The Medical journal of Australia
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To determine the nature of depressive symptoms in a sample of patients with chronic pain, and to examine the relationship between depressive symptoms and physical disability due to pain. ⋯ In patients with chronic pain, depressive symptoms are correlated more strongly with cognitive variables than pain severity and pain distress, while physical disability is correlated more strongly with cognitive, behavioural and pain variables than depressive symptoms. Furthermore, depressive symptoms are characterised predominantly by mood-related symptoms, which suggests differences in the experience of depression in patients with chronic pain compared with those presenting with mental disorders.
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To review the evidence for an association between depression and anxiety and the National Health Priority Area conditions -- heart disease, stroke, diabetes mellitus, asthma, cancer, arthritis and osteoporosis -- and for the effectiveness of treatments for depression and anxiety in these settings. ⋯ The evidence for the association of physical illness and depression and anxiety, and their effects on outcome, is very strong. Further research to establish the effectiveness of interventions is required. Despite the limits of current research, policy and practice still lags significantly behind best evidence-based practice. Models of integrated care need to be developed and trialled.