Depression and Opioid Misuse in Elderly Individuals With Chronic Pain: A Latent Class Analysis

Chronic pain patients tend to have comorbid depressive symptoms, and empirical data investigating differences related to depressive symptoms classes and opioid misuse are scant. The aim of this study was to identify heterogeneous depressive symptoms trajectories in elderly individuals with chronic pain who take opioids, and investigate the association between depressive symptoms subgroups and opioid misuse. Secondary data analysis of a cross-sectional study. Twelve communities were selected from a city in Shandong Province, China, using multi-stage cluster sampling. Individuals aged ≥60 years with self-reported chronic pain lasting more than one year and who took opioids under prescription were screened. Latent class analysis was used to identify homogeneous depressive symptoms groups within the elderly population with chronic pain. Multinomial logistic regression, and one-way analysis of variance were also performed. The best-fitted model suggested three depressive symptoms subgroups: “Impaired Memory,” “Perceived Stress in Life and Work,” and “Low Mood.” Age, education level, and marital status were depression risk factors. The odds of opioid misuse varied among the depressive symptoms subgroups. These findings may help improve depressive symptoms and chronic pain management by identifying high-risk elderly individuals for early intervention and personalizing treatment according to the depressive symptoms subgroup and severity of opioid misuse.