Treatment for depression may be stymied in people with moderate to severe physical pain, according to a study at the Indiana University School of Medicine. It was determined that pain is a common, but often ignored, symptom of depression; and pain severity is a strong predictor of the degree of depression. Two-thirds of the 573 clinically depressed patients beginning antidepressant treatment in the study reported being in physical pain, with the most commonly cited symptoms being back, pain, and abdominal pain, as well as frequent headaches. Over nine months, investigators measured the rates of physical symptoms and their impact on quality of life and depression treatment. At the 3-month mark, patients who reported being in severe pain were four times as likely to have a poor response to antidepressant medication than patients who did not report pain. Those who reported being in moderate pain were twice as likely to have a poor response.

Another study indicated that depression can be a risk factor for onset of severe neck and low back pain. Researchers followed nearly 800 adults without neck and low back pain and learned that those who suffered from depression were four times as likely to develop intense or disabling neck and low back pain than those who were not depressed.

A study at the University of Toledo in Ohio concluded that women with chronic headaches, especially migraines, were more likely to be depressed. Among 1,032 women at headache clinics in five states, those diagnosed with severely disabling migraines had a significantly higher incidence of depression than those without migraines.

Researchers at Indiana University School of Medicine found that of 405 patients with dysthymia or major depressive disorder, pain severe enough to interfere with daily activities was present in 42%. The study concluded that pain has a negative impact on the effectiveness of treatment in depression and pain management could enhance positive outcomes and reduce remission rates.

References
(To view, roll mouse over the "References" heading; to hide, click on the heading)