PMH10 Depression Severity Is Associated with Physical PAIN Severity across Countries

Physical pain has been shown to be associated with depression diagnosis in Japan. However, it is not known how pain severity relates to depression severity for individuals screening for depression according to the Patient Health Questionnaire-9 (PHQ-9). What is also not known is how the burden of pain and depression severity may differ across countries. Data were obtained from the National Health and Wellness Survey (NHWS), an annual, self-reported, internet-based cross-sectional study of adults. Countries (year of data collection) included were: China(2017), Brazil(2018), EU5(2018), Japan(2019), US(2019), South Korea(2020), and Taiwan(2020). Respondents evaluated pain from arthritis, back problems, fibromyalgia, headache, joint pain, migraine, neck pain, neuropathic pain, shoulder pain/stiffness, or other on an eleven-point scale (0=no pain, 10=worst pain imaginable). For respondents reporting more than one pain condition, the most painful condition was analyzed. Respondents were also assessed for depression severity via PHQ-9 and grouped into four categories (none, mild, moderate, moderately-severe/severe). Bivariate correlations determined the strength of the relationship between pain severity and depression severity. Across countries, 14199 respondents reported a pain condition. The top three pain conditions were arthritis, back problems, and headache. There was a statistically significant relationship between pain severity and depression severity, such that increasingly higher pain was reported for each depression severity group. Average pain severity differed by country for individuals screening for moderately-severe/severe depression: South Korea(7.15), US(6.93), EU5(6.55), Brazil(6.43), Taiwan(6.37), Japan(6.16), and China(5.95). Additionally, the incremental increase in pain severity between moderate vs. moderately-severe/severe depression was more pronounced in South Korea(1.14), Taiwan(0.95), China(0.93), and US(0.92), compared to Brazil(0.86), Japan(0.46) and EU5(0.43). Greater depression severity was associated with greater physical pain, especially in South Korea and US. Both mental and physical aspects of health should be considered, and efforts to minimize pain in less severe depression may prevent worsening of outcomes.