Depressive symptoms in community-dwelling older adults receiving opioid therapy for chronic pain

Abstract

Objective: The purpose of the study was to identify factors associated with depressive symptoms in community-dwelling older adults receiving prescription opioids for chronic pain.Design: This was a cross-sectional research design. A survey was used to gather demographic information, pain severity, health status, and factors associated with depressive symptoms.Setting: Eleven outpatient clinics affiliated with the Baltimore Veterans Affairs Medical Center and the University of Maryland Medical System were included.Participants: One hundred sixty-three older adults receiving opioid medications for chronic pain were recruited.Outcome measures: Depressive symptoms were assessed via the Center for Epidemiologic Studies Depression Scale-10 (CESD-10).Results: Univariate, bivariate, and ordinary least square (OLS) regression analyses were conducted to identify frequencies and to address the research questions. Nearly 40 percent of the elderly opioid therapy patients had depressive symptoms on the CESD-10. Bivariate analysis revealed that higher levels of pain severity were related to higher levels of depressive symptoms. OLS regression analysis revealed four risk factors significantly associated with higher depressive symptoms: higher pain severity, lower levels of functional status, lower levels of spirituality, and lower levels of social support. Age, gender, living alone, and perception of health status were not significantly associated with depressive symptoms.Conclusions: Depression is an underdiagnosed, treatable pain comorbidity that should be evaluated in older patients receiving opioid therapy. Undertreated depression in chronic pain patients receiving opioid medications may explain suboptimal improvement in pain and functional status despite increasing opioid dosage.