RT Journal Article
T1 Association between alcohol consumption and chronic pain: a systematic review and meta-analysis
A1 Karimi, Roya
A1 Mallah, Narmeen
A1 Nedjat, Saharnaz
A1 Beasley, Marcus J
A1 Takkouche, Bahi
K1 Chronic pain
K1 Depression
K1 Meta-analysis
K1 Pain
K1 Sleep
K1 Structural equation modelling
AB Introduction: Chronic pain and depression represent two global health problems with considerable economic consequences. While the existing literature reported on the relation between depression and pain conditions, meta-analytic evidence backing the mediating role of sleep disturbance as one of the main symptoms of depression is scarce. To examine the extent to which sleep disturbance mediates the depression- chronic pain association, we conducted a systematic review and meta-analysis of the associations of chronic pain, depression, and sleep quality. Methods: We systematically searched for literature in Medline and other relevant databases and identified cohort and case-control studies on depression, sleep disturbance, and chronic pain. Fourty-nine studies were eligible, with a total population of 120,489 individuals. We obtained direct and indirect path coefficients via two-stage meta-analytic structural equation modelling (TSSEM), examined heterogeneity via subgroup analyses, and evaluated primary studies quality. Results: We found a significant, partial mediation effect of sleep disturbance on the relation between depression and chronic pain. The pooled path coefficient (coef.) of the indirect effect was 0.03 (95% confidence interval (CI): 0.01-0.05) and accounted for 12.5% of the total effect of depression on chronic pain. This indirect effect also existed for cohort studies (coef. = 0.02, 95%CI: 0.002-0.04), European studies (coef. = 0.03, 95% CI: 0.004-0.05), and studies that adjusted for confounders (coef. = 0.04, 95% CI: 0.010.09). Conclusion: Sleep disturbance partially mediates the association between depression and pain. Although plausible mechanisms could explain this mediation effect, other explanations, including reverse causation, must be further explored.
PB Elsevier
YR 2022
FD 2022-09-01
LK http://hdl.handle.net/10347/32833
UL http://hdl.handle.net/10347/32833
LA eng
NO British Journal of Anaesthesia, Volume 130, Issue 6, 2023, Pages 747-762
DS Minerva
RD 28 abr 2026