Cited by 498Treatment of Major DepressionMusculoskeletal pain and rehabilitationPain Mechanisms and Treatments

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Pain and Depression: A Systematic Review

IsHak, Waguih William, Wen, Raymond Y., Naghdechi, Lancer, Vanle, Brigitte, Dang, Jonathan, Knosp, Michelle, Dascal, Julieta, Marcia, Lobsang, Gohar, Yasmine, Eskander, Lidia, Yadegar, Justin, Hanna, Sophia, Sadek, Antonious, Aguilar-Hernandez, Leslie, Danovitch, Itai, Louy, Charles·2018·Harvard Review of Psychiatry

DOI 10.1097/hrp.0000000000000198

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Abstract

Background: Pain comorbid with depression is frequently encountered in clinical settings and often leads to significant impaired functioning. Given the complexity of comorbidities, it is important to address both pain and depressive symptoms when evaluating treatment options. Aim: To review studies addressing pain comorbid with depression, and to report the impact of current treatments. Method: A systematic search of the literature databases was conducted according to predefined criteria. Two authors independently conducted a focused analysis of the full-text articles and reached a consensus on 28 articles to be included in this review. Results: Overall, studies suggested that pain and depression are highly intertwined and may co-exacerbate physical and psychological symptoms. These symptoms could lead to poor physical functional outcomes and longer duration of symptoms. An important biochemical basis for pain and depression focuses on serotonergic and norepinephrine systems, which is evident in the pain-ameliorating properties of serotonergic and norepinephrine antidepressants. Alternative pharmacotherapies such as ketamine and cannabinoids appear to be safe and effective options for improving depressive symptoms and ameliorating pain. In addition, cognitive-behavioral therapy may be a promising tool in the management of chronic pain and depression. Conclusion: The majority of the literature indicates that patients with pain and depression experience reduced physical, mental, and social functioning as opposed to patients with only depression or only pain. In addition, ketamine, psychotropic, and cognitive-behavioral therapies present promising options for treating both pain and depression.

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See all 498

Authors: IsHak, W. W., Wen, R. Y., Naghdechi, L., Vanle, B., Dang, J., Knosp, M., Dascal, J., Marcia, L., Gohar, Y., Eskander, L., Yadegar, J., Hanna, S., Sadek, A., Aguilar-Hernandez, L., Danovitch, I., & Louy, C.
Affiliations: University of California, Riverside (US)
Corresponding author: IsHak, Waguih William
ORCID: IsHak, Waguih William
Vanle, Brigitte
Dang, Jonathan
Marcia, Lobsang
Aguilar-Hernandez, Leslie
Danovitch, Itai
Venue: Harvard Review of Psychiatry
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2018-11
Volume: 26
Issue: 6
Pages: 352-363
ISSN: 1067-3229 (ISSN-L)
1465-7309
DOI: 10.1097/hrp.0000000000000198
OpenAlex: W2921028723
Cited by: 498
References: 54
Citations by year: 2026: 38 · 2025: 76 · 2024: 82 · 2023: 79 · 2022: 80 · 2021: 62 · 2020: 76 · 2019: 4
FWCI: 4.15
Type: journal article
Language: en
Open access: closed
Locations: Harvard Review of Psychiatry (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
Health Sciences › Medicine › Physiology (medical) › Pain Mechanisms and Treatments
Keywords: pain-depression comorbidity, chronic pain, depression, serotonergic antidepressants, norepinephrine reuptake inhibitors, ketamine, cannabinoids, cognitive behavioral therapy, functional disability
MeSH terms: Depressive Disorder, Humans, Comorbidity, Chronic Pain

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Pain and Depression: A Systematic Review

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