Chiriţa V, Chiriţa R, Cosmovici N, Mungiu O C, Pirozynski T
Clinica de psihiatrie, Universitatea de Medicină şi Farmacie Iaşi.
Rev Med Chir Soc Med Nat Iasi. 1993 Apr-Jun;97(2):257-60.
The frequency of depression-pain association, gives the authors the opportunity of evaluating the actual pattern of managing pain according to its sensory-discriminatory, affective-emotional, cognitive and behavioral features. The neurophysiologic, affective and psychologic factors generally correlate in the induction and evolution of pain, being dependent on the individual reactivity environmental and socio-cultural relations. The efficacy of antidepressive drugs in the therapy of pain, explained by their action on the serotoninergic systems, advocates the clinical relationship depression-pain, but also their analgesic properties independent from the thymoanaleptic effect. The results of the clinical essays the authors have carried on some antidepressants (Imipramine, Amitryptyline, Mianserine, Maprotyline) evidenced their effect on the various forms of manifestation and localizations of pain complains. The amelioration of pain, certified by the use in dynamics of Hamilton's depression scale, occurs earlier than the improvement of depressive symptoms, thus attesting the analgesic properties of the antidepressants. The preservation and merging of these effects during the investigation interval, at the same time with an improvement in the depressive symptoms support the clinical correlation depression-pain, emphasizing the complex character of the algopathic syndrome, both somatically and mentally.
抑郁与疼痛关联的频率，使作者有机会根据疼痛的感觉辨别、情感情绪、认知和行为特征来评估实际的疼痛管理模式。神经生理、情感和心理因素在疼痛的诱发和演变过程中通常相互关联，这取决于个体反应性、环境及社会文化关系。抗抑郁药物在疼痛治疗中的疗效，可通过其对血清素能系统的作用来解释，这不仅支持了抑郁与疼痛的临床关系，也表明了它们独立于抗抑郁作用的镇痛特性。作者对一些抗抑郁药（丙咪嗪、阿米替林、米安色林、马普替林）进行的临床研究结果，证明了它们对疼痛主诉的各种表现形式和部位的影响。通过动态使用汉密尔顿抑郁量表证实的疼痛改善，比抑郁症状的改善出现得更早，从而证明了抗抑郁药的镇痛特性。在研究期间这些效应的持续和合并，同时伴随着抑郁症状的改善，支持了抑郁与疼痛的临床相关性，强调了疼痛综合征在躯体和心理方面的复杂性。
