Chronic Pain as a Variant of Depressive Disease The Pain-Prone Disorder

Blumer, Dietrich; Heilbronn, Mary

doi:10.1097/00005053-198207000-00001

Cited by 570 publications

(215 citation statements)

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“…Our results provide evidence in support of an association between chronic pain and anxiety disorders as well as the first large cross-national evidence that the association of chronic pain with both mood and anxiety disorders extends to non-Western countries. The notion that chronic pain is a variant of depression (Blumer and Heilbronn, 1982), or is a depressive equivalent or masked depression (Magni and De Bertolini, 1983), is not consistent with our findings, as anxiety disorders showed a comparable level of association with pain at single and multiple anatomic sites. That is, chronic pain condition, either in single or multiple anatomic sites, is no less related to anxiety than it is to depression.…”

Section: Discussioncontrasting

confidence: 89%

The relation between multiple pains and mental disorders: Results from the World Mental Health Surveys

Gureje

Korff

Kola

et al. 2008

Pain

289

170

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It is unclear whether differences exist in the prevalence of mood, anxiety and alcohol use disorders among persons with multiple pain conditions compared with those with single pain problems. We conducted population surveys in 17 countries in Europe, the Americas, the Middle East, Africa, Asia, and the South Pacific. Participants were community-dwelling adults (N = 85,088). Mental disorders were assessed with the Composite International Diagnostic Interview. Pain was assessed by self-report. Both multiple and single site pain problems were associated with mood and anxiety disorders, but not with alcohol abuse or dependence. In general, the prevalence of specific mood and anxiety disorders followed a linear pattern with the lowest rates found among persons with no pain, intermediate rates among those with one pain, and highest rates among those with multi-site pain problems. Relative to persons not reporting pain, the pooled estimates of the age-sex adjusted odds ratios were 1.8 (1.7-2.0) for mood disorders and 1.9 (1.8-2.1) for anxiety disorders for persons with single site pain; 3.7 (3.3-4.1) for mood disorders and 3.6 (3.3-4.0) for anxiety disorders among those with multi-site pain. Our results indicate that the presence of multiple pain conditions was strongly and comparably associated with mood and anxiety disorders in diverse cultures. This consistent pattern of associations suggests that diffuse pain and psychiatric disorders are generally associated, rather than diffuse pain representing an idiom for expressing distress that is specific to particular cultural settings or diffuse pain solely representing a form of masked depression. Ó

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Section: Discussioncontrasting

confidence: 89%

The relation between multiple pains and mental disorders: Results from the World Mental Health Surveys

Gureje

Korff

Kola

et al. 2008

Pain

289

170

View full text Add to dashboard Cite

show abstract

“…While some authors have argued for a causal link between these conditions (40), others have argued that nonspecific pain is a depression symptom or a form of masked depression (41), and therefore it is not possible to distinguish them. Even among those researchers who believe in a causal link between these conditions, there is no agreement regarding the direction of the causality.…”

Section: Discussionmentioning

confidence: 99%

Symptoms of Depression and Risk of New Episodes of Low Back Pain: A Systematic Review and Meta‐Analysis

Pinheiro

Ferreira

Refshauge

et al. 2015

Arthritis Care & Research

151

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Objective. To investigate the contribution of symptoms of depression to future episodes of low back pain (LBP). Methods. A search was conducted of AMED, CINAHL, Embase, Health and Society (H&S), LILACS, MEDLINE, PsycINFO, Scopus, and Web of Science databases. We included cohort studies investigating the effect of symptoms of depression on the development of new episodes of LBP, either lifetime incidence or a recurrent episode, in a population free of LBP at baseline. We accepted the original study's definition for a new episode of LBP, and for classifying patients as LBP-free at study entry. Two independent investigators extracted data and assessed methodological quality. Meta-analyses with random effects were used to pool risk estimates. Results. We included 19 studies, with 11 incorporated in the meta-analyses. Overall pooled results showed that symptoms of depression increased the risk of developing LBP (odds ratio [OR] 1.59, 95% confidence interval [95% CI] 1.26-2.01). The risk was similar in studies that used the diagnostic interview method (OR 1.66, 95% CI 1.14-2.42) and in studies using selfreport screening questionnaires (OR 1.68, 95% CI 1.05-2.70). No statistically significant relationship was observed when we pooled studies that employed nonspecific screening questionnaires (OR 1.17, 95% CI 0.48-2.87). Three studies provided results in incremental categories of symptoms of depression and the pooled OR for the most severe level of depression (OR 2.51, 95% CI 1.58-3.99) was higher than for the lowest level (OR 1.51, 95% CI 0.89-2.56). Conclusion. Individuals with symptoms of depression have an increased risk of developing an episode of LBP in the future, with the risk being higher in patients with more severe levels of depression.

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“…Fibromyalgia was once thought to be a psychogenic syndrome because of the absence of laboratory or radiographic abnormalities and the lack of significant histopathologic changes in the painful tissues (5,6). If family and/or psychological factors are strongly related to fibromyalgia, a number of differences between children with fibromyalgia and healthy controls or children with a known organic illness (e.g., juvenile rheumatoid arthritis [JRA]) should be found.…”

Section: Discussionmentioning

confidence: 99%

Primary juvenile fibromyalgia. Psychological adjustment, family functioning, coping, and functional disability

Reid¹,

Lang²,

McGrath³

1997

Arthritis & Rheumatism

154

102

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Objectives. 1) To determine the importance of psychological adjustment and family functioning in primary juvenile fibromyalgia by assessing these factors in children with fibromyalgia and in their parents, compared with children with juvenile rheumatoid arthritis (JRA) and with pain-free control children and their parents. 2) To examine which of these factors predict functional disability.Methods. Fifteen children in each of the 3 study groups, and their parents, completed self-report questionnaires and pain diaries. A medical evaluation of each child was performed, including assessment of tender points by palpation and by dolorimetry.Results. All children in the fibromyalgia group met the Yunus and Masi criteria for fibromyalgia, and 11 met the American College of Rheumatology criteria. There were almost no significant group differences in the children's or parents' psychological adjustment, ratings of family functioning, or coping strategies. Significant group differences in functional disability, pain, fatigue, tender point threshold, and control point tolerance were found. A number of the psychological adjustment, pain, fatigue, and coping variables were significantly associated with functional disability. Conclusion. The notion that fibromyalgia is a psychogenic condition is not supported by these results. Fibromyalgia is associated with disability of a magnitude comparable to that of other chronic pain conditions. Disability among children with fibromyalgia or JRA is a function of the children's psychological adjustment and physical state, and of the parents' physical state and method of coping with pain.

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Chronic Pain as a Variant of Depressive Disease The Pain-Prone Disorder

Cited by 570 publications

References 0 publications

The relation between multiple pains and mental disorders: Results from the World Mental Health Surveys

The relation between multiple pains and mental disorders: Results from the World Mental Health Surveys

Symptoms of Depression and Risk of New Episodes of Low Back Pain: A Systematic Review and Meta‐Analysis

Primary juvenile fibromyalgia. Psychological adjustment, family functioning, coping, and functional disability

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