Childhood abuse, depression, and chronic pain.

OBJECTIVE

To investigate the relationships among history of childhood abuse, type of pain, and depression.

DESIGN

Survey, consecutive sample, correlational.

SETTING

An interdisciplinary pain-management center in a rehabilitation hospital.

PATIENTS: The participants were 201 consecutive patients with chronic pain complaints, 68% women, mean age 38 years, of whom 28% complained of pain in more than three major sites, 26% had low back pain, 19% had craniofacial pain, and 25% had pain in other regions.

OUTCOME MEASURES: Beck Depression Inventory, Childhood History recorded presence or absence of abuse, age of onset, age when abuse was acknowledged, duration and frequency of abuse, relationship of abuser to the participant. Pain type was classified by IASP.

RESULTS

Patients with history of both sexual and physical abuse in childhood had more depression. The differences among abuse groups was significant (p < 0.03). The impact of childhood abuse and type of pain on depression was tested by a two-factor analysis of variance. The influence of childhood abuse was significant (p < 0.04), whereas the influence of type of pain (p < 0.76) and the interaction between type of pain and childhood abuse (p < 0.40) were not significant.

CONCLUSIONS

There is a positive, significant relationship between depression and history of childhood sexual and physical abuse. The influence of type of pain on depression was not significant. Prevailing research explained depression as an expected, natural consequence of chronic pain. Our research suggests that the relationship between chronic pain and depression may be attributable in part to childhood abuse history.