Pain and Depression: An Integrative Review of Neurobiological and Psychological Factors
Abstract
The comorbidity of pain and depression has been well established in the literature and is associated with a greater burden to the individual and society than either condition alone. The relationship between pain and depression is quite complex and multiple factors must be considered when trying to disentangle the pain-depression link including shared neurobiology, precipitating environmental factors and cognitive influences. This article aims to provide an overview of the leading neurobiological and psychosocial theories that have advanced our understanding of the link between pain and depression. To this end we describe the shared neurobiological mechanisms in the brain thought to explain the overlap and consider psychological processes and how they inform a cognitive behavioral model. The article also provides an overview of the evidence based treatment for comorbid pain and depression.
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The numerous physical and psychosocial challenges associated with living with chronic pain may naturally contribute to symptoms of depression.
“The numerous physical and psychosocial challenges associated with living with chronic pain may naturally contribute to symptoms of depression [57,58].”
From Short-Term Findings From Testing EPIO, a Digital Self-Management Program for People Living With Chronic Pain: Randomized Controlled Trial (2023) · cites this paper as [58]
Depression and pain share neurological pathways and psychological factors, and respond to the same treatments, both pharmacological and psychological.
“Depression and pain share neurological pathways as well as psychological factors (e.g., catastrophizing, feeling of loss, behavioral avoidance), and respond to same treatments, both pharmacological (e.g., TCAs, SSRIs) and psychological (e.g., CBT).9”
From Psychological interventions for depression and anxiety: a systematic review and meta-analysis of Iranian chronic pain trials. (2020) · cites this paper as [9]
Stress, depression and anxiety have been suggested as triggers of flares and clinical deterioration in IBD.
“Stress, depression and anxiety have been suggested as triggers of flares and clinical deterioration in IBD. 10,11”
From Depressive symptoms predict clinical recurrence of inflammatory bowel disease (2022) · cites this paper as [11]
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Onwumere, J., Stubbs, B., Stirling, M., Shiers, D., Gaughran, F., Rice, A. S. C., C de C Williams, A., & Scott, W. (2022) · Pain · doi:10.1097/j.pain.0000000000002633 · Cited by 35 · see citing works
Huntington's Disease: Prevalence and Psychological Indicators of Pain
Underwood, M., Bonas, S., Dale, M., & REGISTRY Investigators of the European Huntington's Disease Network (2017) · Movement Disorders Clinical Practice · doi:10.1002/mdc3.12376 · Cited by 24 · see citing works
Behavioral inhibition, maladaptive pain cognitions, and function in patients with chronic pain
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Correlates of depressive symptoms in individuals attending outpatient stroke clinics
Vermeer, J., Rice, D., McIntyre, A., Viana, R., Macaluso, S., & Teasell, R. (2017) · Disability and Rehabilitation · doi:10.3109/09638288.2016.1140837 · Cited by 16 · see citing works
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“The numerous physical and psychosocial challenges associated with living with chronic pain may naturally contribute to symptoms of depression [57,58].”
Challenges in treatment of comorbid chronic pain, depression, and anxiety
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- Authors
- Goesling, J., Clauw, D. J., & Hassett, A. L.
- Affiliations
- University of Michigan (US)
- Michigan Medicine (US)
- Corresponding author
- Goesling, Jenna
- Venue
- Current Psychiatry Reports
- Published
- 2013-11-10
- Volume
- 15
- Issue
- 12
- Pages
- 421-421
- ISSN
- 1523-3812 (ISSN-L)
- 1535-1645
- OpenAlex
- W2086333420
- Cited by
- 285
- References
- 89
- Citations by year
- 2026: 19 · 2025: 18 · 2024: 21 · 2023: 21 · 2022: 21 · 2021: 35 · 2020: 21 · 2019: 30 · 2018: 27 · 2017: 23 · 2016: 17 · 2015: 25 · 2014: 6
- FWCI
- 1.76
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Current Psychiatry Reports (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Pain Mechanisms and Treatments
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Keywords
- pain, depression, pain-depression comorbidity, neurobiology of pain, psychosocial factors, cognitive-behavioral model, environmental risk factors, evidence-based treatment
- MeSH terms
- Brain, Central Nervous System, Cognition, Depressive Disorder, Humans, Pain, Comorbidity, Cognitive Behavioral Therapy, Neurotransmitter Agents
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