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Original research
History of abuse is associated with thoughts of harm among patients with pain after accounting for depressive symptoms
  1. Nitesh Mohan,
  2. Guohao Zhu,
  3. Afton L Hassett,
  4. Megha G Fatabhoy and
  5. Jennifer Pierce
  1. Anesthesiology, University of Michigan Medical School, Ann Arbor, Michigan, USA
  1. Correspondence to Dr Jennifer Pierce, Anesthesiology, University of Michigan, Ann Arbor, MI 48109, USA; jmboik{at}med.umich.edu

Abstract

Introduction Screening for depressive symptoms is often the first step to understanding risk for thoughts of harm among patients with pain. Pain characteristics and history of abuse are also associated with thoughts of harm; however, little is known about these associations after accounting for depressive symptoms. This study examined the association between pain characteristics and history of abuse with thoughts of harm among pain patients with moderate to severe and low to mild depressive symptoms.

Methods We conducted a cross-sectional analysis of patients (n=7510) who presented to a tertiary-care, outpatient pain clinic.

Results Abuse history was significantly associated with increased odds of reporting thoughts of harm for both patients with moderate to severe depressive symptoms as well as low to mild depressive symptoms. Abuse did not modify the association between any of the pain characteristics and thoughts of harm.

Discussion Our results highlight the importance of abuse history in assessing thoughts of harm. Although we are unable to infer causality due to the cross-sectional design, this study highlights the importance of screening for abuse history when assessing for suicidal and homicidal ideation.

  • chronic pain
  • clinical pain
  • pain management

Data availability statement

Data are available on reasonable request.

https://doi.org/10.1136/rapm-2022-103647

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    Data availability statement

    Data are available on reasonable request.

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    Footnotes

    • Contributors NM and JP were responsible for the conception and design of the study, acquisition of the data, analysis and interpretation of the data, drafting and revising the manuscript, and approval of the final version. GZ was responsible for acquisition of the data, analysis and interpretation of the data, drafting and revising the manuscript, and approval of the final version. ALH and MGF contributed to the conception and design of the study, interpretation of the data, revising the manuscript, and approval of the final version. All authors discussed the results and commented on the manuscript. JP is a guarantor responsible for the overall content.

    • Funding JP was supported by a Postdoctoral Translational Scholars Program training grant from the Michigan Institute for Clinical & Health Research (UL1TR002240; PI: George Mashour).

    • Competing interests ALH is a consultant to Happify. NM, GZ, MGF and JP have no disclosures. All authors have read and approved the paper.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.