Bair MJ, Robinson RL, Katon W, Kroenke K. Depression and pain comorbidity: a literature review. Arch Intern Med 163: 2433-2445

Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Archives of Internal Medicine (Impact Factor: 17.33). 12/2003; 163(20):2433-45. DOI: 10.1001/archinte.163.20.2433
Source: PubMed


Because depression and painful symptoms commonly occur together, we conducted a literature review to determine the prevalence of both conditions and the effects of comorbidity on diagnosis, clinical outcomes, and treatment. The prevalences of pain in depressed cohorts and depression in pain cohorts are higher than when these conditions are individually examined. The presence of pain negatively affects the recognition and treatment of depression. When pain is moderate to severe, impairs function, and/or is refractory to treatment, it is associated with more depressive symptoms and worse depression outcomes (eg, lower quality of life, decreased work function, and increased health care utilization). Similarly, depression in patients with pain is associated with more pain complaints and greater impairment. Depression and pain share biological pathways and neurotransmitters, which has implications for the treatment of both concurrently. A model that incorporates assessment and treatment of depression and pain simultaneously is necessary for improved outcomes.

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Available from: Rebecca L Robinson, Dec 19, 2013
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    • "The coexistence of pain and depression significantly increases the risk of negative clinical outcomes. Moreover, shared biological pathways have been described between the two (e.g., dysregulation of serotonin and norepinephrine associated with depression also influences the transmission of nociceptive signals) (Bair MJ et al., 2003). "
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    • "Chronic pain is related to an increased risk for depressive mood and anxiety disorders (Gerrits et al., 2012). According to a systematic review, 52% of pain patients presented with major depression (Bair et al., 2003). Furthermore, people that present with multiple pain symptoms are 3 to 5 times more likely to be depressed than Fig. 2. Pain-induced by crush neuropathic pain model. "
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