EWAP 2009

Depression and Chronic Pain
European Week Against Pain – 12-19 October 2009
EFIC campaign on one of the most important pain co-morbidities

People with chronic pain have three times the average risk of developing psychiatric symptoms and depressed patients have three times the average risk of developing chronic pain. People in pain who are also suffering from depression typically use medical services very often, even if they have no severe underlying illness. But that doesn’t mean they receive better treatment.

QUALITY OF LIFE AND CHRONIC PAIN

Chronic pain is a complex experience that affects thought, mood, and behaviour and can lead to isolation, immobility, as well as drug dependence.

Chronic pain has an undoubted negative impact on sufferer’s daily lives. People report that chronic pain reduces their ability to undertake certain activities. It affects their independence and interpersonal relationships: One quarter of people feel that they cannot take care of themselves as they would like; 27% are less able or unable to maintain relationship with friends and family; 30% are less able to maintain an independent lifestyle; 19% are no longer able to have sexual relations. Suffering chronic pain also has a negative impact on people’s emotional health: 50% report feeling tired all the time; 43% report suffering from pain makes them feel helpless; 44% declare that their pain kept them from thinking or concentrating clearly; 16% think on some days, that their pain is so bad that they want to die. (Pain in Europe Survey data).

Chronic pain can make someone experience tremendous losses, such as the loss of exercise, sleep, social network, relationships, job and income. These losses may in turn be responsible for increasing the incidence/the risk of depression.
 

Pain is depressing, and depression causes and intensifies pain

People with chronic pain have three times the average risk of developing psychiatric symptoms and depressed patients have three times the average risk of developing chronic pain. People in pain who are also suffering from depression typically use medical services very often, even if they have no severe underlying illness. But that doesn’t mean they receive better treatment; studies show that they actually use fewer mental health services than other patients with mood disorders. According to some estimates, more than 50% of depressed patients who visit general practitioners complain only of physical symptoms, and in most cases pain is one of them. Other studies suggest that if physicians tested all pain patients for depression, they might discover 60% of currently undetected depression.

Pain slows recovery from depression

Pain slows recovery from depression, and depression makes pain more difficult to treat; for example, it may cause patients to drop out of pain rehabilitation programs. Worse, both pain and depression feed on themselves by changing both brain function and behaviour. Depression leads to isolation and isolation leads to further depression; pain causes fear of movement, and immobility is often the reason for further pain. When depression is treated, pain often fades into the background, and when pain goes away, so does depression.

Because depression goes frequently undiagnosed in chronic pain patients, it often goes untreated. Pain symptoms and complaints take centre stage on most doctor visits. Because of the emotional component of persistent pain, patients would benefit from a comprehensive assessment and multidisciplinary treatment.

The aim of the 2009-2010 campaign of the European Federation of IASP Chapters will be to educate health-care providers, government leaders and the general public about the issues surrounding this important pain co-morbidity.

EFIC represents the views of over 18.000 scientists, physicians, nurses, physiotherapists, psychologists and other healthcare professionals across Europe involved in the active management of chronic pain.

European Federation of IASP Chapters (EFIC)
www.efic.org