"Chronic pain as a variant of depressive disease". A critical reappraisal

This paper critically examines the hypothesis that chronic pain is the physical manifestation of an underlying depressive disorder, as proposed by Blumer and Heilbronn in 1982 ( Blumer , D., and Heilbronn , M. Chronic pain as a variant of depressive disease. The pain-prone disorder. J. Nerv . Ment . Dis., 170: 381-406, 1982). The logic of this argument and the empirical evidence provided by Blumer and Heilbronn to support their hypothesis are discussed and their validity challenged. Alternative interpretations for the results as well as for the relationship between pain and depression are noted. Although it may be plausible to view a small subset of chronic pain patients as manifesting a " muted depressive state," the burden of proof still lies with those theorists who adhere to this formulation.