Does clinical depression bring about chronic pain? Or does pain lead to depression? Because these two conditions frequently co-exist--30 to 54 percent of patients with major depressive disorder also suffer persistent physical pain--there has been much speculation about whether one causes the other or whether a common underlying factor provokes both. Results of studies into the precise nature of this relationship, however, have been inconsistent.

To gain a clearer understanding of the depression-pain connection, researchers affiliated with the University of Michigan and the University of Cologne, Germany, focused on the underlying mechanisms in the perception of pain, physical and emotional: the brain. Their findings, featured in the May 2005 issue of Arthritis & Rheumatism (http://www.interscience.wiley.com/journal/arthritis), challenge existing notions on the interplay of emotion and sensation and have important implications for treating depression and pain as separate conditions, even when they occur simultaneously.

The study focused on 53 patients, 33 women and 20 men, with fibromyalgia (FM). This symdrome is characterized by intense widespread pain and tenderness to touch and is often accompanied by depression. Using this patient population, the research team set out to evaluate whether higher levels of symptoms of depression are associated with increased sensitivity to pressure-induced pain, as well as to determine which regions of the brain are involved in processing acute pain, chronic pain, and depressive symptoms. 42 healthy controls, 20 women and 22 men, were also included in the study. The mean age was 42 for the FM patients and 38 for the controls.

Conducted at Georgetown University's General Clinical Research Center, the study began by assessing the severity of chronic pain and depression in FM patients, through a combi
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Contact: Amy Molnar
amolnar@wiley.com
John Wiley & Sons, Inc.
5-May-2005

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