A Study Of Clinical Manifestation And Neurotransmitters Of Depression Comorbidity With Chronic Pain

Recently, more and more people went to see doctors of comprehensive hospitals for the problems of chronic pain. During the repeated inspections, we couldn't get the definite diagnosis of diseases. So the treatments of diseases were influenced. The patients suffered a lot and it raised the burdens of the patients, families, society. The chronic pain symptoms could emerge in various Psychiatric diseases and we can especially find them in Depression. So people attached importance to the chronic pain gradually. In these situations, it is significant that we study chronic pain symptoms,economic psychological scale and neurotransmitters of depression.Clinical manifestation and economic burden: In order to find the clinical symptoms, the general socio-demographic data and economic burdens in the depression comorbidity with chronic pain. This study investigated the patients of neurosis and depression by SCL–90, HAMD, GCP, SDSS and the investigation questionnaire about features and economic burdens of somatic symptoms produced by zhang Li-Li. We learned about the rate of appearance, the features, the treated situations and the influence factors of somatic symptoms. Meanwhile, we explored the relationship between chronic pain symptoms which existed or not and economic burdens.Neurotransmitter: In order to explore the interaction and regulatory role of neurotransmitters between chronic pain and depression. In this study, we detected the plasma concentrations of 5-HT, DA, NA, NPY, CGRP by radioimmunoassay. We learn about the change of neurotransmitters in depression whether comorbidity with chronic pain symptoms. It is hoped that the understanding of mechanism of the depression comorbidity with chronic pain were improved .It is beneficial to diagnosis and treat those diseases as soon as possible. We try our best to reduce the waste of medical resources.Results show,Clinical manifestation and economic burden: 1. The total point, the anxious or somatizations, cognition obstruction, diurnal variation element's score in Hamilton depression scale (HAMD) of the group with chronic pain symptoms were higher than the group without the chronic pain symptoms. The somatizations of pain and digestive system were serious in depression with chronic pain symptoms. 2. The direct economic burdens of the chronic pain group were more than another group. And the direct economic burdens were positively correlated with the severity of chronic pain.Neurotransmitter: 1. The plasma concentration of 5-HT in pure group was significantly higher than it in combined group and controlled group. Furthermore, the plasma concentrations of 5-HT in controlled group was significantly higher than it in combined group. The Plasma concentration of NE in controlled group was significantly higher than pure group. The plasma concentration of NPY in pure group was significantly higher than it in combined group and controlled group. The Plasma concentration of CGRP in pure group was significantly lower than it in combined group and controlled group. Furthermore, the Plasma concentration of CGRP in combined group was significantly lower than controlled group. 2. Significantly positive correlations existed in all depressive patients between NPY and 5-HT, DA and CGRP,NPY and CGRP, respectively. Significantly negative correlations existed in all depressive patients between CGRP and 5-HT respectively. Conclusion: Accompanied by chronic pain, the depression would aggravate the severity of somatic symptom and social function, the ability to work and the dysfunction. It also indicated that the compliance of treatment would be worse and the economic burden increased. Also, chronic pain will change the level of neurotransmitter in patients with depression.