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Is pain perception altered in people with depression? A systematic review and meta-analysis of experimental pain research

Is pain perception altered in people with depression? A systematic review and meta-analysis of experimental pain research

Thompson, Trevor ORCID: 0000-0001-9880-782X, Correll, Christoph U., Gallop, Katy, Vancampfort, Davy and Stubbs, Brendon (2016) Is pain perception altered in people with depression? A systematic review and meta-analysis of experimental pain research. The Journal of Pain, 17 (12). pp. 1257-1272. ISSN 1526-5900 (doi:https://doi.org/10.1016/j.jpain.2016.08.007)

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Abstract

While clinical studies suggest depressed patients may be more vulnerable to pain, experimental research is equivocal. This meta-analysis aimed to clarify whether depression is associated with altered pain perception in response to noxious stimulation and to identify factors that might influence this association. A search of major electronic databases was conducted to identify experimental studies investigating pain response in depressed participants vs. healthy controls using established pain outcome measures. Random effects meta-analysis of standardized mean differences was conducted on data from 32 studies (N=1,317). For high-intensity noxious stimulation, overall pain tolerance was similar across depressed and control groups (Hedge's g=0.09, p=0.71, studies=10). For low-intensity stimulation, a small, but statistically significant higher mean sensory threshold (g=0.35, p=0.01, studies=9) and pain threshold (g=0.32, p=0.02, studies=25) was observed in depressed participants, suggesting diminished pain. However, considerable heterogeneity in the direction and magnitude of effects was observed, indicating a likely condition-specific impact of depression on pain. Subgroup analysis found that pain threshold/tolerance was increased in depression for exteroceptive (cutaneous) stimulation but decreased for interoceptive (ischemic) stimulation, but that substantial heterogeneity remained. Overall, results provide some support for altered pain processing in depression, but suggest this link is dependent upon modality and additional, unidentified factors.

Item Type: Article
Additional Information: © 2016. This manuscript version is made available under the CC-BY-NC-ND 4.0 license.
Uncontrolled Keywords: Depression; depressive disorder; pain; meta-analysis; systematic review.
Subjects: B Philosophy. Psychology. Religion > BF Psychology
Faculty / School / Research Centre / Research Group: Faculty of Education, Health & Human Sciences
Faculty of Education, Health & Human Sciences > School of Human Sciences (HUM)
Last Modified: 22 Feb 2018 11:20
URI: http://gala.gre.ac.uk/id/eprint/15832

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