Perceived pain in AIDS patients often linked to anxiety, depression

Perceived pain in AIDS patients is often associated with pain distress, anxiety and depression, according to a report in the December 2000 issue of AIDS Patient Care and STDs. These findings may help clinicians identify patients who are at increased risk of perceived pain, according to the study’s author, Dr. Mary Jane Rotheram-Borus, of the University of California at Los Angeles.

Dr. Rotheram-Borus collected data for 151 AIDS patients from in-home interviews that asked about symptoms, health status, utilization of medical services and emotional distress. The majority of patients were Latinos (42%), while 39% were African-Americans, 9% were non-Latino whites (9%) and 11% were from other racial or ethnic groups. Most of the participants, 83%, reported having AIDS-related pain within the previous 3 months. Joint and muscle pain was reported by 75%, numbness and pain in the extremities by 69%, headache by 68%, and nausea, vomiting and abdominal pain by 58%.

Dr. Rotheram-Borus found that emotional distress, depression and anxiety were all significantly associated with the number of pain symptoms. In addition, Latinos were more likely to report pain than were African-Americans. In multiple regression analysis, however, only higher levels of emotional distress and fewer months since AIDS diagnosis were significantly associated with the number of pain symptoms.

The inverse association between months since AIDS diagnosis and perceived pain was “surprising,” Dr. Rotheram-Borus points out. One possible explanation is that the higher level of perceived pain in an earlier disease stage stems from “a high level of stress associated with the event of diagnosis itself,” she suggests.

“Clinicians may identify groups of people living with AIDS at heightened risk of distress, depression and anxiety related to perceptions of pain,” Dr. Rotheram-Borus writes. She notes that “subgroups of patients varying in perceived pain may lead providers to manage pain in very different ways in these clinical practices.”