Magni Guido
Department of Psychiatry, University of Padua, PaduaItaly Department of Psychiatry, University of Western Ontario, London, Ont.Canada.
Pain. 1987 Oct;31(1):1-21. doi: 10.1016/0304-3959(87)90002-9.
Patients suffering from pain without evidence of either depression or organic lesions, or of any pathophysiological process to which the pain might be attributed, may be diagnosed as suffering from 'indeterminate pain.' The evidence in the literature which suggests that some of these cases might be due to a 'depressive equivalent' is examined. It is suggested that it is difficult, if not impossible, to formulate a diagnosis of depressive illness in patients who do not have clear symptoms of depression. However, there is evidence in the literature that a relatively high percentage of patients with chronic indeterminate pain appear to have a family history of depression and depressive spectrum disorders. Biological markers of depression also give some indication that certain of these patients may have a link with depressive illness as well as with pain. It is suggested that there is a need to explore the existence of a sub-group of patients with indeterminate pain in whom the mechanism of the pain may be related to the mechanism of depressive illness even though formal depressive symptoms are not found.
患有疼痛但无抑郁或器质性病变证据，或无任何可归因于疼痛的病理生理过程的患者，可能被诊断为患有“不明原因疼痛”。本文研究了文献中表明这些病例中的一些可能归因于“抑郁等效症”的证据。研究表明，对于没有明显抑郁症状的患者，很难（如果不是不可能的话）做出抑郁症的诊断。然而，文献中有证据表明，相当高比例的慢性不明原因疼痛患者似乎有抑郁症和抑郁谱系障碍的家族史。抑郁症的生物标志物也表明，这些患者中的某些人可能与抑郁症以及疼痛都存在关联。研究表明，有必要探索是否存在一个不明原因疼痛的亚组患者，尽管未发现典型的抑郁症状，但这些患者疼痛的机制可能与抑郁症的机制有关。
