Patients with depression frequently suffer from medically unexplained pain

July 16, 2009

Pain symptoms that cannot be attributed, or at least not fully attributed, to an organic origin are more frequently and more severely experienced by patients with depression than by those without.

"It is the case that women are much more frequently affected by depression and also by so-called somatoform pain disorder than men," explains Dirk Frieser, psychologist at the Institute of Psychology at Johannes Gutenberg University Mainz, Germany. For the purposes of his doctoral dissertation, Frieser and fellow psychologist Stephanie Körber questioned 308 patients attending two practices of general practitioners in Mainz. Patients were asked about their state of health and their pain symptoms, but also about their anxieties with regard to illness, how they react when ill, what social support they receive, and what psychological stress they experience, together with many other aspects. Subsequently, the pain symptoms reported by the patients were evaluated by their doctors.

Somatoform symptoms, i.e., symptoms that cannot or not fully be explained in medical terms, are an astonishingly widespread phenomenon. According to Frieser "up to 80 percent of the symptoms reported in GP practices are somatoform. However, this does not mean that patients are simply 'imagining' that they have these symptoms." Somatoform symptoms are very real; they impair quality of life, and can also cause clinically relevant disorders that may require psychological treatment, such as .

Somatoform disorders, which are often popularly dismissed as 'hypochondria,' frequently not only involve pain symptoms but also other symptoms such as dizziness, sensations of hypersensitivity in various regions of the body, and even fatigue or exhaustion. What is important, according to Frieser, is that not everyone who has somatoform symptoms is diagnosed as having a somatoform disorder. The extent to which a patient's quality of life is impaired and the severity of the they experience are the determining factors here.

Taking as their starting point the survey of GP practices in Mainz under the supervision of Professor Wolfgang Hiller of Mainz University, Frieser and Körber decided to investigate what influence depression has on the pain experience of patients and to determine whether this differs if the pain is of clinical origin and if the pain has no medically identifiable cause.

"The results indicate that there is a significantly higher occurrence of somatoform pain in various body regions in patients with existing depression or who suffered depression in the previous 12 months than in patients without depression." According to Frieser then, it is possible that patients who report to their doctors with multiple pain symptoms that cannot be explained in clinical terms are very probably suffering from a depressive disorder requiring treatment. In cases of major depression, the affected patients often exhibit dejection, despair, swings in appetite and body weight, insomnia or an increased need for sleep, tiredness, lack of energy, and psychomotor disturbances. These patients not infrequently also consider committing suicide. Short term mood swings with a duration of less than two weeks are not considered characteristic elements of this disorder.

The results of the GP survey in Mainz underline the importance of the correct classification and evaluation of pain symptoms for healthcare services; the general practitioners concluded that pain was somatoform in 73 percent of cases, and could be fully explained in medical terms in only 27 percent of cases. Where the pain is attributable to an organic cause, it is irrelevant whether the patient has or not: The frequency, duration, and the debilitating effect of the pain are roughly equivalent in both patient groups.

Source: University Mainz

Explore further: Gabapentin may treat fibromyalgia pain

Related Stories

Gabapentin may treat fibromyalgia pain

June 11, 2007

U.S. scientists say the anticonvulsant medication gabapentin might be effective in treating pain and other symptoms arising from fibromyalgia.

Whiplash may produce delayed jaw pain

August 16, 2007

One in three people exposed to whiplash trauma is at risk of developing delayed TMJ symptoms that may require treatment, according to research published in the August issue of The Journal of the American Dental Association.

MRI reveals relationship between depression and pain

November 3, 2008

The brains of individuals with major depressive disorder appear to react more strongly when anticipating pain and also display altered functioning of the neural network that modifies pain sensitivity, according to a report ...

Unexplained chest pain can be due to stress

February 9, 2009

Each year, many people seek emergency treatment for unexplained chest pains. A thesis from the Sahlgrenska Academy, University of Gothenburg, Sweden, indicates several common factors among those affected, including stress ...

Study Pinpoints Links of Depression with Chronic Pain

June 17, 2009

It is well known that chronic pain and clinical depression go together, but a study in The Journal of Pain, published by the American Pain Society, shows that the connection between pain and depression is strongest in middle-age ...

Recommended for you

How the finch changes its tune

August 3, 2015

Like top musicians, songbirds train from a young age to weed out errors and trim variability from their songs, ultimately becoming consistent and reliable performers. But as with human musicians, even the best are not machines. ...

Cow embryos reveal new type of chromosome chimera

May 27, 2016

I've often wondered what happens between the time an egg is fertilized and the time the ball of cells that it becomes nestles into the uterine lining. It's a period that we know very little about, a black box of developmental ...

Shaving time to test antidotes for nerve agents

February 29, 2016

Imagine you wanted to know how much energy it took to bike up a mountain, but couldn't finish the ride to the peak yourself. So, to get the total energy required, you and a team of friends strap energy meters to your bikes ...


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.