175) Effect of depression and abuse on chronic pain and opioid use and abuse

Depression is prevalent among chronic pain patients, and can often amplify the condition. In addition, depression has shown to positively correlate with higher opioid use and abuse by the patient, as well as increased use and abuse in their family history. Depression and chronic pain are often seen concurrently. We are reporting the preliminary results of an IRB-approved, prospective observational study with 135 patients enrolled, with the ultimate goal of 1000 participants. Inclusion factors consist of depression quantified using the PHQ-9 Depression Assessment, decrease in opioid efficacy, abuse risk, and overall quality of life. Patient PHQ-9 scores significantly correlate with higher opioid risk tool scores (p=0.0002, r=0.2346) while negatively correlating with DIRE treatment efficacy scores (p=0.0007, r= -0.2419). Patients were more likely to report poor mental health on the RAND 36 questionnaire and have a personal family history of drug abuse (p=0.01). Elevated PHQ-9 scores indicated worse quality of life metrics, including decreased emotional well-being (p<0.0001, r= -0.5500), energy (p<0.0001, r= -0.4751), general health (p<0.0001, r= -0.4572), social functioning (p<0.0001, r= -0.4005), role limitations due to emotional problems (p<0.0001, r= -0.3903), bodily pain (p<0.0001, r= -0.2640), role limitations due to health problems (p<0.0001, r= -0.2509), physical functioning (p<0.0001, r= -0.2366), and health changes (p<0.0001, r= -0.2095). Additionally, their reliability scores on the DIRE tests are significantly lower (p=0.009) with higher levels of depression as measured on the PHQ-9. History of preadolescent sexual abuse substantially predicted opioid abuse potential (p<0.0001, r= 0.4204) as well as decreased general health (p= 0.0444, r= -0.1485), vitality/energy (p= 0.0074, r=-0.2010) and emotional well-being (p= 0.0085, r=-0.1945), but histories significant for childhood or adult physical abuse, as well as adult sexual abuse, were not significantly correlated with abuse potential (p>0.05).