High Times for Painful Blues: The Endocannabinoid System in Pain-Depression Comorbidity

Few studies have examined the underlying psychosocial mechanisms of pain in Asian Americans. Using the biopsychosocial model, we sought to determine whether variations in depression contribute to racial group differences in symptomatic knee osteoarthritis pain between Asian Americans and non-Hispanic whites. The sample consisted of 100 participants, including 50 Asian Americans (28 Korean Americans, 9 Chinese Americans, 7 Japanese Americans, 5 Filipino Americans, and 1 Indian American) and 50 age- and sex-matched non-Hispanic whites with symptomatic knee osteoarthritis pain. The Centers for Epidemiologic Studies Depression Scale was used to assess symptoms of depression, and the Western Ontario and McMaster Universities Osteoarthritis Index and the Graded Chronic Pain Scale were used to measure clinical pain. In addition, quantitative sensory testing was used to measure experimental sensitivity to heat- and mechanically-induced pain. The results indicated that higher levels of depression in Asian Americans may contribute to greater clinical pain and experimental pain sensitivity. These findings add to the growing literature regarding ethnic and racial differences in pain and its associated psychological conditions, and additional research is warranted to strengthen these findings. Perspective This article demonstrates the contribution of depression to clinical pain and experimental pain sensitivity in Asian Americans with knee osteoarthritis. Our results suggest that Asian Americans have higher levels of depressive symptoms and that depression plays a relevant role in greater clinical pain and experimental pain sensitivity in Asian Americans.

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“…55 Recently, the endogenous cannabinoid system was implicated in reciprocal interactions between depression and pain. 22 …”

Section: Discussionmentioning

confidence: 99%

Depression and Pain in Asian and White Americans With Knee Osteoarthritis

Ahn

Weaver

Lyon

et al. 2017

The Journal of Pain

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“…Stress, fear, and anxiety can modulate pain (Asmundson and Katz, 2009; Burke et al, 2015; Butler and Finn, 2009; Fitzgibbon et al, 2015; Ford and Finn, 2008; Jennings et al, 2014; Olango and Finn, 2014; Rhudy and Meagher, 2000; Rhudy and Meagher, 2001; Wiech and Tracey, 2009). Negative emotions with low to moderate arousal tend to exacerbate pain through the phenomenon of stress-induced hyperalgesia (SIH), while negative emotions with high arousal tend to inhibit pain through the phenomenon of stress-induced analgesia (SIA) (de Wied and Verbaten, 2001; Dougher, 1979; Meagher et al, 2001; Rhudy and Meagher, 2000; Rhudy and Meagher, 2001; Rhudy and Meagher, 2003).…”

Section: The Ec System and Stress-induced Modulation Of Painmentioning

confidence: 99%

The cannabinoid system and pain

et al. 2017

Self Cite

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Chronic pain states are highly prevalent and yet poorly controlled by currently available analgesics, representing an enormous clinical, societal, and economic burden. Existing pain medications have significant limitations and adverse effects including tolerance, dependence, gastrointestinal dysfunction, cognitive impairment, and a narrow therapeutic window, making the search for novel analgesics ever more important. In this article, we review the role of an important endogenous pain control system, the endocannabinoid (EC) system, in the sensory, emotional, and cognitive aspects of pain. Herein, we briefly cover the discovery of the EC system and its role in pain processing pathways, before concentrating on three areas of current major interest in EC pain research; 1. Pharmacological enhancement of endocannabinoid activity (via blockade of EC metabolism or allosteric modulation of CB1 receptors); 2. The EC System and stress-induced modulation of pain; and 3. The EC system & medial prefrontal cortex (mPFC) dysfunction in pain states. Whilst we focus predominantly on the preclinical data, we also include extensive discussion of recent clinical failures of endocannabinoid-related therapies, the future potential of these approaches, and important directions for future research on the EC system and pain.

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“…There is a high prevalence of comorbidity of psychiatric disorders with chronic pain states, and brain regions and neural substrates mediating both overlap considerably (Burke et al, 2015;Fitzgibbon et al, 2016;. A clinical study in 2012 reported that 77% of subjects with chronic pain along with generalised anxiety disorder reported the onset of anxiety disorder prior to chronic pain suggesting that the affective component may predispose to the development of chronic pain (Knaster et al, 2012).…”

Section: Hyperalgesia Associated With Negative Affective Statementioning

confidence: 99%