Pain perception in major depression depends on pain modality

• Published in: Pain (Amsterdam) Vol. 117; no. 1; pp. 97 - 103
• Main Authors: Bär, Karl-Jürgen, Brehm, Stanislaw, Boettger, Michael Karl, Boettger, Silke, Wagner, Gerd, Sauer, Heinrich
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier B.V 01-09-2005; Elsevier
• Subjects: Adult; Adult and adolescent clinical studies; Analysis of Variance; Biological and medical sciences; Case-Control Studies; Depression; Depressive Disorder, Major - complications; Electric Stimulation - adverse effects; Female; Functional Laterality; Hot Temperature - adverse effects; Humans; Ischemia - physiopathology; Ischemic pain; Lateralization; Male; Medical sciences; Middle Aged; Mood disorders; Nervous system (semeiology, syndromes); Nervous system as a whole; Neurology; Pain; Pain - etiology; Pain - psychology; Pain Measurement - methods; Pain Measurement - psychology; Pain Threshold - physiology; Pain Threshold - psychology; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Sensory system; Thermal threshold; Depression; Thermal threshold; Pain; Ischemic pain; Sensory system; Lateralization; Mood disorder; Human; Pain sensitivity; Noxious stimulus; Tolerance; Vulnerability; Hypoalgesia; Hand; Hyperalgesia; Perception; Localization
• ISSN: 0304-3959; 1872-6623
• DOI: 10.1016/j.pain.2005.05.016

One frequently described feature of depression is an increased vulnerability to pain complaints, and chronic pain is frequently accompanied by symptoms of depression. In contrast to this, a decreased sensitivity to experimental pain has been described in major depression. The physiological basis of this phenomenon is yet elusive. We investigated 30 patients suffering from a major depressive disorder and matched controls. Pain testing (threshold and tolerance) was performed on both sides of the body and included assessment of thermal, electrical and ischemic pain. While confirming hypoalgesia to heat and electrical pain in comparison to controls, we found hyperalgesia to ischemic muscle pain. Furthermore, thermal pain tolerance and electrical pain tolerance were significantly increased on the right hand side confirming previous results of a lateralized perception of pain in depression. Our main finding suggests that painful stimuli are processed differentially depending on the localization of pain induction in depression. This knowledge may enable us to understand and ultimately treat pain complaints more appropriately in depressed patients.