OT: Study: Treat Depression, Pain Separately

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Study: Treat Depression, Pain Separately

Thursday, May 05, 2005

By Miranda Hitti

 

http://www.foxnews.com/story/0,2933,155642,00.html

 

Depression often accompanies chronic pain, but the two conditions may

best be treated separately, a study in May's Arthritis & Rheumatism shows.

 

The study centered on people with fibromyalgia -- a syndrome

characterized by a history of chronic, widespread pain and tenderness to

touch. Many of these patients also may suffer from depression.

 

" There is an incorrect impression among many doctors that if you treat a

patient's depression, it will make their pain better. Not so, " says

researcher Daniel J. Clauw, MD, in a news release.

 

" If someone has pain and depression, you have to treat both, " says

Clauw. He is a rheumatology professor at the University of Michigan and

the director of the University of Michigan's Chronic Pain and Fatigue

Research Center.

 

It's possible that the findings could apply to other patients with

chronic pain conditions, the news release notes. However, the study only

looked at chronic pain and depression with fibromyalgia. They show that

brain regions activated by pain are different from those activated by

depression.

 

Finding From Fibromyalgia Study

 

Clauw's study tracked depression and pain in 33 women and 20 men

diagnosed with fibromyalgia and 42 people who did not have fibromyalgia.

 

Researchers scanned participants' brain activity in regions that process

pain sensation.

 

The findings showed that the existence or level of depression in people

with fibromyalgia did not modulate pain sensation. In other words, the

magnitude of pain was only weakly associated with self-reported depression.

 

However, depression was associated with the level of activity in brain

regions that process the emotional aspects of pain.

 

Clauw and colleagues say their results are consistent with the findings

of a number of other studies.

 

Pain-Depression Pattern

 

" We have seen that if you give antidepressants to the average patient

with fibromyalgia, they'll come back a couple of months later and say,

'My pain isn't' any better, but I don't feel so sad about it,' " says

Clauw in the news release.

 

" Our research provides further evidence that these pathways are quite

independent, " he says.

 

" Much has been made of the overlap and similarities between pain and

symptoms of depression, but these and other data suggest it is also

important to identify pain processing mechanisms that are independent of

mood, " write the researchers.

 

The study did not involve prescribing antidepressants for participants.

 

Widespread Problems; Help Is Available

 

Depression is extremely common in the U.S., affecting nearly 19 million

adults (or 9.5 percent of the population) per year, says the National

Institute of Mental Health. Not all of those people also have chronic pain.

 

" Major depressive disorder is often found in conjunction with chronic

pain, with a prevalence of 30 percent-54 percent among tertiary care

patients, " write researchers.

 

Depression can be treated, and chronic pain can be managed. Asking for

help is the first step; resources include doctors and mental health

professionals.

 

By Miranda Hitti, review by Brunilda Nazario, MD

 

SOURCES: Giesecke, T. Arthritis & Rheumatism, May 2005; vol 52: pp

1577-1584. News release, University of Michigan. National Institute of

Mental Health, " Depression. " WebMD Medical Reference from Healthwise:

" Chronic Pain - Treatment Overview. " News release, John Wiley & Sons.

 

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