Cross-Sectional Associations Among Symptoms of Pain, Irritability, and Depression and How These Symptoms Relate to Social Functioning and Quality of Life: Findings From the EMBARC and STRIDE Studies and the VitalSign6 Project
This article is available to members only. Please enjoy the abstract for free. Subscribe for instant access to the full article.
This content is restricted to subscribers
Continue Reading...
Did you know members enjoy unlimited free PDF downloads as part of their subscription? Subscribe today for instant access to this article and our entire library in your preferred format. Alternatively, you can purchase the PDF of this article individually.
Members enjoy free PDF downloads on all articles. Join today
Author Affiliations
Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
Department of Psychiatry and Center for Depression Research and Clinical Care, University of Texas Southwestern Medical Center, Dallas, Texas
Department of Psychiatry and Behavioral Science, Stanford University, Stanford, California
Department of Psychiatry and Center for Depression Research and Clinical Care, University of Texas Southwestern Medical Center, Dallas, Texas
Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, Texas
Department of Psychiatry and Center for Depression Research and Clinical Care, University of Texas Southwestern Medical Center, Dallas, Texas
Department of Psychiatry and Center for Depression Research and Clinical Care, University of Texas Southwestern Medical Center, Dallas, Texas
Department of Psychiatry and Center for Depression Research and Clinical Care, University of Texas Southwestern Medical Center, Dallas, Texas
Corresponding author: Madhukar H. Trivedi, MD, Department of Psychiatry, Professor of Psychiatry, Julie K. Hersh Chair for Depression Research and Clinical Care, Betty Jo Hay Distinguished Chair in Mental Health, Founding Director, Center for Depression Research and Clinical Care, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390-9119 ([email protected]).
References (66)
Vos T, Abajobir AA, Abbafati C, et al; GBD 2016 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017;390(10100):1211–1259. PubMedCrossRef
Bair MJ, Robinson RL, Katon W, et al. Depression and pain comorbidity: a literature review. Arch Intern Med. 2003;163(20):2433–2445. PubMedCrossRef
Ohayon MM, Schatzberg AF. Chronic pain and major depressive disorder in the general population. J Psychiatr Res. 2010;44(7):454–461. PubMedCrossRef
Arnow BA, Hunkeler EM, Blasey CM, et al. Comorbid depression, chronic pain, and disability in primary care. Psychosom Med. 2006;68(2):262–268. PubMedCrossRef
Vaccarino AL, Sills TL, Evans KR, et al. Multiple pain complaints in patients with major depressive disorder. Psychosom Med. 2009;71(2):159–162. PubMedCrossRef
Ohayon MM, Schatzberg AF. Using chronic pain to predict depressive morbidity in the general population. Arch Gen Psychiatry. 2003;60(1):39–47. PubMedCrossRef
Owen-Smith A, Stewart C, Sesay MM, et al. Chronic pain diagnoses and opioid dispensings among insured individuals with serious mental illness. BMC Psychiatry. 2020;20(1):40. PubMedCrossRef
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Washington, DC: American Psychiatric Association; 2013.
Fava M, Hwang I, Rush AJ, et al. The importance of irritability as a symptom of major depressive disorder: results from the National Comorbidity Survey Replication. Mol Psychiatry. 2010;15(8):856–867. PubMedCrossRef
Jha MK, Minhajuddin A, Chin Fatt C, et al. Association between irritability and suicidal ideation in three clinical trials of adults with major depressive disorder. Neuropsychopharmacology. 2020;45(13):2147–2154. PubMedCrossRef
Jha MK, Minhajuddin A, South C, et al. Irritability and its clinical utility in major depressive disorder: prediction of individual-level acute-phase outcomes using early changes in irritability and depression severity. Am J Psychiatry. 2019;176(5):358–366. PubMedCrossRef
Judd LL, Schettler PJ, Coryell W, et al. Overt irritability/anger in unipolar major depressive episodes: past and current characteristics and implications for long-term course. JAMA Psychiatry. 2013;70(11):1171–1180. PubMedCrossRef
Orri M, Perret LC, Turecki G, et al. Association between irritability and suicide-related outcomes across the life-course. systematic review of both community and clinical studies. J Affect Disord. 2018;239:220–233. PubMedCrossRef
Toohey MJ, DiGiuseppe R. Defining and measuring irritability: construct clarification and differentiation. Clin Psychol Rev. 2017;53:93–108. PubMedCrossRef
Holtzman S, O’Connor BP, Barata PC, et al. The Brief Irritability Test (BITe): a measure of irritability for use among men and women. Assessment. 2015;22(1):101–115. PubMedCrossRef
Jha MK, Minhajuddin A, Greer TL, et al. Early improvement in work productivity predicts future clinical course in depressed outpatients: findings from the CO-MED Trial. Am J Psychiatry. 2016;173(12):1196–1204. PubMedCrossRef
Trivedi MH, Morris DW, Wisniewski SR, et al. Increase in work productivity of depressed individuals with improvement in depressive symptom severity. Am J Psychiatry. 2013;170(6):633–641. PubMedCrossRef
Jha MK, Minhajuddin A, Greer TL, et al. Early improvement in psychosocial function predicts longer-term symptomatic remission in Depressed Patients. PLoS One. 2016;11(12):e0167901. PubMedCrossRef
Hays RD, Wells KB, Sherbourne CD, et al. Functioning and well-being outcomes of patients with depression compared with chronic general medical illnesses. Arch Gen Psychiatry. 1995;52(1):11–19. PubMedCrossRef
Jha MK, Greer TL, Grannemann BD, et al. Early normalization of quality of life predicts later remission in depression: findings from the CO-MED trial. J Affect Disord. 2016;206:17–22. PubMedCrossRef
Ishak WW, Christensen S, Sayer G, et al. Sexual satisfaction and quality of life in major depressive disorder before and after treatment with citalopram in the STAR*D study. J Clin Psychiatry. 2013;74(3):256–261. PubMedCrossRef
Jha MK, Teer RB, Minhajuddin A, et al. Daily activity level improvement with antidepressant medications predicts long-term clinical outcomes in outpatients with major depressive disorder. Neuropsychiatr Dis Treat. 2017;13:803–813. PubMedCrossRef
Jha MK, South C, Trivedi J, et al. Prediction of acute-phase treatment outcomes by adding a single-item measure of activity impairment to symptom measurement: development and validation of an interactive calculator from the STAR*D and CO-MED Trials. Int J Neuropsychopharmacol. 2019;22(5):339–348. PubMedCrossRef
Trivedi MH, McGrath PJ, Fava M, et al. Establishing moderators and biosignatures of antidepressant response in clinical care (EMBARC): Rationale and design. J Psychiatr Res. 2016;78:11–23. PubMedCrossRef
Trivedi MH, South C, Jha MK, et al. A novel strategy to identify placebo responders: prediction index of clinical and biological markers in the EMBARC Trial. Psychother Psychosom. 2018;87(5):285–295. PubMedCrossRef
Trivedi MH, Greer TL, Grannemann BD, et al. Stimulant reduction intervention using dosed exercise (STRIDE) - CTN 0037: study protocol for a randomized controlled trial. Trials. 2011;12(1):206. PubMedCrossRef
Trivedi MH, Jha MK, Kahalnik F, et al. VitalSign6: a Primary Care First (PCP-First) model for universal screening and measurement-based care for depression. Pharmaceuticals (Basel). 2019;12(2):71. PubMedCrossRef
dela Cruz AM, Bernstein IH, Greer TL, et al. Self-rated measure of pain frequency, intensity, and burden: psychometric properties of a new instrument for the assessment of pain. J Psychiatr Res. 2014;59:155–160. PubMedCrossRef
Krebs EE, Carey TS, Weinberger M. Accuracy of the pain numeric rating scale as a screening test in primary care. J Gen Intern Med. 2007;22(10):1453–1458. PubMedCrossRef
First MB, Spitzer RL, Gibbon M, et al. Structured Clinical Interview for DSM-IV-TR Axis I Disorders, Research Version, Patient Edition. New York, NY; SCID-I/P; 2002.
Rush AJ, Trivedi MH, Ibrahim HM, et al. The 16-Item Quick Inventory of Depressive Symptomatology (QIDS), clinician rating (QIDS-C), and self-report (QIDS-SR): a psychometric evaluation in patients with chronic major depression. Biol Psychiatry. 2003;54(5):573–583. PubMedCrossRef
Chandler GM, Iosifescu DV, Pollack MH, et al. RESEARCH: validation of the Massachusetts General Hospital Antidepressant Treatment History Questionnaire (ATRQ). CNS Neurosci Ther. 2010;16(5):322–325. PubMedCrossRef
Trivedi MH, Greer TL, Rethorst CD, et al. Randomized controlled trial comparing exercise to health education for stimulant use disorder: results from the CTN-0037 STimulant Reduction Intervention Using Dosed Exercise (STRIDE) Study. J Clin Psychiatry. 2017;78(8):1075–1082. PubMedCrossRef
Chartier KG, Sanchez K, Killeen TK, et al. Men and women from the STRIDE clinical trial: an assessment of stimulant abstinence symptom severity at residential treatment entry. Am J Addict. 2015;24(4):336–340. PubMedCrossRef
Jha MK, Grannemann BD, Trombello JM, et al. A structured approach to detecting and treating depression in primary care: VitalSign6 Project. Ann Fam Med. 2019;17(4):326–335. PubMedCrossRef
Löwe B, Kroenke K, Gräfe K. Detecting and monitoring depression with a two-item questionnaire (PHQ-2). J Psychosom Res. 2005;58(2):163–171. PubMedCrossRef
Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606–613. PubMedCrossRef
Jha MK, Minhajuddin A, South C, et al. Worsening anxiety, irritability, insomnia, or panic predicts poorer antidepressant treatment outcomes: clinical utility and validation of the Concise Associated Symptom Tracking (CAST) Scale. Int J Neuropsychopharmacol. 2018;21(4):325–332. PubMedCrossRef
Minhajuddin A, Jha MK, Chin Fatt C, et al. Psychometric properties of the concise associated symptom tracking scale and validation of clinical utility in the EMBARC study. Psychiatric Res Clin Prac. 2020;2(1):10–18. CrossRef
Gameroff MJ, Wickramaratne P, Weissman MM. Testing the short and screener versions of the Social Adjustment Scale-Self-report (SAS-SR). Int J Methods Psychiatr Res. 2012;21(1):52–65. PubMedCrossRef
Endicott J, Nee J, Harrison W, et al. Quality of Life Enjoyment and Satisfaction Questionnaire: a new measure. Psychopharmacol Bull. 1993;29(2):321–326. PubMed
Pollack MH, Endicott J, Liebowitz M, et al. Examining quality of life in patients with generalized anxiety disorder: clinical relevance and response to duloxetine treatment. J Psychiatr Res. 2008;42(12):1042–1049. PubMedCrossRef
Reilly MC, Zbrozek AS, Dukes EM. The validity and reproducibility of a work productivity and activity impairment instrument. Pharmacoeconomics. 1993;4(5):353–365. PubMedCrossRef
Hooper D, Coughlan J, Mullen M. Structural equation modelling: guidelines for determining model fit. Electronic Journal of Business Research Methods. 2008;6(1):53–60.
Samejima F. Graded reponse model. In: van der Linden WJ, Hambleton RK, eds. Handbook of Modern Item Response Theory. New York, New York: Springer-Verlag; 1997.
Rush AJ, South CC, Jha MK, et al. Toward a very brief Quality of Life Enjoyment and Satisfaction Questionnaire. J Affect Disord. 2019;242:87–95. PubMedCrossRef
Cronbach LJ. Coefficient alpha and the internal structure of tests. Psychometrika. 1951;16(3):297–334. CrossRef
Villarroel MA, Terlizzi EP. Symptoms of depression among adults: United States, 2019. NCHS Data Brief, no 379. Hyattsville, MD: National Center for Health Statistics; 2020. https://www.cdc.gov/nchs/products/databriefs/db379.htm Accessed December 28, 2020.
Baron RM, Kenny DA. The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. J Pers Soc Psychol. 1986;51(6):1173–1182. PubMedCrossRef
Eshel N, Leibenluft E. New frontiers in irritability research-from cradle to grave and bench to bedside. JAMA Psychiatry. 2019;77(3):227–228. PubMed
van Bronswijk S, Moopen N, Beijers L, et al. Effectiveness of psychotherapy for treatment-resistant depression: a meta-analysis and meta-regression. Psychol Med. 2019;49(3):366–379. PubMedCrossRef
Boschloo L, Bekhuis E, Weitz ES, et al. The symptom-specific efficacy of antidepressant medication vs cognitive behavioral therapy in the treatment of depression: results from an individual patient data meta-analysis. World Psychiatry. 2019;18(2):183–191. PubMedCrossRef
Cherkin DC, Anderson ML, Sherman KJ, et al. Two-year follow-up of a randomized clinical trial of mindfulness-based stress reduction vs cognitive behavioral therapy or usual care for chronic low back pain. JAMA. 2017;317(6):642–644. PubMedCrossRef
Fisher E, Law E, Dudeney J, et al. Psychological therapies for the management of chronic and recurrent pain in children and adolescents. Cochrane Database Syst Rev. 2018;9(9):CD003968. PubMed
Kircanski K, Clayton ME, Leibenluft E, et al. Psychosocial treatment of irritability in youth. Curr Treat Options Psychiatry. 2018;5(1):129–140. PubMedCrossRef
Kircanski K, Craske MG, Averbeck BB, et al. Exposure therapy for pediatric irritability: theory and potential mechanisms. Behav Res Ther. 2019;118:141–149. PubMedCrossRef
Scher C, Meador L, Van Cleave JH, et al. Moving beyond pain as the fifth vital sign and patient satisfaction scores to improve pain care in the 21st cPain Manag Nurs. 2018;19(2):125–129. PubMedCrossRef
LaVance MS, Fairchild R, Rosado RJ. Turning the table: depression screening as the 6th vital sign. J Nurse Pract. 2015;11(2):199–206. CrossRef
Walker AK, Kavelaars A, Heijnen CJ, et al. Neuroinflammation and comorbidity of pain and depression. Pharmacol Rev. 2013;66(1):80–101. PubMedCrossRef
Sheng J, Liu S, Wang Y, et al. The link between depression and chronic pain: neural mechanisms in the brain. Neural Plast. 2017;2017:9724371. PubMedCrossRef
Papakostas GI, Salloum NC, Hock RS, et al. Efficacy of esketamine augmentation in major depressive disorder: a meta-analysis. J Clin Psychiatry. 2020;81(4):19r12889. PubMedCrossRef
McIntyre RS, Lipsitz O, Rodrigues NB, et al. The effectiveness of ketamine on anxiety, irritability, and agitation: Implications for treating mixed features in adults with major depressive or bipolar disorder. Bipolar Disord. 2020;22(8):831–840. PubMedCrossRef
Brotman MA, Kircanski K, Leibenluft E. Irritability in children and adolescents. Annu Rev Clin Psychol. 2017;13(1):317–341. PubMedCrossRef
Leibenluft E. Irritability in children: what we know and what we need to learn. World Psychiatry. 2017;16(1):100–101. PubMedCrossRef
Jha MK, Fava M, Minhajuddin A, et al. Association of anger attacks with suicidal ideation in adults with major depressive disorder: findings from the EMBARC study. Depress Anxiety. 2020;38(1)57–66. PubMed
Jha MK, Fava M, Minhajuddin A, et al. Anger attacks are associated with persistently elevated irritability in MDD: findings from the EMBARC study. Psychol Med. 2020;6:1–9. PubMedCrossRef