Relationship between clinical pain complaints and pain sensitivity in patients with depression and panic disorder

There is evidence that depression and panic disorder are birth associated w ith an increased frequency of clinical pain complaints. A change in pain se nsitivity is alleged to be involved in this phenomenon. However, few studie s have assessed clinical pain complaints and pain sensitivity in the same g roup of patients. Methods: Thirteen patients with a major depressive disord er. 13 patients with a panic disorder (diagnoses based on the Diagnostic an d Statistical Manual of Mental Disorders, fourth edition), and 13 healthy c ontrol subjects were investigated. None of the subjects were taking medicat ions. Body maps were used to measure the number of painful sites as well as the intensity and unpleasantness of pain complaints in the previous 6 mont hs. Furthermore, pain thresholds for pressure, cold, and heat were assessed at the forearm or hand. Results: Patients with depression and panic disord er had significantly more frequent, more intense, and more unpleasant pain complaints than healthy control subjects. Despite this similarity, patients with depression had significantly higher pain thresholds than patients wit h panic disorder in two (pressure and cold) of three stimulus modalities an d significantly higher pressure pain thresholds than the healthy control su bjects. There were no differences between the pain thresholds of patients w ith panic disorder and healthy control subjects. The correlations between c linical pain measures and pain thresholds were generally weak. Conclusions: These findings suggest that the clinical pain complaints of patients with depression and panic disorder cannot simply be explained by changes in pain sensitivity.