Pain and moodThe Interface of Pain and Mood Disturbances in the Rheumatic Diseases
Section snippets
Methods
A literature search was performed through PubMed and Medline, for the years 1978 to 2008 and using the keywords depression, mood disorders, pain, arthritis, fibromyalgia, rheumatoid arthritis, osteoarthritis, systemic lupus erythematosus, scleroderma, antidepressants, exercise, and cognitive behavioral therapy (CBT). All English language scientific papers pertaining to those subjects were reviewed. Any reports with both pain and depression as keywords were carefully evaluated.
There were very
The Pain/Depression Overlap
At any 1 time, 10 to 20% of the population reports generalized pain (4, 5, 6). Mood disturbances are also ubiquitous. In one's lifetime, 46% of the U.S. population will have a psychiatric disorder. The lifetime prevalence of depression in the United States is 12% in men and 20% in women (7). Thus, by chance alone, mood disturbances and chronic pain will often coexist. However, this coexistence is so prevalent that it has been designated as the pain-depression dyad.
In a population sample of 3032
Discussion
This review provides a basis for understanding the importance of the pain/depression interface in the rheumatic illnesses. Most of the literature, especially regarding potential pathophysiologic mechanisms, have focused on poorly understood chronic pain disorders, such as headaches and chronic back pain. Extensive clinical and mechanistic studies of FM during the past 20 years can be extrapolated to provide a better understanding of the pain/depression interface in RA and other chronic
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Dr. Goldenberg is a consultant and on the Advisory Board for Pfizer, Lilly, and Forest Pharmaceuticals.