Fishbain D A, Cutler R, Rosomoff H L, Rosomoff R S
Department of Psychiatry, University of Miami, School of Medicine, Florida 33131, USA.
Clin J Pain. 1997 Jun;13(2):116-37. doi: 10.1097/00002508-199706000-00006.
To determine the current status for the association of chronic pain and depression and to review the evidence for whether depression is an antecedent or consequence of chronic pain (CP).
A computer and manual literature review yielded 191 studies that related to the pain-depression association. These reports were reviewed and sorted into seven categories relating to the topic of this paper. Eighty-three studies were then selected according to inclusion criteria and subjected to a structured review.
Any medical treatment setting including pain treatment as inclusion criteria for selection of studies.
Any patients with any type of chronic pain.
The reviewed studies were consistent in indicating that there is a statistical relationship between chronic pain and depression. For the relationship between pain and depression, there was greater support for the consequence and scar hypotheses than the antecedent hypothesis.
Depression is more common in chronic pain patients (CPPs) than in healthy controls as a consequence of the presence of CP. At pain onset, predisposition to depression (the scar hypothesis) may increase the likelihood for the development of depression in some CPPS. Because of difficulties in measuring depression in the presence of CP, the reviewed studies should be interpreted with caution.
确定慢性疼痛与抑郁之间关联的当前状况，并审视关于抑郁是慢性疼痛（CP）的先兆还是后果的证据。
通过计算机检索和人工检索文献，共获得191项与疼痛 - 抑郁关联相关的研究。对这些报告进行了审查，并根据本文主题分为七类。然后根据纳入标准选择了83项研究进行结构化审查。
任何医疗环境，包括将疼痛治疗作为研究选择的纳入标准。
患有任何类型慢性疼痛的任何患者。
经审查的研究一致表明，慢性疼痛与抑郁之间存在统计学关系。对于疼痛与抑郁之间的关系，后果和疤痕假说比先兆假说得到了更多支持。
由于存在慢性疼痛，抑郁症在慢性疼痛患者（CPPs）中比在健康对照中更为常见。在疼痛发作时，抑郁倾向（疤痕假说）可能会增加一些慢性疼痛患者发生抑郁症的可能性。由于在存在慢性疼痛的情况下测量抑郁存在困难，因此对经审查的研究应谨慎解读。
