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A new study led by the Central Institute of Mental Health shows that people with depression and fibromyalgia exhibit nearly identical patterns of impaired emotional regulation and that stress significantly worsens pain and mood in both groups. The findings highlight the close interconnection between pain, stress, and emotions and underscore the importance of psychotherapeutic treatment approaches.
Fibromyalgia is a chronic pain disorder characterized by widespread discomfort in muscles, tendons, and ligaments. Like depression, it is one of the most common causes of severe impairment in everyday life. Both conditions often occur together and can exacerbate each other.
A recent study involving researchers from the Central Institute of Mental Health (CIMH) in Mannheim, the Heidelberg and Mannheim Medical Faculty of Heidelberg University, and the University Hospitals of Heidelberg and Mainz shows that patients with fibromyalgia, like people with depression, suffer from comparable difficulties in regulating their emotions. They brood more, blame themselves more often, and have problems controlling their emotions appropriately. Stress acts as a central amplifier in this process: it exacerbates both pain and depressive moods.
Stress as an amplifier of pain and depression
“Our data clearly show that pain and mood are inextricably linked and that difficulties in emotion regulation characterize both clinical pictures,” says Prof. Dr. Dr. Heike Tost, head of the Systems Neuroscience in Psychiatry (SNiP) working group at the CIMH and last author of the study.
A clear correlation was evident in everyday life. Stressful situations not only led to a worse mood, but also to a significant increase in pain intensity. This was observed in people with fibromyalgia as well as in people with depression. Many sufferers experience this vicious circle on a daily basis.
In order to comprehensively map these interactions, the researchers combined several methods. The participants answered scientific questionnaires, reported on their current state of health several times a day via smartphone, and underwent MRI scans. Among other things, this revealed how well they were able to regulate their emotional responses and how active the amygdala was in this process. The amygdala is a central brain region for the evaluation of emotional stimuli.
People with fibromyalgia also showed increased sensitivity in the areas of the brain that process pain. This provides a possible explanation for why pain is often experienced more intensely and persistently in this group. “Stress increases pain, and pain increases stress. Understanding this interaction is an important step toward effective treatment,” says Prof. Dr. Andreas Meyer-Lindenberg, Director of the CIMH and Medical Director of the Clinic for Psychiatry and Psychotherapy.
New perspectives for treatment and prevention
The study demonstrates the high relevance of psychotherapeutic methods that specifically target improving emotion and stress regulation. Such approaches could further improve treatment for both chronic pain and depression.
Building on the latest findings, a follow-up study is now being launched to test an innovative brief intervention for stress reduction. The method is based on EMDR (Eye Movement Desensitization and Reprocessing) and uses eye-guided desensitization to reduce emotional stress more quickly. The aim is to examine whether this can specifically influence dysregulation in the brain and break the vicious cycle of pain and stress in the long term.
Interested parties can register via this link and fill out a questionnaire. The study team will then contact you and check your suitability for the study. Registration:
https://redcap2.zi-mannheim.de/surveys/?s=C47Y4EECDXNMWDFF
Further information:
The present results of the study are part of the Collaborative Research Center SFB1158 “From Nociception to Chronic Pain” at Heidelberg University. Further information on the SFB:
https://sfb1158.de/
About CIMH
The Central Institute of Mental Health (CIMH) stands for internationally outstanding research and pioneering treatment concepts in psychiatry and psychotherapy, child and adolescent psychiatry, psychosomatics and addiction medicine. The CIMH clinics provide psychiatric care for the population of Mannheim. At the CIMH, mentally ill people of all ages can rely on the most advanced treatments based on international standards of knowledge. Educating people about mental illness, creating understanding for those affected and strengthening prevention is another important part of our work. In psychiatric research, the CIMH is one of the leading institutions in Europe. Since 2021, it has been a site of the German Centre for Mental Health. The CIMH is institutionally linked to the University of Heidelberg through jointly appointed professors from the Medical Faculty Mannheim. The CIMH is a member of the Health + Life Science Alliance Heidelberg Mannheim.
Central Institute of Mental Health
Prof. Dr. Dr. Heike Tost
E-Mail: heike.tost@zi-mannheim.de
Renz MP, Schmidt H, Drusko A, Berhe O, Zidda F, Sebald C, Andoh J, Wieland S, Tesarz J, Treede RD, Meyer-Lindenberg A, Tost H. Neural, psychological, and daily life evidence for a transdiagnostic process of affective dysregulation in depression and chronic widespread pain. Pain. 2024. DOI: 10.1097/j.pain.0000000000003800.
https://pmc.ncbi.nlm.nih.gov/articles/PMC12617658/
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