Association between sense of coherence and depression in patients with chronic pain: A systematic review and meta-analysis

Alejandra Aguilar-Latorre; Ángela Asensio-Martínez; Bárbara Oliván-Blázquez; Celia Álvarez-Bueno; Iván Cavero-Redondo; Christos Lionis; Emmanouil K Symvoulakis; Rosa Magallón-Botaya

doi:10.1371/journal.pone.0279959

Association between sense of coherence and depression in patients with chronic pain: A systematic review and meta-analysis

PLoS One. 2023 Jan 11;18(1):e0279959. doi: 10.1371/journal.pone.0279959. eCollection 2023.

Authors

Alejandra Aguilar-Latorre^{1

2}, Ángela Asensio-Martínez^{1

2

3}, Bárbara Oliván-Blázquez^{1

2

3}, Celia Álvarez-Bueno^{2

4

5}, Iván Cavero-Redondo^{2

4

6}, Christos Lionis⁷, Emmanouil K Symvoulakis⁷, Rosa Magallón-Botaya^{1

2

8}

Affiliations

¹ Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain.
² Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS, RD21/0016/0005), Carlos III Health Institute, Madrid, Spain.
³ Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain.
⁴ Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain.
⁵ Universidad Politécnica y Artística del Paraguay, Asunción, Paraguay.
⁶ Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca, Chile.
⁷ Clinic of Social and Family Medicine (CSFM), School of Medicine, University of Crete, Heraklion, Crete, Greece.
⁸ Department of Medicine, Psychiatry and Dermatology, University of Zaragoza, Zaragoza, Spain.

Abstract

Background: Chronic pain is a common complaint having distressing consequences for those that suffer from it. Pain and depression concur within the context of comorbidity, and both share underlying stress conditions. Sense of coherence (SOC) is a factor that determines how well an individual manages stress and stays healthy. Its relationship with depression has been frequently reported in the literature. Our objective was to assess the amount of evidence available regarding the association between SOC and depression in patients suffering from chronic pain.

Methods: A systematic review and meta-analysis were performed. Searches were conducted between November 01 and December 31, 2020 in PubMed, Web of Science, Embase, PsycINFO, Psicodoc, ScienceDirect and Dialnet. There were no restrictions regarding the date of publication of the study. Evidence related to the relationship between SOC and depression in patients with chronic pain was summarized and compared.

Results: A total of 163 articles were identified. We included 9 papers in the qualitative and quantitative synthesis. The pooled correlation coefficient was -0.55 (95%: -0.70; -0.41) and was not modified after removing any study. The heterogeneity across the studies was considerable (I2 = 94.8%; p < 0.001). The random-effects meta-regression models for the association between SOC and depression showed that age (p = 0.148) and percentage of women (p = 0.307) were not related to heterogeneity across studies. No publication bias was detected (p = 0.720).

Conclusions: At first glance, the included studies give the impression that SOC is an important factor in depression levels of patients with chronic pain. Most of the included studies revealed a moderate association between SOC and depressive symptoms.

Copyright: © 2023 Aguilar-Latorre et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Publication types

Meta-Analysis
Systematic Review
Research Support, Non-U.S. Gov't

MeSH terms

Anxiety
Chronic Pain* / complications
Comorbidity
Depression / complications
Depression / diagnosis
Female
Humans
Sense of Coherence*

Grants and funding

This work was supported by Carlos III Health Institute (ISCIII) grant number PI18/01336, the Aragonese Primary Care Research Group (GAIAP, B21_20R) that is part of the Department of Innovation, Research and University at the Government of Aragón (Spain) and the Institute for Health Research Aragón (IIS Aragón); the Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS, RD21/0016/0005) that is part of the Results-Oriented Cooperative Research Networks in Health (RICORS) (Carlos III Health Institute); and Feder Funds “Another way to make Europe”. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.