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Area of Science:

  • Psychology
  • Medicine
  • Behavioral Science

Background:

  • Co-occurrence of pain and depression is common in clinical settings.
  • The mechanisms linking pain and depression are not fully understood.
  • Depression is associated with the development of chronic pain and poorer treatment outcomes.

Purpose of the Study:

  • To critically review the literature on the relationship between pain and depression.
  • To introduce the Örebro Behavioral Emotion Regulation Model.
  • To enhance understanding and stimulate research into the pain-depression link.

Main Methods:

  • Literature search of MedLine and PsychINFO databases for articles published since 2000.
  • Inclusion of relevant articles and previous reviews.
  • Identification and synthesis of 244 articles, including 6 reviews.

Main Results:

  • A strong link exists between depression and pain, but mechanisms remain unclear.
  • Co-morbid pain and depression negatively affect prognosis and are often under-assessed by clinicians.
  • Early improvement in depression correlates with better overall treatment gains for musculoskeletal pain.
  • Catastrophizing and emotion regulation are identified as key linking mechanisms.
  • The Örebro Behavioral Emotion Regulation Model explains the recurrent nature of pain and depression.

Conclusions:

  • Pain and depression interact, contributing to the development and maintenance of chronic conditions.
  • Early assessment and integrated treatment of both pain and depression are crucial for maximizing outcomes.
  • Cognitive-behavioral therapy shows promise, particularly behavioral emotion regulation, for managing co-morbid pain and depression.
  • Further research into psychological mechanisms and treatments for co-morbid pain and depression is warranted.