A Preliminary Report on Fatigue and Pain Tolerance in Depressive and Psychoneurotic Patients

Hemphill, R. E.; Hall, Katherine; Crookes, T. G.

doi:10.1192/bjp.98.412.433

Cited by 42 publications

(15 citation statements)

References 4 publications

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“…For more than 60 years, the experience of pain has been reported to be associated with various negative emotional states, including depression, anxiety, fear, and anger (Chapman et al, 1946; Hemphill et al, 1952; Ramzy & Wallerstein, 1958; Schachter, 1957; Webb & Lascelles, 1962). Studies have generally found that higher levels of negative emotions are associated with greater acute and chronic pain intensity (e.g., Bruehl et al, 2002; Janssen, 2002; Linton, 2000; Staud, 2004), and possibly with increased risk of developing chronic pain (Linton, 2005).…”

Section: Introductionmentioning

confidence: 99%

Pain-related effects of trait anger expression: Neural substrates and the role of endogenous opioid mechanisms

Bruehl

Burns

Chung

et al. 2009

Neuroscience & Biobehavioral Reviews

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Literature is reviewed indicating that greater tendency to manage anger via direct verbal or physical expression (trait anger-out) is associated with increased acute and chronic pain responsiveness. Neuroimaging data are overviewed supporting overlapping neural circuits underlying regulation of both pain and anger, consisting of brain regions including the rostral anterior cingulate cortex, orbitofrontal cortex, anterior insula, amygdala, and periaqueductal gray. These circuits provide a potential neural basis for observed positive associations between anger-out and pain responsiveness. The role of endogenous opioids in modulating activity in these interlinked brain regions is explored, and implications for understanding pain-related effects of anger-out are described. An opioid dysfunction hypothesis is presented in which inadequate endogenous opioid inhibitory activity in these brain regions contributes to links between trait anger-out and pain. A series of studies is presented that supports the opioid dysfunction hypothesis, further suggesting that gender and genetic factors may moderate these effects. Finally, possible implications of interactions between trait angerout and state behavioral anger expression on endogenous opioid analgesic activity are described.

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Section: Introductionmentioning

confidence: 99%

Pain-related effects of trait anger expression: Neural substrates and the role of endogenous opioid mechanisms

Bruehl

Burns

Chung

et al. 2009

Neuroscience & Biobehavioral Reviews

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“…Changed pain thresholds have been observed in depressed patients with both higher (von Knorring, 1974a;von Knorring and Espvall, 1974b;Davis et al, 1979;Lautenbacher et al, 1999) and lower pain thresholds (Merskey, 1965;Schreider et al, 2003). Depressed women have the lowest pain thresholds (von Knorring, 1974a;von Knorring and Espvall, 1974b), and depressed patients with neurotic features are reported to have lower thresholds than depressed patients with psychotic features (Hemphill and Crookes, 1951;Hall and Stride, 1954;Stengel et al, 1955;von European Journal of Pain 8 (2004) [487][488][489][490][491][492][493] www.EuropeanJournalPain.com Knorring, 1978). Although the relationship between pain thresholds and depression is still unclear the above findings suggest that perception of pain in depressed patients differs from that seen under normal conditions.…”

Section: Introductionmentioning

confidence: 99%

Pain thresholds during and after treatment of severe depression with electroconvulsive therapy

Gormsen

Ribe

Raun

et al. 2004

European Journal of Pain

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Pain and depression are often associated suggesting that both conditions share a common neurobiological mechanism, which modulate emotional function and processing of noxious information. Pain thresholds are hypothesized to be altered in depressed patients and normalized with the amelioration of depression. The purpose of this study was therefore to determine pain thresholds in patients during and after treatment with electroconvulsive therapy (ECT) of severe depression and in healthy controls. Seventeen depressed patients (Hamilton depression score > 18) and an age and gender matched control group of same size participated in the study. Pain detection and tolerance thresholds to pressure and pain tolerance thresholds to the Cold Pressor Test by exposure to ice-water was measured twice in depressed patients during and after ECT and twice in controls with a similar time interval. While ECT significantly improved Hamilton depression score (from mean 23.9 (SD:5) to mean 12.5 (SD:5.7)) there was no significant change in pain thresholds during and after ECT in the patient group. However, depressed patients had significantly lower pain tolerance in the Cold Pressor Test on both examinations and on pressure pain tolerance on the second examination day than their corresponding control subjects. The differential effect of ECT on depression score and pain processing indicate that mood and noxious processing are not medicated directly by the same systems but that a complex relationship between pain and depression exists.

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“…The modification of response to pain in depressed patients has been reported by several authors: von Knorring et al [1974], Hall and Stride [1950], Hemphill et al [1952], Tosca et al [in press]. However, these authors failed to recognize any difference between the different clinical types of depression.…”

Section: Discussionmentioning

confidence: 85%

Motor Reactivity, Pain Threshold and Effects of Sleep Deprivation in Unipolar Depressives

Bezzi¹,

Pinelli²,

Tosca³

1981

Psychopathology

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The authors studied the motor reactivity by means of serial choice reaction, electromyography of simple reactions, and defense reflexes in normal and in depressed patients. Significant differences were observed between normal and depressed patients, especially in those with retardation. The ‘retarded’ depressives exhibited higher pain threshold values, a lower number of motor reactions, and more prolonged reaction times. 2 normal and 4 depressed patients were submitted to the same tests after 1 night’s total sleep deprivation. In normals negative effects were found in the levels of vigilance and endurance. In depressed patients, at variance with normals, the number of motor reactions increased, the reaction time decreased, and the rate of basal motor innervation improved, tending to normalization. On the contrary, pain threshold underwent the same type of changes as in controls. Sleep deprivation seemed to specifically reduce retardation phenomena in depressives, thus strongly improving motor reactivity.

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A Preliminary Report on Fatigue and Pain Tolerance in Depressive and Psychoneurotic Patients

Cited by 42 publications

References 4 publications

Pain-related effects of trait anger expression: Neural substrates and the role of endogenous opioid mechanisms

Pain-related effects of trait anger expression: Neural substrates and the role of endogenous opioid mechanisms

Pain thresholds during and after treatment of severe depression with electroconvulsive therapy

Motor Reactivity, Pain Threshold and Effects of Sleep Deprivation in Unipolar Depressives

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