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this could be a breakthrough if they figure out what antidepreeants work for chronic pain maybe in ten years or so they'll figure out which work for ibs?STANFORD, Calif. - A persistent, long-lasting headache or anendlessly painful back may indicate something more serious than a badweek at the office. A new study finds that people who have majordepression are more than twice as likely to have chronic pain whencompared to people who have no symptoms of depression. This studycould change how depression is diagnosed and treated, say StanfordSchool of Medicine researchers."This is potentially a really important finding," said AlanSchatzberg, MD, the Kenneth T. Norris Jr. Professor of Psychiatry andBehavioral Sciences, who participated in the study published in theJanuary issue of the journal Archive of General Psychiatry. "Thiswill change how we view pain and depression."Schatzberg said previously published research hinted that people withdepression may be more likely to experience chronic pain and thatdepressed people with chronic pain may respond better to a class ofdrugs that treats both symptoms. If the relationship exists, thenpain may be a symptom that guides doctors to the drugs they prescribefor depressed patients.After hearing anecdotal evidence that certain drugs are moreeffective in depressed people who also have chronic pain, Schatzbergand his colleague Maurice Ohayon, MD, PhD, associate professor ofpsychiatry and behavioral sciences at the Stanford School ofMedicine, tested the correlation using data collected previously byOhayon. These data included information from 18,980 people in fiveEuropean countries who agreed to answer health questions over thephone.Among the participants, 17 percent had chronic pain and 4 percent hadsymptoms of major depression; however, 43 percent of those with majordepression also had chronic pain. Of the symptoms, headaches andbackaches were most commonly found in depressed people. People whohad pain for 24 hours were also more likely to have major depression,indicating that continuous pain increases the likelihood of having amajor depressive disorder diagnosis.Schatzberg said he had no idea so many of the patients he treated fordepression may also need treatment for chronic pain."I was totally shocked," he said. Now he'll know to ask his depressedpatients if they also have chronic pain that should be treated, hesaid. He added that other doctors can monitor their chronic-painpatients for symptoms of depression.When doctors first diagnose a person with depression, they use achecklist that includes symptoms such as changes in mood, appetiteand sleep patterns to determine the severity of the person'sdepression along with the appropriate treatment. Schatzberg suspectsthat the presence of chronic pain should be added to this list as asymptom for assessing depression. He said that by more preciselydiagnosing a person's symptoms doctors have a better chance ofprescribing medication that will be effective in that patient.The question now is which comes first: the depression or the pain."We all have a certain amount of pain," Schatzberg said. "It could bethat the perception of pain is greater in depressed people." Hepointed out that many people with depression reported more headache,back pain or limb pain rather than pain stemming from disease.Schatzberg added that future studies will look at how people withdepression and chronic pain respond to different drugs used to treatdepression.tom
 
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