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Depression and Anxiety

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PSYCHIATRIC COMORBIDITY IN CHRONIC PAIN: CHICKEN OR EGG?

It seems a matter of common sense to say that people suffering from unremitting pain are likely to suffer from low mood and anxiety. Indeed, it would be odd for such individuals not to experience psychological impact from the physiological problems they are faced with.

Chronic pain symptoms are often confused with symptoms of depression/anxiety, and some researchers suggest that pain is the best indicator of depression in certain populations, such as the elderly.

As Melzack, and his colleague Casey remarked ([1]):

"To consider only sensory features of pain, and ignore motivational and affective  properties, is to look at only part of the problem, and not even the most important one at that."

Specialists have referred to "the ?terrible triad' of suffering, sleeplessness, and sadness, a calamity that is as hard on the family as it is on the victim" ([2])

However, there remains a long running debate as to which came first, the depression or the pain, and can pain result from depression rather than vice versa?


[1] Melzack R, Casey KL The Skin Senses Springfield IL: Charles C Thomas, 1968, pp.423-443

[2] from: Chronic Pain by The National Institute of Neurological Disorders and Stroke: NINDS
 


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