Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Oct 6:16:128.
doi: 10.1186/s12875-015-0343-5.

Ethnic differences in the association between depression and chronic pain: cross sectional results from UK Biobank

Barbara I Nicholl  1 , Daniel J Smith  2 , Breda Cullen  3 , Daniel Mackay  4 , Jonathan Evans  5 , Jana Anderson  6 , Donald M Lyall  7 , Chloe Fawns-Ritchie  8 , Andrew M McIntosh  9 , Ian J Deary  10 , Jill P Pell  11 , Frances S Mair  12
Affiliations

Ethnic differences in the association between depression and chronic pain: cross sectional results from UK Biobank

Barbara I Nicholl et al. BMC Fam Pract. .

Abstract

Background: Comorbid chronic pain and depression is a challenging dyad of conditions to manage in primary care and reporting has shown to vary by ethnic group. Whether the relationship between depression and chronic pain varies by ethnicity is unclear. This study aims to explore chronic pain and depression reporting across ethnic groups and examine whether this association differs, independently of potential confounding factors.

Methods: Cross-sectional study of UK Biobank participants with complete data on chronic pain and probable lifetime history of depression, who reported their ethnic group as White, Asian/Asian British or Black/Black British. Chronic pain classification: present if participants had ≥ 1 site of body pain (up to seven sites or "pain all over the body" could be selected) that lasted ≥ 3 months; extent of chronic pain categories: 0, 1, 2-3, 4-7 sites or pain all over the body. Probable depression classification: an algorithm of low mood, anhedonia and help-seeking behaviour. Relationship between depression and presence/extent of chronic pain assessed using logistic/multinomial regression models (odds ratio (OR); relative risk ratio (RRR), 95 % confidence intervals), adjusted for sociodemographic, lifestyle, and morbidity factors; and a final adjustment for current depressive symptoms.

Results: The number of participants eligible for inclusion was 144,139: 35,703 (94 %) White, 4539 (3 %) Asian, and 3897 (3 %) Black. Chronic pain was less (40.5 %, 45.8 %, 45.0 %, respectively) and depression more (22.1 %, 12.9 %, 13.8 %, respectively) commonly reported in White participants than Asian and Black participants. Statistically significant associations between depression and presence/extent of chronic pain persisted following adjustment for potential confounding variables; this relationship was strongest for Black participants (presence of chronic pain: OR 1.86 (1.52, 2.27); RRR 1 site 1.49 (1.16, 1.91), 2-3 sites 1.98 (1.53, 2.56), 4-7 sites 3.23 (2.09, 4.99), pain all over the body 3.31 (2.05, 5.33). When current depressive symptoms were considered these relationships were attenuated.

Conclusions: Chronic pain and depression reporting varies across ethnic groups. Differences in health seeking behaviour between ethnic groups may impact on the results reported. Clinicians, particularly in primary care, need to be aware of the cultural barriers within certain ethic groups to expressing concern over mood and to consider their approach accordingly.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Detailed description of the classification of a probable lifetime history of depression using available data fields in UK Biobank; a positive classification for probable lifetime depression included all three depression categories: single, recurrent (moderate), and recurrent (severe)
See this image and copyright information in PMC

References

    1. Linton SJ, Bergbom S. Understanding the link between depression and pain. Scand J Pain. 2011;2(2):47–54. doi: 10.1016/j.sjpain.2011.01.005. - DOI - PubMed
    1. Allison TR, Symmons DP, Brammah T, Haynes P, Rogers A, Roxby M, et al. Musculoskeletal pain is more generalised among people from ethnic minorities than among white people in Greater Manchester. Ann Rheum Dis. 2002;61(2):151–156. doi: 10.1136/ard.61.2.151. - DOI - PMC - PubMed
    1. Palmer B, Macfarlane G, Afzal C, Esmail A, Silman A, Lunt M. Acculturation and the prevalence of pain amongst South Asian minority ethnic groups in the UK. Rheumatology (Oxford) 2007;46(6):1009–1014. doi: 10.1093/rheumatology/kem037. - DOI - PubMed
    1. Choudhury Y, Bremner SA, Ali A, Eldridge S, Griffiths CJ, Hussain I, et al. Prevalence and impact of chronic widespread pain in the Bangladeshi and White populations of Tower Hamlets. East London Clin Rheumatol. 2013;32(9):1375–1382. doi: 10.1007/s10067-013-2286-3. - DOI - PMC - PubMed
    1. Reyes-Gibby CC, Aday LA, Todd KH, Cleeland CS, Anderson KO. Pain in aging community-dwelling adults in the United States: non-Hispanic whites, non-Hispanic blacks, and Hispanics. J Pain. 2007;8(1):75–84. doi: 10.1016/j.jpain.2006.06.002. - DOI - PMC - PubMed

Publication types