The relationship between pain and depression in a trial using paroxetine in sufferers of chronic low back pain

Previous studies have shown a positive association between pain and depress ion, though evidence supporting a direct link between these two variables i s less robust. Using a placebo-controlled trial, the authors examined the a nalgesic and antidepressant efficacy of paroxetine (20 mg) in chronic low b ack pain sufferers. The authors examined the associations among pain, depre ssion, disability and illness attitudes. Paroxetine showed no effects on pa in or depression compared with placebo; however subjects randomized to paro xetine were more likely to reduce concomitant analgesic medication. The cro ss-sectional association of depression and pain at baseline (r = 0.2, P = 0 .02) was weaker than the association between depression and disability (r = 0.3, P = 0.004). Similarly the association of change ill depression scores with change in pain (r = 0.25, P = 0.016) was weaker than change between d epression and disability (r = 0.49, P<0.0005). whereas the relationship bet ween pain and depression because nonsignificant when disability and illness attitudes were controlled, the relationship between depression and disabil ity remained highly significant when pain and illness attitudes were contro lled. These darn are consistent with the association between pain and depre ssion bring wholly modulated by disability and illness attitudes, with no d irect relationship between pain and depression.