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J Addict Med. 2017 Mar/Apr;11(2):98-105. doi: 10.1097/ADM.0000000000000281.

Pain Interference, Psychopathology, and General Medical Conditions Among Black and White Adults in the US General Population.

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Department of Psychiatry (DTB, RAH, MNP), Yale University School of Medicine; APT Foundation Pain Treatment Services (DTB); Department of Biostatistics (CPG), Yale School of Public Health; Department of Neurobiology (RAH, MNP); Yale Child Study Center (MNP); CASA Columbia, Yale University School of Medicine (MNP); and Connecticut Mental Health Center, New Haven, CT (MNP).



To assess how race might moderate relationships between pain interference and psychopathology, and general medical conditions among a nationally representative sample of black and white adults.


Chi-square tests and multivariable logistic regression analyses were performed on data from the National Epidemiologic Survey on Alcohol and Related Conditions on 32,474 adult respondents (25% black, 75% white), who were categorized according to 1 of 3 levels of pain interference (ie, no/low, moderate, or severe).


Pain interference was associated with race in bivariate analyses (P < .001); relative to white respondents, black respondents had lower rates of no/low pain interference (78.9% vs 80.3%), lower rates of moderate pain interference (6.8% vs 7.8%), and higher rates of severe pain interference (14.3% vs 11.9%). Pain interference was associated with past-year axis I psychiatric disorders in both black and white respondents (P < 0.001) with the largest odds typically observed in association with moderate or severe pain interference. A stronger relationship was observed in black as compared with white respondents between severe pain interference and any axis I disorder (odds ratio [OR] 1.28, P < 0.05) and alcohol abuse or dependence (OR 1.90, P < 0.05), and between moderate pain interference and tachycardia (OR 1.69, P < 0.05). In contrast, a weaker relationship was observed in black as compared with white respondents between moderate pain interference and any general medical condition (OR 0.70, P < 0.05).


These findings underscore the complexity of race-related disparities in health and suggest the importance of further study of the possible mechanisms underlying the apparent differences between black and white groups in the relationships between pain interference, psychopathology, and general medical conditions.

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