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Child Abuse and Neglect as Risk Factors for Comorbidity Between Depression and Chronic Pain in Adulthood

Macedo, Brisa Burgos Dias MSc*†; von Werne Baes, Cristiane MD, MSc, PhD; Menezes, Itiana Castro MSc, PhD; Juruena, Mario F. MD, MPhil, MSc, Dip CBT, PhD

The Journal of Nervous and Mental Disease: July 2019 - Volume 207 - Issue 7 - p 538–545
doi: 10.1097/NMD.0000000000001031
Original Articles

It is estimated that comorbidity between depression and chronic pain reaches more than half of the depressed adult patients around the world. Evidence indicates that some stressors, such as early-life stress (ELS), mediate the co-occurrence of depression and chronic pain. This study aimed to assess whether ELS or any of its subtypes could be considered as risk factors for comorbidity between depression and chronic pain. For this purpose, 44 patients in depressive episode were evaluated, in which 22 were diagnosed with depression and chronic pain, and the other 22 patients were diagnosed with depression but without chronic pain. Results had shown that ELS occurrence is more significant among depressive patients with chronic pain compared with those without pain. When subtypes of ELS were evaluated, the group of depressive patients with pain showed significantly higher prevalence of emotional neglect than those depressive participants without pain. Data analysis has shown that severity of the depressive symptoms has a significant impact on the total score of childhood trauma, emotional abuse, physical abuse, emotional neglect, and physical neglect, and that emotional abuse, sexual abuse, and physical neglect have significant impact on the severity of depression. In conclusion, our findings indicate that ELS can be considered as a risk factor for the comorbidity between depression and chronic pain.

*Department of Psychology and Education, Faculty of Philosophy, Sciences, and Letters at Ribeirão Preto, and

Department of Neurosciences and Behavior, School of Medicine at Ribeirão Preto, University of São Paulo, São Paulo, Brazil; and

Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom.

Send reprint requests to Mario F. Juruena, MD, MPhil, MSc, Dip CBT, PhD, Department of Psychological Medicine, Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, Room M3.24, PO72, De Crespigny Park, Denmark Hill, London SE5 8AF, United Kingdom. E-mail:

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