{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T09:49:23Z","timestamp":1791625763877,"version":"4.3.4"},"reference-count":39,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T00:00:00Z","timestamp":1779062400000},"content-version":"vor","delay-in-days":17,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Brain and Behavior"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Arthritis manifests with joint pain and stiffness that impair physical function and significantly elevate depression risk. However, the magnitude of pain's impact on depressive symptoms and related factors in arthritis patients warrants further investigation. Clarifying this association and its mechanisms is important for improving mental health and quality of life in this population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>This study analyzed data from the China Health and Retirement Longitudinal Study (CHARLS) in 2020, focusing on 1020 patients with arthritis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Depressive symptoms were assessed using the 10\u2010item Center for Epidemiologic Studies Depression Scale (CESD\u201010), with a score \u226510 defining the presence of clinically significant depressive symptoms. Univariate analysis was performed using the Chi\u2010square test. A binary logistic regression model was employed to examine the association between pain intensity (binary: present\/absent) and depressive symptoms, while controlling for multiple covariates, including demographics, health behaviors, and functional status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among the 1020 arthritis patients, the presence of pain significantly increased the risk of depressive symptoms (OR = 1.743,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.002). Older age (OR = 0.982,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.042), a higher educational level (e.g., high school or above: OR = 0.446,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.005), better self\u2010rated health (OR = 0.408,\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001), possessing internet use skills (OR = 0.625,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.004), and retaining housework ability (OR = 0.466,\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001) were identified as protective factors against depressive symptoms. Stratified analyses further revealed that the association between pain and depression was more pronounced among males, patients aged &lt;65 years, and those with lower educational attainment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study confirms that pain is an independent risk factor for depressive symptoms in arthritis patients, and this association exhibits heterogeneity across demographic subgroups. Higher educational attainment, positive self\u2010rated health, and maintenance of daily functional and social connectivity serve as psychological protective resources. Clinical practice should identify high\u2010risk patients and implement personalized strategies integrating pain management, psychological support, and functional promotion to alleviate depressive symptoms and enhance health.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/brb3.71493","type":"journal-article","created":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T05:30:38Z","timestamp":1779168638000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Association Between Depressive Symptoms and Pain Intensity in Patients With Arthritis"],"prefix":"10.1002","volume":"16","author":[{"given":"Limei","family":"Jiang","sequence":"first","affiliation":[{"name":"Shandong University of Traditional Chinese Medicine  Jinan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming","family":"Tang","sequence":"additional","affiliation":[{"name":"Shandong Provincial Hospital Affiliated to Shandong First Medical University  Jinan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yufan","family":"Zheng","sequence":"additional","affiliation":[{"name":"Affiliated Hospital of Shandong University of Traditional Chinese Medicine  Jinan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yao","family":"Zhang","sequence":"additional","affiliation":[{"name":"Shandong College of Traditional Chinese Medicine  Yantai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Li","sequence":"additional","affiliation":[{"name":"Shandong University of Traditional Chinese Medicine  Jinan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qingyue","family":"Kong","sequence":"additional","affiliation":[{"name":"Shandong University of Traditional Chinese Medicine  Jinan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fujie","family":"Jing","sequence":"additional","affiliation":[{"name":"Shandong University of Traditional Chinese Medicine  Jinan China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,18]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.304"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.1080\/19338244.2014.955164"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.1080\/07370016.2022.2077072"},{"issue":"3","key":"e_1_2_14_5_1","first-page":"302","article-title":"Depressive Symptoms Among Patients With Diabetes in Qatar: Frequency and Potential Determinants","volume":"9","author":"Bawadi H.","year":"2021","journal-title":"Healthcare (Basel, Switzerland)"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/geront\/gnw002"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nedt.2016.06.001"},{"key":"e_1_2_14_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1752-0606.1977.tb00446.x"},{"key":"e_1_2_14_9_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnmol.2022.886916"},{"issue":"4","key":"e_1_2_14_10_1","article-title":"Pain Management in Pediatric Age. 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