Screening and Treating Pain in Depression to Improve Cognition
Those with depression experience pain differently than those without depression.
Researchers have found not only that pain is more common in those with depression but also that those with both depression and pain are more likely to have cognitive impairment.1 These findings provide evidence to screen for pain in those with depression and cognitive impairment, and suggest that effectively treating pain in these populations may increase cognitive and functional outcomes.
Roger S. McIntyre, MD, professor at the University of Toronto and Head of the Mood Disorders Psychopharmacology Unit at the University Health Network in Toronto, Ontario, Canada, and colleagues assessed cognition and pain levels of 100 participants with depression and 100 healthy controls using THINC-it, a computer or tablet-based cognitive assessment tool, and the visual analog scale for pain (ClinicalTrials.gov Identifier: NCT02508493).
Although this study replicates results from previous studies showing that those with depression experience pain differently than those without depression, it further identifies that there is a relationship between subjective cognitive function and pain ratings in predicting objective measures of cognitive function.
"Clinicians attempting to assess cognitive function in adults with [major depressive disorder] perhaps could rely on self-reported cognitive measures as a proxy of objective cognitive function in patients experiencing pain symptomatology," the authors wrote.
The researchers concluded that their findings provide evidence to screen for pain in patients with depression, especially in situations in which "persisting functional problems are observed." They also hypothesized that based on their findings, effectively treating pain in depression may also increase cognitive and functional outcomes.
"Research that aims to measure cognitive function in [major depressive disorder] should seek to adjust for the effect of pain measures on cognitive-dependent measures," they concluded.
Disclosure: Dr McIntyre has received research grants from Stanley Medical Research Institute, Lundbeck, Janssen Ortho, Purdue, AstraZeneca, Shire, Pfizer, Otsuka, and Allergan, and is an Advisory Board member for Lundbeck, Pfizer, AstraZeneca, Eli Lilly, Janssen Ortho, Purdue, Johnson & Johnson, Moksha8, Sunovion, Mitsubishi, Takeda, Forest, Otsuka, Bristol-Myers Squibb, and Shire. Dr McIntyre has also served as a speaker for Lundbeck, Pfizer, AstraZeneca, Eli Lilly, Janssen Ortho, Purdue, Johnson & Johnson, Moksha8, Sunovion, Mitsubishi, Takeda, Forest, Otsuka, Bristol-Myers Squibb, and Shire. The other authors have disclosed no relevant financial relationships.
- Cha DS, Carmona NE, Mansur RB, et al. Pain and major depressive disorder: associations with cognitive impairment as measured by the THINC-integrated tool (THINC-it). Scand J Pain. 2017;15:62-67. doi: 10.1016/j.sjpain.2016.12.004