Neurochemical similarities in depression and pain, with special emphasis on serotonin

Abstract

Lund A. Neurochemical similarities in depression and pain, with special emphasis on serotonin. Nord J Psychiatry 1994;48:419-428. Oslo. Clinical experience indicates that depression and pain may have some connection, and a critical review of the literature shows some common neurochemical changes. Abnormal serotoninergic (5-hydroxytqptamine (5-HT)) function in the central nervous system (CNS) has been reported in both conditions. In major depression with suicidality and in aggression or impulsivity, lowered activity in the 5-HT system is found. This reduced activity is measured as lowered concentration of 5-hydroxyindolacetic acid (5-HIAA) in the cerebrospinal fluid (CSF), indicating a reduced turnover of 5-HT in the CNS. Lowered 5-HIAA in the CSF is also found in some painful conditions, but disagreement exists. Abnormalities in the function of dopamine and noradrenaline have also been reported in both depression and pain, but the data are less conclusive. Some investigators have reported a hypersecretion of cortisol and a reduced suppression of cortisol in plasma after pretreatment with dexamethasone in both conditions. For the painful conditions, however, the data are few and conflicting. A reduction of somatostatin-like immunoreactivity in the CSF has been reported in both depression and pain, but only occasional reports exist. Except for the decreased activity of 5-HT in the C N S of some depressed patients and in some patients with pain, the data supporting a common neurochemical change in the two conditions are not very convincing. However, the data on somatostatin seem to be of interest. The incongruent data may partly be due to the fact that heterogeneous and not very well defined groups of patients have been included in some of the pain studies.

Interactive Effects of Internalizing and Externalizing Problem Behaviors on Recurrent Pain in Children

“…Third, pain and emotion regulation may also share a common etiology. Serotonin metabolism could be the basis for low self-control of emotions and pain, as it has been associated with both phenomena (France et al, 1987;Jensen et al, 1994;Lund, 1994). From the psychological perspective, negative affectivity could be associated with reports of high levels of negative feelings, as well as physical symptoms (Deary, Scott, & Wilson, 1997;Watson & Pennebaker, 1989).…”

Relations Among Muscle Pain, Sleep Variables, and Depression

“…Both depression scores contributed to the variance of the pain threshold index in a negative direction, i.e., low pain threshold was related to high score on the depression inventories. This is an interesting finding which may relate to common neurochemical characteristics of depression and pain transmission (34).…”