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Listen to our newest podcast episode where the lead author of a recent meta-analysis shares his findings on the safety and efficacy of antidepressant medications to treat back and osteoarthritis pain. 

Primary Viewpoints Episode 7: Antidepressants for Back Pain, Osteoarthritis Pain

Many people with arthritis also have depression; this has been known for many years. Now it has been established that anxiety is even more common than depression among arthritis patients, in a study published in 

by authors from the Centers for Disease Control and Prevention. In this podcast, Dr. Elizabeth Lin (who was not involved with the CDC study, but has focused on comorbid depression and pain for many years) discusses  why and how the mental health problem  as well as the physical symptoms need to be addressed and resolved. 

Dr. Lin is a family medicine physician at Group Health Institute and clinical professor of psychiatry at University of Washington Medical School in Seattle.



 1. What's new about this study?
 2. Could you tell us a little bit about how the study was done and what you think of the results?
 3. What do you think doctors should do to assess their patients who have arthritis or anxiety or depression or both?
 4. What about the risk of interactions between the two drugs? Isn't it difficult to treat patients with drugs that affect their mood as well as drugs that affect their pain?
 5. Do you think that when it comes to treating these mood disorders it would be wise to refer to a mental health professional?
 6. What about followup? How frequently should a patient who has this comordibity be seen in the office?  

Arthritis, Anxiety, and Depression: Managing a Common Comorbidity

Anxiety is more common than depression among US adults with arthritis 

Generalized Anxiety Disorder 7-item scale (GAD-7)  

Effect of improving depression care on pain and function among older adults with arthritis: A randomized controlled study. 

Pharmacotherapy of pain in depressed older adults. 

Arthritis pain and disability:  Response to collaborative depressive care. 

Anxiety is even more common than depression among people who have arthritis, a new study has shown. Here to discuss the implications for diagnosis and treatment is  Eilzabeth Lin MD, a family medicine physician who is a longstanding researcher in the field of depression and pain.

Podcast:  Arthritis, Anxiety, and Depression: Managing a Common Comorbidity

Among women with normal initial bone mass who took part in a major osteoporosis study, only 10% developed osteoporosis within 15 years. What are the implications of this knowledge for best practices in osteoporosis screening? Dr Margaret Gourlay, lead author of the report in 

tells what you should take into account as you work with patients to decide how often they need a bone density test. Dr Gourlay is Assistant Professor of Family Medicine at the University of North Carolina at Chapel Hill.

1. No previous studies have documented the best screening intervals for osteoporosis.

2. For women aged 67 and older who have an initial T score greater than -1.5, retrospective analysis of data from a large cohort study suggests the next bone density test may not be informative within the next 15 years. In general, these women progress very slowly to osteoporosis.

3. For women with lower initial T scores, especially older women, screening is justified more often.

4. All women aged 65 and older should have an initial bone density test. Too few women in this age group are receiving bone density measurements.

Judging Osteoporosis Screening Intervals From the Latest T Score

Osteoporosis Study Suggests Bone Density Testing Intervals for Older Women

Bone-Density Testing Interval and Transition to Osteoporosis in Older Women

Data from a long-term prospective study reveal that for many older women, the pace of bone mass deterioration takes place on the scale of decades, not single years. Here, the lead author of the study describes how to interpret the results to choose the date for your own patient's next bone density test.

Podcast: Judging Osteoporosis Screening Intervals From the Latest T Score

What’s new in the treatment of osteoporosis?

That’s the question we put to Dr. Kenneth Saag, who is Jane Knight Lowe Professor of Medicine in the Division of Clinical Immunology and Rheumatology at the University of Alabama at Birmingham. In the next few minutes, Dr Saag, who is also  Professor of Epidemiology, at the UAB School of Public Health, will summarize the latest developments in osteoporosis therapy.

What’s New in the Treatment of Osteoporosis?

That’s the question we put to Dr. Kenneth Saag. In the next few minutes, Dr. Saag, will summarize the latest developments in osteoporosis therapy.

That's the question we put to Dr. Leigh Callahan, and in the next 10 minutes, she will address this important issue. Dr. Callahan has over 20 years of experience in arthritis and health outcomes research, and she was an arthritis epidemiologist at the CDC. She is associate professor in the departments of medicine and social medicine and adjunct associate professor in the department of epidemiology at the University of North Carolina at Chapel Hill. She is also director of methology at the Thurston Arthritis Research Center, also in Chapel Hill.

What Role Does Physical Activity Play in the Management of Arthritis?

CDC Division of Nutrition, Physical Activity and Obesity – Physical Activity for Everyone

National Institute of Aging –Your Every Day Guide to Exercise and Physical Activity

American College of Rheumatology – Exercise and Arthritis 

That's the question we put to Dr. Leigh Callahan, and in the next 10 minutes, she will address this important issue. Dr. Callahan has over 20 years of experience in arthritis and health outcomes research, and she was an arthritis epidemiologist at the CDC.

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