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35th AM (2025) - Poster Session
The Role of Depression in Pain Coping and Opioid U ...
The Role of Depression in Pain Coping and Opioid Use in Traumatic Injury Patients
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This study investigates the interrelationships between trauma-related distress, depressive symptoms, pain coping, and opioid misuse risk in patients recovering from severe traumatic injury. Notably, 54% of such patients are discharged with opioid prescriptions, and increased opioid refills are linked to higher misuse risk. Pre-injury trauma distress and poor pain coping are known contributors, but the specific roles and interactions of depression and trauma distress on pain coping and opioid use remain underexplored.<br /><br />Using baseline data from 30 patients enrolled in a clinical trial (NCT06527599), the study measured trauma symptoms (PCL-5), depression (PHQ-8), pain catastrophizing (PCS), and opioid refill frequency via medication checks. Statistical analyses included Pearson correlations, logistic regressions, t-tests, and a mediation model testing depression as a mediator between trauma distress and pain coping.<br /><br />Key findings demonstrate that trauma-related distress is associated with depressive symptoms and poor pain coping, with depressive symptoms also linked to pain coping difficulties. Importantly, depressive symptoms mediate the relationship between trauma distress and pain catastrophizing, such that trauma distress alone no longer significantly predicts poor pain coping once depression is accounted for. Furthermore, clinically elevated depression (PHQ-8 ≥10) predicts an increased number of opioid refills, which prior research associates with heightened opioid misuse risk.<br /><br />These results highlight depressive symptoms as a critical intervention target to improve pain coping strategies and consequently reduce opioid refill frequency and misuse risk in trauma patients. The study supports integrating mental health screening and early psychological interventions in trauma recovery care to address depression, improve pain coping, and prevent opioid misuse.<br /><br />In summary, depression plays a central mediating role linking trauma-related distress to maladaptive pain coping and increased opioid use, emphasizing the need for comprehensive psychological care in trauma patient management.
Keywords
trauma-related distress
depressive symptoms
pain coping
opioid misuse risk
severe traumatic injury
opioid prescriptions
pain catastrophizing
depression mediation
opioid refills
psychological interventions
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