HIGH risk of chronic pain in women with LOW education, LOW socio-economic status, and LOW mood

Abstract

[ In this issue of the Scandinavian Journal of Pain Thomten et al. ublish an interesting study on chronic pain in women indicating hat depressive symptoms may have a mediating role in the high isk of developing chronic pain inwomenwith low socio-economic tatus [1]. Their study confirms what Eriksen et al. have reported n their publications from the ongoing health surveys in Denmark or almost two decades [2]: low education and depression in midle aged women are significantly associated with persistent pain onditions. We do not know what is the egg and what is the hen: oes low mental mood and depression cause chronic pain [3,4]? r does a persistent pain condition and the accompanying stress n mental energy, working abilities, social interactions and finanial strain cause depression [3,4]? Or is the explanation that some nfortunate persons have a shared vulnerability to both chronic ain and mental diseases such as depression, possibly through a ysfunctional brain dopamine system as suggested by Taiminen t al. [5]. It is not possible to successfully treat chronic pain withut treating the accompanying depression as suggested by Linton nd Bergbom [3] and strongly supported by Nicholas [4]. It is also ot possible to help a complex chronic pain patient with a massive urden of socio-economic problems in addition to the pain conition without helping the patient with her (most often women) conomic and social problems as emphasized by Hagelberg [6] and ho et al. [7,8]. The study by Thomten et al. [1] in this issue of the candinavian Journal of Pain is therefore a valuable reminder that hronic pain is strongly associated with the socio-economic status f the patient and that those who try to help these unfortunate omen face a complex challenge where a truly multidisciplinary eam approach is necessary [9]. The social worker, the psychologist nd psychiatrist [3,4,10], the physiotherapist [11], as well as speialists inwomen’s diseases [11] aremore important than the “pain pecialist” using pharmacology and interventional techniques. All of these aspects of chronic pain among women have been eviewed and discussed in-depth during the three first years of our ublishing the Scandinavian Journal of Pain [1,3–11]. As founding ditor-in-Chief, I am grateful for all the enthusiastic contributors to