Among participants in the GRACE trial with sickle cell disease, depressive symptoms were associated with worse pain outcomes both directly and indirectly through pain catastrophizing. The study is the first to observe the mediating role of catastrophizing between depression and pain outcomes in adults with sickle cell disease and chronic pain.
The report was published online ahead of print in General Hospital Psychiatry.
Adults with sickle cell disease often have chronic pain and experience symptoms of depression more frequently than the general population and other patients with chronic pain. Depression and pain catastrophizing are known to exacerbate pain outcomes. However, the mediating role of catastrophizing between depression and pain outcomes is less well studied.
Using baseline data from the GRACE trial, researchers confirmed that depression was common in adults with sickle cell disease and chronic pain and was associated with worse pain outcomes. They also found that pain catastrophizing partly linked depressive symptoms to worse pain outcomes. The findings suggest that integrated pain-focused interventions that target both depression and catastrophizing may be useful.
GRACE, an NIH Collaboratory Trial, is a pragmatic clinical trial embedded in 3 large healthcare systems to assess the effectiveness of guided relaxation and acupuncture treatments to improve pain control for patients with sickle cell disease. GRACE is supported within the NIH Pragmatic Trials Collaboratory through the NIH HEAL Initiative by a grant administered by the National Center for Complementary and Integrative Health. Learn more about GRACE.