Nowhere are the limitations of current psychiatric diagnostic schemas more apparent than at the interface of Major Depressive Disorder and chronic pain
DSM-IV-TR does not list pain as a symptom of any mood disorder and anxiety/depression are strikingly marginalized in the list of symptoms required to meet criteria for a chronic pain disorder
Several decades of research demonstrate that this segregation of mood and pain maps poorly onto clinical and neurobiological reality
Appears to be more the rule than the exception with a 30-60% co-occurrence rate
Evidence suggests that chronic pain and depression do more than co-occur, they also promote the development of each other
When comorbid, pain and depression mutually amplify each other, contributing significantly to treatment resistance in both pain and depressive disorders
Pain is a major obstacle to achieving remission in the treatment of depression and a significant risk factor for relapse
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