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Depression and chronic pain

This is a republished version of an article previously published in MJA Open

Chronic pain and depression are frequently comorbid.1 The presence of depression in a patient with chronic pain is associated with decreased function,1 poorer treatment response2,3 and increased health care costs.4 An accurate diagnosis of major depression can be challenging in the setting of comorbid chronic pain. Antidepressants and psychological treatments can be effective and are best delivered as part of a coordinated, cohesive, multidisciplinary pain management plan. Here, we describe the current approach to the assessment and management of major depression in patients with chronic pain.

Biological basis of pain

The International Association for the Study of Pain defines pain as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described…