Mental health affects the quality of life and recovery after liver transplantation.

There has been little research examining the effects of mental health before liver transplantation on quality of life (QOL) and recovery after transplantation. Therefore, the purpose of the current study was to examine how pretransplant depression and anxiety affect mental health, QOL, and recovery after transplantation. Eighty-two transplant recipients provided data when they were listed for transplantation and 6 months after transplantation. Pretransplant anxiety predicted posttransplant anxiety (P < 0.001), and there was a trend in predicting posttransplant depression (P = 0.06). Pretransplant depression predicted posttransplant depression (P = 0.03), and there was a trend in predicting posttransplant anxiety (P = 0.06). Additionally, pretransplant anxiety predicted posttransplant QOL for several domains, including Body Pain, Role Limitations Due to Emotional Problems, and Mental Health, as well as the Mental Health Composite Score (P < 0.05). However, in comparison with anxiety, pretransplant depression independently predicted outcomes for more QOL domains, which included Physical Functioning, Role Limitations Due to Physical Problems, General Health, Vitality, and Social Functioning, as well as the Physical Composite Score (P < 0.05). Patients with depression at the baseline were more likely to report incomplete recovery 6 months after transplantation (P < 0.001). With respect to baseline anxiety, there was a trend suggesting that these patients were also more likely to report incomplete recovery (P = 0.09). These findings highlight the importance of evaluating transplant candidates both before and after transplantation for anxiety and depressive symptoms. Once patients with these symptoms are identified, they can be referred for treatment, which may lead to better posttransplant outcomes for mental health, QOL, and recovery.

A motivational therapeutic assessment improves pain, mood, and relationship satisfaction in couples with chronic pain.

UNLABELLED: The current study tested whether a therapeutic assessment improved pain and well-being in couples facing chronic pain. Couples (N = 47) in which 1 spouse had chronic pain completed surveys about pain, mood, marital satisfaction, and empathy, followed by an interview and an assessment session to which they were randomly assigned: a tailored assessment of their marriage and pain coping that incorporated motivational interviewing strategies, or a control condition that included education about the gate control theory of pain. Multilevel modeling revealed that couples in the motivational assessment group experienced significant decreases in pain severity and negative mood, and increases in marital satisfaction and positive mood from baseline to postassessment, relative to the education control group. All participants experienced increases in empathy toward their partner except for spouses in the control group, who experienced declines in spousal empathy. The motivational assessment and control groups did not experience differential change in any of the variables at 1-month follow-up. Moderators of improvement were also explored, including age, race, gender, education, pain duration, spouse pain status, and marriage duration. The results provide preliminary evidence for the short-term benefits of a brief motivational assessment to improve psychosocial functioning in both patients and spouses. PERSPECTIVE: This article presents preliminary evidence in support of a brief therapeutic psychosocial assessment for couples with chronic pain. Assessments such as this may potentially help patients and their spouses feel more optimistic about pain treatment and increase the likelihood of entering treatment.

Spouse beliefs about partner chronic pain.

UNLABELLED: Although research has shown that patients' beliefs about their pain are related to pain adjustment and treatment outcomes, little is known about the beliefs of their significant others. The purpose of this study was to develop a measure of pain beliefs in significant others and to examine the correlates of these beliefs. Participants were 104 married couples in which 1 partner reported chronic pain. Spouses completed an amended version of the Survey of Pain Beliefs (SOPA). The scale development procedure described in Jensen et al was used to select appropriate items for the significant other version of the SOPA. This procedure yielded 7 subscales that closely resembled the original SOPA. Spousal pain beliefs about disability, emotion, control, and medication were significantly correlated with partners' pain severity and other indicators of pain adjustment. Emotion, disability, and other beliefs were related to spouse responses to pain, and spouses' depressive symptoms and marital dissatisfaction. Spouses' personal experiences with pain were not related to their beliefs about their partners' pain. Additional research on the pain-related beliefs of significant others may extend cognitive-behavioral theory concerning the social context of pain and provide an additional avenue through which clinicians can address cognition in patients and families. PERSPECTIVE: This study describes a new measure that can be used to assess significant others' beliefs about their partners' pain problems. Little is known about the beliefs of family members so this measure is expected to provide a way for clinicians and researchers to assess and track changes in those beliefs.

Comorbid chronic pain and depression: who is at risk?

UNLABELLED: The purpose of this study was to investigate the prevalence and demographic risk factors of chronic pain and its comorbidity with depression. Computer-assisted telephone interviewing was utilized to obtain a representative community sample in the state of Michigan (n = 1,179). The prevalence of chronic pain due to any cause was 21.9%. Approximately 35% of participants with chronic pain also had comorbid depression (7.7% of the entire sample). Depression was not associated with pain types or sites. A multinomial-regression analysis revealed several demographic correlates of chronic pain and depression. Participants with chronic pain or comorbid pain and depression were more likely to be older, female, employed less than full-time, and have less education than persons without either condition. Logistic regression analyses showed that younger participants were more likely to have comorbid pain and depression than chronic pain only. A similar but marginally significant effect was found for African American participants. Compared to the depression-only group, those in the comorbid group were more likely to be women and middle-aged. These findings provide additional evidence on the prevalence of comorbid pain and depression in the community and suggest that certain demographic groups with chronic pain may especially benefit from depression screenings. PERSPECTIVE: This article reports on the prevalence of chronic pain and co-occurring depression in a representative community sample. The high prevalence rates of pain and comorbid depression point to the clinical importance of assessing depression in chronic pain samples.