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The Moderating Role of Comorbidity Burden in the Relationship Between Depression and Pain Among Older Women with Breast Cancer
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Mentor: Dr. Michael Antoni
The Moderating Role of Comorbidity Burden in the Relationship Between Depression and Pain Among Older Women with Breast Cancer
Manisha K. Woodruff, Sarah N. Webster, BA, Millan R. Kanaya, BS, Mary Roberts, Sara N. Ebrahimi, Emily A. Walsh, MS, Rachel Plotke, BA, Paula J. Pepak, BA, Molly Ream, MS, Michael H. Antoni, PhD
Department of Psychology, Coping & Recovery Lab, University of Miami
ABSTRACT
Pain is common during and after treatment for breast cancer (BC), and can negatively impact health-related quality of life. BC patients often report depressive symptoms, such as feelings of guilt/worthlessness, loss of appetite and sleep disturbance, that may contribute to the overall pain experience. Comorbidity burden has also been shown to exacerbate pain interference and severity. This study examines whether comorbidity burden moderates the relationship between depression and pain.
Older women (>50 years; N = 109) with nonmetastatic BC participated in stress management intervention. Participants completed baseline measures of depression (Center for Epidemiological Studies-Depression), pain (Brief Pain Inventory), and comorbidity burden (Charlson Comorbidity Index). Linear regression models investigated the moderating effect of comorbidity burden on the relationship between depression and pain, adjusting for age, BC stage, and time since BC surgery.
Participants with greater depression levels experienced greater pain severity (B=0.25, SE=0.11, p=.034) and pain interference (B=0.51, SE=0.22, p=.022), suggesting that depression is significantly related to pain. Additionally, comorbidity burden significantly moderated the relationship between depressive symptoms and both pain severity (B=0.16, SE=.06, and p=.007) and interference (B=0.28, SE=0.11, p=0.011), such that participants with more depressive symptoms and higher comorbidity burden had greater experiences of pain.
Comorbidity burden amplifies the impact of depression on pain, underscoring the need to manage comorbidity burden among patients with high depressive symptoms to reduce the experience of pain.
