- Nowhere are the limitations of current psychiatric diagnostic schemas more apparent than at the interface of Major Depressive Disorder and chronic pain
- DSM-IV-TR does not list pain as a symptom of any mood disorder and anxiety/depression are strikingly marginalized in the list of symptoms required to meet criteria for a chronic pain disorder
- Several decades of research demonstrate that this segregation of mood and pain maps poorly onto clinical and neurobiological reality
- Appears to be more the rule than the exception with a 30-60% co-occurrence rate
- Evidence suggests that chronic pain and depression do more than co-occur, they also promote the development of each other
- When comorbid, pain and depression mutually amplify each other, contributing significantly to treatment resistance in both pain and depressive disorders
- Pain is a major obstacle to achieving remission in the treatment of depression and a significant risk factor for relapse
