NEUROPSYCHOLOGICAL MARKERS OF DEPRESSION IN CHRONIC PAIN PATIENTS: A PREDICTIVE MODEL FOR EARLY INTERVENTION

Abstract

Introduction Chronic pain and depression are commonly comorbid and their relationship is complex and contributes to substantial impairment in quality of life, and cognitive functioning among patients. These studies provide evidence that neurocognitive deficits, particularly in executive function, attention, and working memory, may be potential markers of early detection of depression in chronic pain cohorts. Objective: To identify neuropsychological markers of depression in chronic pain, and to develop a model for intervention based on cognitive performance. Methodology: hundred and twenty chronic pain patients between 25-60 years of age were recruited according to cross-sectional design. Participants underwent the Beck Depression Inventory (BDI-II), PHQ-9, Stroop Test, Trail Making Test (Parts A&B), and Digit Span Task. The correlation and regression analyses were performed to investigate the relationship of cognitive performance with the level of depression. A prediction model for depression risk was constructed by logistic regression. Results: Elevated depression levels were correlated with decreased Stroop scores, Trail Making Test scores, and Digit Span Task scores. Cognitive markers reliably predicted depression severity, explaining 46% of the variance in BDI scores. The best fitting logistic model had 84.7% accuracy, and an area under the curve (AUC) of 0.89 for identifying depression risk. Conclusions Neuropsychological dysfunctions, especially executive function and working memory, are markers of depression in chronic pain patients. Introduction: Adding cognitive screenings to the clinical evaluation could enhance early detection and assist in appropriately early intervention.