Depression unrelated to level of chronic pain

June 3, 2005

Mon May 30, 2005 10:25 AM ET

By Karla Gale

NEW YORK (Reuters Health) - Individuals with depression often suffer

from chronic physical pain and chronic pain sufferers are often

depressed. A new study shows that both conditions should be tackled

separately and independently from each other.

" There is a sense in clinical practice that if someone has both pain

and depression, that maybe depression is causing the pain and if you

address depression the pain will get better, " Dr. J. Clauw from

the University of Michigan in Ann Arbor told Reuters Health. His

group's findings contradict that theory.

Does depression bring about pain? Or does pain lead to depression?

Because these two conditions frequently co-exist, there has been much

speculation about whether one causes the other or whether a common

underlying factor provokes both, Clauw and colleagues note in a report

in the medical journal Arthritis and Rheumatism.

To investigate, they studied 53 patients with fibromyalgia, a condition

characterized by widespread pain and tenderness to the touch, which is

often accompanied by depression. They also studied 42 healthy controls.

Based on results of brain imaging studies and a thumbnail pressure

test, the researchers found that fibromyalgia patients needed much less

applied pressure to the thumbnail than healthy controls to activate

neurons associated with acute pain. This heightened sensitivity to pain

applied to fibromyalgia patients, regardless of whether or not they

were depressed.

Additionally, according to the researchers, there was only a weak link

between sensory regions of the brain associated with pain and emotional

regions of the brain associated with depression.

While depression and pain often occur concurrently, that does not mean

they're the same underlying problem and can be managed in the same way,

Clauw said. Therefore, prescribing an antidepressant will not

necessarily relieve the suffering of a depressed patient whose pain is

not only real but also intensely physical, he and colleagues note.

SOURCE: Arthritis and Rheumatism May 2005.

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