Explaining the Relationship between Pain and Depressive Symptoms in African-American and White Women with Arthritis

Arthritis is a common chronic illness that disproportionately affects women and African Americans and is often associated with depression. The mechanisms through which arthritis-related pain are associated with depression remain unclear. This study examined the relationship between arthritis-related pain and depressive symptoms to determine if functional impairment and sense of mastery mediated this relationship. Participants included 77 African-American and 98 white women with arthritis (aged 45-90) who completed structured questionnaires assessing pain, functional impairment, sense of mastery and depressive symptoms. Regression analyses showed that sense of mastery and functional impairment partially mediated the relationship between pain and depressive symptoms for whites such that the previously significant pain-depression relationship (β=0.40, p<0.001) was no longer significant (β=0.05, p=0.62). Only sense of mastery partially mediated between pain and depressive symptoms for African Americans. Again, the previously significant pain-depression relationship (β=0.32, p<0.01) was reduced (β=0.16, p=0.19). Implications of the study suggest that it is important for service providers and healthcare professionals to be aware of different lifetime experiences and perceptions of illness in order to better serve the needs of women from different race groups.