Elevated depressive symptoms are common in youth with chronic pain, and pain symptoms are frequent in adolescents with depressive disorders. While studies have identified concurrent associations between pain and depression over time in youth, it is unclear how change in one symptom impacts change in the other symptom.This three-time point 12-month longitudinal study examined reciprocal associations among pain and depression in a clinical sample of adolescents (12-18) diagnosed with chronic pain (n?=?55) or a depressive disorder (n?=?40). Mixed-effects multivariate models were used to test if changes over a preceding time interval predicted symptom severity at subsequent time points. Study group, age, sex, race, baseline pain intensity and baseline depressive symptoms were included as covariates.Generalized estimating equations revealed that pain and depressive symptoms were significantly associated over time (β?=?1.54; p?
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机译：抑郁症症状加重在患有慢性疼痛的年轻人中很常见，而疼痛症状在患有抑郁症的青少年中很常见。虽然研究已经确定了青年人随着时间的推移疼痛和抑郁之间存在并发关联，但尚不清楚一种症状的改变如何影响另一种症状的改变。这项为时12个月，为期3个月的纵向研究研究了临床上疼痛和抑郁之间的相互关联青少年样本（12-18岁）被诊断患有慢性疼痛（n = 55）或抑郁症（n = 40）。混合效果多元模型用于测试在先前时间间隔内的变化是否可预测随后时间点的症状严重程度。研究组，年龄，性别，种族，基线疼痛强度和基线抑郁症状作为协变量包括在内。广义估计方程表明，随着时间的推移，疼痛和抑郁症状显着相关（β≤1.54;p≤0.001）。如所假设的，疼痛的改变与随后的抑郁症状有关（β≥1.16;p≤0.001）。相反，抑郁症状的改变预示着随后的疼痛（β= 0.026; p <0.05），但关联性较弱。在预测疼痛的模型中，出现了抑郁症状与研究组之间的相互作用（β？=？-0.02; p？<？0.05），其中抑郁症状的变化对抑郁样品的疼痛影响最大。对青少年样本的研究表明疼痛强度的变化可预示随后的抑郁症状。与成人数据相比，抑郁症状的改变对年轻人随后的疼痛影响较小。未来的研究可以检查针对性持续疼痛如何还可以帮助治疗青少年的抑郁症状。
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