• Shinji Shimodera, Aoi Kawamura, and Toshi A Furukawa.
• Department of Neuropsychiatry, Kochi Medical School, Kochi University, Oko-cho, Kohasu, Nankoku, Kochi 783-8505, Japan. shimodes@kochi-u.ac.jp
• Compr Psychiatry. 2012 Aug 1; 53 (6): 843-9.

ObjectivesThere is an increasing recognition that pain often coexists with depression. The current survey was undertaken to ascertain patients' and clinicians' perceptions of pain as a physical symptom associated with depression in everyday clinical practices in Japan.MethodsWeb-based surveys were undertaken by a market research company for patients with depression and for physicians treating patients with depression (psychiatrists, psychosomatic physicians, general internists).ResultsA total of 848 patients aged 20 to 59 years entered the main survey, of whom 663 returned the completed survey (78.2%). Of the respondents, 424 (64.0%) experienced at least 1 painful symptom, with almost three quarters (72.1%) reporting that the pain affected mental symptoms and 68.6% indicating that it prevented recovery from depression itself. Among 337 patients who discussed their painful symptoms with their physician, 52.5% initiated the discussion. Four hundred fifty-six physicians completed the physician survey. When asked about the influence of pain associated with depression, 61.7% of physicians indicated that they ask their patients about pain during a consultation, 79.9% considered that painful symptoms might disturb the patients' daily life, and 52.8% felt that they would delay recovery from depression. With regard to treatment, 73.2% of physicians considered that they would "like to treat if depressed patients talked about their pain" and 64.7% considered that treatment "would be more effective when patients talked about pain symptoms."ConclusionsThe survey provides further evidence of the association between depression and pain, highlighting the fact that pain is prevalent in this patient population. An increased patient and physician awareness of pain in association with depression and improved physician-patient communication, enabling patients to discuss painful symptoms with their physicians and vice versa, should lead to a better overall management and treatment strategies.Copyright © 2012 Elsevier Inc. All rights reserved.

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