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• W335104180 abstract "Abstract Objectives: To review the prevalence of painful somatic symptoms in depressed patients, and to evaluate the significance of such symptoms in modulating the course and outcome of the disorder. Methods: Online databases including PubMed, Ovid, and Medline were searched using the key words: 'depression', 'dysthymia', 'hypochondriasis', 'pain', 'painful somatic symptoms', 'somatoform disorders', and 'somatisation'. Clinical studies published in recent 20 years (1986-2006) related to the co-occurrence of unexplained pain and depression were selected and reviewed. Results: Six reviews and 11 original articles were selected. Among them, 6 recent clinical studies showed the prevalence of painful symptoms in diagnosed depressive western populations ranged from 43.4 to 92%, depending on the study setting and adopted research scales. Wide variations in the assessment of pain and depression were observed. Three longitudinal studies showed a negative effect of co-morbid pain on depression in respect of treatment response, quality of life, functional and economic burdens. Conclusion: Co-morbid pain and depression is common in western populations, but its prevalence remains unknown in other communities. Despite its clinical importance, the lack of evidence to conclude the significance of co-morbid pain in modulating depressive symptomatology suggests the need for more clinical research in this area. Key words: Comorbidity; Depressive disorder, major; Pain; Somatoform disorders [TEXT NOT REPRODUCIBLE IN ASCII] Introduction It is now well-established that pain and depression are related. (1-3) The frequent co-occurrence of depression and somatic symptoms poses a continuing challenge to clinicians and researchers. (3,4) A large proportion of patients with a somatoform disorder also satisfied the criteria for other psychiatric disorders, especially affective disorder. (3,5) Somatisation is the process by which psychological distress is experienced and communicated in the form of somatic symptoms but has no pathophysiological explanation. (6) Persistent somatisation is associated with a broad spectrum of heterogeneous psychiatric diagnoses and syndromes, imposing a serious burden on the mental health care system. (7,8) Regarding personal burdens, since within these somatic symptoms, painful physical symptoms without diagnosed pathology (including headaches and backaches) are common, they can result in distress, dysfunction, and even disability. (9-11) Although the underlying mechanism of the reciprocal relationship between painful somatic symptoms and depression is still unclear, different theories of the pain-depression relationship suggest the possibility of multiple levels involvement including different neurobiological, psychological, and behavioural mechanisms. (3,4,12) Clinically, there was a high prevalence of anxiety, depression, and severe impairment in health-related quality of life in Hong Kong among Chinese patients with chronic non-cancer pain. (13) Despite the fact that depressive symptoms in patients with chronic pain have been well-researched in a wide range of clinical settings, pain which can be one of the medically unexplained somatic symptoms in people with depression has attracted much less attention, as shown by the limited number of existing retrospective or cross-sectional studies. (14,15) Most of the studies concerned the prognostic value of depression for poor pain outcomes but not the reverse. (14) Although pain can be a predictor of depressive symptoms in some specific groups in primary care such as American women, (15) and Chinese elderly, (16) there is no conclusion about the significance of coexistence of painful somatic and depressive symptoms in clinical settings. In short, besides the lack of prospective studies, other problems include ill-defined and poorly targeted study sampling. (11,15) In addition to the overlap among different psychiatric diagnoses and a lack of well-designed clinical studies, cultural effects further complicate evidence-based evaluation of co-morbid pain in modulating depressive symptoms. …" @default.
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• W335104180 date "2006-12-01" @default.
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• W335104180 title "The Impact of Painful Somatic Symptoms on Depressive Disorder: A Selected Literature" @default.
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