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09-12-2008 | Mental health | Article

Social rejection linked with pain in depressed patients


Free abstract

MedWire News: The feeling of social rejection in patients with depression appears to be associated with physical pain, suggesting that the two characteristics share common neurobiologic circuits, say researchers.

Approximately half of patients with depression suffer from physical pain including chest pain, headaches, and body aches.

"For most pain sufferers for whom an organic cause is not evident, the use of terms such as 'unexplained,' 'functional,' and 'psychosomatic' to describe painful symptoms generates frustration and distress, while offering few pointers towards appropriate treatment," explain Anna Ehnvall (Centre for Cognitive Psychotherapy and Education, Sweden) and colleagues.

Notably, a recent functional magnetic resonance imaging study found that the dorsal anterior cingulate cortex is activated during the distressing experience that accompanies physical pain and during the perception of social rejection.

To investigate further, the researchers asked 186 patients with treatment-resistant depression to complete a self-report questionnaire regarding current perceived pain and rejection sensitivity over a 3-year period.

Specifically, patients were asked if they had noticed any increase in sensitivity to feeling rejected by people when they became depressed, with state rejection sensitivity being rated on a four-point scale ranging from no increase, some increase, moderate increase to major increase.

During the course of the study, 12.9% of patients reported no increase in sensitivity to rejection, 16.1% reported some increase in sensitivity, 23.1% reported a moderate increase, and 47.3% reported a major increase in rejection sensitivity.

An increase in sensitivity to rejection was significantly associated with chest pain, headaches, and body aches and pain, with odds ratios of 2.81, 2.11, and 2.24, respectively.

"The nature of the link between pain and social support is not yet understood, but we propose that increased social support may be one means of decreasing the feeling of rejection during depression and thereby reducing the perception of pain," Ehnvall and colleagues conclude.

The research is published in the journal Acta Psychiatrica Scandinavica.

By Andrew Czyzewski