: 19-27
        • Ulbricht C.M.
        • Chrysanthopoulou S.A.
        • Levin L.
        • Lapane K.L.
        The use of latent class analysis for identifying subtypes of depression: A systematic review.
        Psychiatry Research. 2018; 266: 228-246
        • Van Tilburg T.G.
        • Suanet B.
        Unmarried older people: Are they socially better off today?.
        Journals of Gerontology: Series B. 2018; 74: 1463-1473
        • Vowles K.E.
        • McEntee M.L.
        • Julnes P.S.
        • Frohe T.
        • Ney J.P.
        • van der Goes D.N.
        Rates of opioid misuse, abuse, and addiction in chronic pain: A systematic review and data synthesis.
        Pain. 2015; 156: 569-576
        • Webster L.R.
        Risk factors for opioid-use disorder and overdose.
        Anesthesia and Analgesia. 2017; 125: 1741-1748
        • Zhang X.
        • Cao D.
        • Sun J.
        • Shao D.
        • Sun Y.
        • Cao F.
        Sleep heterogeneity in the third trimester of pregnancy: Correlations with depression, memory impairment, and fatigue.
        Psychiatry Research. 2021; 303114075