Depression amid Chronic Disease

By: Psych Central News Editor

on Monday, Jan, 29, 2007

Reviewed by: John M. Grohol, Psy.D.
on Monday, Jan, 29, 2007

Receiving the diagnosis of a chronic disease or cancer is a traumatic, life-changing event. Unfortunately, the mental health effect of the incident is often obscured by attention to the physical disorder and the inability to determine “appropriate sadness” from clinical depression.

Researchers have developed a new tool to detect depression that will improve patients’ ability to come to terms with their disease.

Depression affects 25 percent of patients with advanced cancer – the stage at which the disease has begun to spread from its original tumor. At this stage, depression is difficult to diagnose as symptoms can be confused with a patient displaying ‘appropriate sadness’ – feelings which commonly result from suffering a terminal illness.

Accordingly, a University of Liverpool research team has created a method of testing for depression so clinicians can introduce additional treatment to enable patients to cope with the cancer more effectively. The tool could also be applied to sufferers of other serious illnesses such as Parkinson’s Disease and chronic heart disease.

Based on a screening system originally developed for sufferers of post-natal depression, the new tool - known as the ‘Brief Edinburgh Depression Scale’ (BEDS) - includes a six-step scale that assesses a cancer patient’s mental condition. The test includes questions on worthlessness, guilt and suicidal thoughts.

Read more . . .

Genes May Help Some People Bear Pain

(HealthDay News) -- People who tolerate pain better may just be blessed with better genes.

Scientists say levels of a molecule called BH4 -- required for the production of major neurotransmitter chemicals -- influence the body's sensitivity to pain.

The team of international researchers, based at Massachusetts General Hospital (MGH), Boston, say BH4 levels might also determine a person's vulnerability to chronic pain.

Reporting in the November issue of Nature Medicine, they found that a certain set of variations in a gene that's involved in producing BH4 appear to reduce a person's pain sensitivity.

"This is the first evidence of a genetic contribution to the risk of developing neuropathic pain in humans. The pain-protective gene sequence, which is carried by about 25 percent of the population, appears to be a marker both for less pain sensitivity and a reduced risk for chronic pain," study senior author Dr. Clifford Woolf, director of the Neural Plasticity Research Group at MGH, said in prepared statement.

"Identifying those at greater risk of developing chronic pain in response to medical procedures, trauma or diseases could lead to new preventive strategies and potential treatments," Woolf said.

In research involving hundreds of volunteers, the scientists concluded that people with a protective GCH1 haplotype -- a set of variations in the gene that are inherited together -- were less sensitive to pain. This GCH1 haplotype reduces production of BH4.

"Our results tell us that BH4 is a key pain-producing molecule -- when it goes up, patients experience pain, and if it is not elevated, they will have less pain," Woolf said.

"The data also suggest that individuals who say they feel less pain are not just stoics but genuinely have inherited a molecular machinery that reduces their perception of pain. The difference results not from personality or culture, but real differences in the biology of the sensory nervous system."

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