History of abuse is associated with thoughts of harm among patients with pain after accounting for depressive symptoms

• Published in: Regional anesthesia and pain medicine Vol. 48; no. 3; pp. 120 - 126
• Main Authors: Mohan, Nitesh, Zhu, Guohao, Hassett, Afton L, Fatabhoy, Megha G, Pierce, Jennifer
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group Ltd 01.03.2023; BMJ Publishing Group LTD
• Subjects: Adult abuse & neglect; Adults; Anesthesiology; Child abuse & neglect; Child development; Chronic pain; clinical pain; Cross-Sectional Studies; Demographics; Depression - diagnosis; Depression - epidemiology; Humans; Mental depression; Original research; Pain; pain management; Patients; Regional anesthesia; Sex crimes; Sexual abuse; Suicidal behavior; Suicidal Ideation; Suicides & suicide attempts; Victimization; United States > US; Michigan; clinical pain; chronic pain; pain management
• ISSN: 1098-7339; 1532-8651
• DOI: 10.1136/rapm-2022-103647

IntroductionScreening for depressive symptoms is often the first step to understanding risk for thoughts of harm among patients with pain. Pain characteristics and history of abuse are also associated with thoughts of harm; however, little is known about these associations after accounting for depressive symptoms. This study examined the association between pain characteristics and history of abuse with thoughts of harm among pain patients with moderate to severe and low to mild depressive symptoms.MethodsWe conducted a cross-sectional analysis of patients (n=7510) who presented to a tertiary-care, outpatient pain clinic.ResultsAbuse history was significantly associated with increased odds of reporting thoughts of harm for both patients with moderate to severe depressive symptoms as well as low to mild depressive symptoms. Abuse did not modify the association between any of the pain characteristics and thoughts of harm.DiscussionOur results highlight the importance of abuse history in assessing thoughts of harm. Although we are unable to infer causality due to the cross-sectional design, this study highlights the importance of screening for abuse history when assessing for suicidal and homicidal ideation.