Comorbid symptoms of depression and musculoskeletal pain and risk of long term sickness absence

Abstract Background Symptoms of depression and musculoskeletal pain have both been found to be associated with increased risk of long term sickness absence (LTSA). The comorbidity between depression and pain i.e. simultaneous presence of both symptoms, is well established in the literature. The aim...

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Main Authors:	Ole Melkevik, Thomas Clausen, Jacob Pedersen, Anne Helene Garde, Andreas Holtermann, Reiner Rugulies
Format:	Article
Language:	English
Published:	BioMed Central 2018-08-01
Series:	BMC Public Health
Online Access:	http://link.springer.com/article/10.1186/s12889-018-5740-y

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spelling	doaj-art-7328f1a6e0874b358c0d704e542517092018-08-15T21:22:10ZengBioMed CentralBMC Public Health1471-24582018-08-011811910.1186/s12889-018-5740-yComorbid symptoms of depression and musculoskeletal pain and risk of long term sickness absenceOle Melkevik0Thomas Clausen1Jacob Pedersen2Anne Helene Garde3Andreas Holtermann4Reiner Rugulies5NRCWENRCWENRCWENRCWENRCWENRCWEAbstract Background Symptoms of depression and musculoskeletal pain have both been found to be associated with increased risk of long term sickness absence (LTSA). The comorbidity between depression and pain i.e. simultaneous presence of both symptoms, is well established in the literature. The aim for the current investigation was to investigate whether the presence of comorbid pain influences the associations between depressive symptoms and LTSA or if the presence of comorbid depressive symptoms influences associations between musculoskeletal pain and LTSA. Methods A sample of 6572 Danish female health care workers responding to a questionnaire about health and working conditions were followed up in a national register of social transfer payments (DREAM) for 550 days. We estimated the risk for LTSA of four weeks or more, associated with depressive symptoms and number of musculoskeletal pain locations using a Cox proportional hazards model allowing multiple observations per individual. We conducted a test for multiplicative interaction between musculoskeletal pain locations and depressive symptoms, and presented stratified regression models to facilitate the interpretation of the results. Results The severity of depressive symptoms was correlated with the number of pain locations reported (Spearman’s rho = .24, p < 0.001). We found a significant multiplicative interaction between depressive symptoms and musculoskeletal pain in predicting the risk of LTSA. Depressive symptoms and number of musculoskeletal pain locations were associated with increased risk of LTSA for individuals who did not have comorbid symptoms. However, we found no significant associations between the two predictors and LTSA among participants who reported comorbid symptoms. Conclusions The risk of LTSA associated with depressive symptoms and musculoskeletal pain appears to be moderated by the presence of comorbid symptoms. The modified risk for LTSA among workers with comorbid symptoms requires further investigation.http://link.springer.com/article/10.1186/s12889-018-5740-y
institution	Open Data Bank
collection	Open Access Journals
building	Directory of Open Access Journals
language	English
format	Article
author	Ole Melkevik Thomas Clausen Jacob Pedersen Anne Helene Garde Andreas Holtermann Reiner Rugulies
spellingShingle	Ole Melkevik Thomas Clausen Jacob Pedersen Anne Helene Garde Andreas Holtermann Reiner Rugulies Comorbid symptoms of depression and musculoskeletal pain and risk of long term sickness absence BMC Public Health
author_facet	Ole Melkevik Thomas Clausen Jacob Pedersen Anne Helene Garde Andreas Holtermann Reiner Rugulies
author_sort	Ole Melkevik
title	Comorbid symptoms of depression and musculoskeletal pain and risk of long term sickness absence
title_short	Comorbid symptoms of depression and musculoskeletal pain and risk of long term sickness absence
title_full	Comorbid symptoms of depression and musculoskeletal pain and risk of long term sickness absence
title_fullStr	Comorbid symptoms of depression and musculoskeletal pain and risk of long term sickness absence
title_full_unstemmed	Comorbid symptoms of depression and musculoskeletal pain and risk of long term sickness absence
title_sort	comorbid symptoms of depression and musculoskeletal pain and risk of long term sickness absence
publisher	BioMed Central
series	BMC Public Health
issn	1471-2458
publishDate	2018-08-01
description	Abstract Background Symptoms of depression and musculoskeletal pain have both been found to be associated with increased risk of long term sickness absence (LTSA). The comorbidity between depression and pain i.e. simultaneous presence of both symptoms, is well established in the literature. The aim for the current investigation was to investigate whether the presence of comorbid pain influences the associations between depressive symptoms and LTSA or if the presence of comorbid depressive symptoms influences associations between musculoskeletal pain and LTSA. Methods A sample of 6572 Danish female health care workers responding to a questionnaire about health and working conditions were followed up in a national register of social transfer payments (DREAM) for 550 days. We estimated the risk for LTSA of four weeks or more, associated with depressive symptoms and number of musculoskeletal pain locations using a Cox proportional hazards model allowing multiple observations per individual. We conducted a test for multiplicative interaction between musculoskeletal pain locations and depressive symptoms, and presented stratified regression models to facilitate the interpretation of the results. Results The severity of depressive symptoms was correlated with the number of pain locations reported (Spearman’s rho = .24, p < 0.001). We found a significant multiplicative interaction between depressive symptoms and musculoskeletal pain in predicting the risk of LTSA. Depressive symptoms and number of musculoskeletal pain locations were associated with increased risk of LTSA for individuals who did not have comorbid symptoms. However, we found no significant associations between the two predictors and LTSA among participants who reported comorbid symptoms. Conclusions The risk of LTSA associated with depressive symptoms and musculoskeletal pain appears to be moderated by the presence of comorbid symptoms. The modified risk for LTSA among workers with comorbid symptoms requires further investigation.
url	http://link.springer.com/article/10.1186/s12889-018-5740-y
_version_	1612706162035130368

Comorbid symptoms of depression and musculoskeletal pain and risk of long term sickness absence

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