Table 1.

Diagnostic criteria for Major Depression and Generalized Anxiety and the altered psychological state in chronic pain

Process	Psychiatric Condition	Altered Psychological State in Pain
Depression	Major Depressive Disorder*
	1. Depressed mood or irritable.	Depressed mood (Ohayon and Schatzberg, 2010; Tang et al., 2008)
		Anger (Bruehl et al., 2009)
		Catastrophizing (Wood et al., 2012)
	2. Decreased interest or pleasure in activities	Anhedonia (Nicholas et al., 2009)
	3. Weight or appetite change	Weight gain/obesity (Ursini et al., 2011)
	4. Insomnia or hypersomnia	Sleep disturbance (Palermo et al., 2012; Palermo et al., 2011; Tang et al., 2012a)
	5. Psychomotor agitation or retardation	Motor control (Gerdle et al., 2010; Tang et al., 2012a)
	6. Fatigue or loss of energy	Fatigue (Dansie et al., 2012)
	7. Feelings of worthlessness or excessive guilt	Self-perceived burden (Kanzler et al., 2012; Kowal et al., 2012)
	8. Difficulty concentrating	Cognitive impairment (Reyes Del Paso et al., 2012)
		Decision-making deficits (Apkarian et al., 2004a)
	9. Thoughts of death or suicide	Suicidal ideation (Fishbain et al., 2012; Ilgen et al., 2008; van Tilburg et al., 2011)
Anxiety/Fear	Generalized Anxiety Disorder*
	“Excessive anxiety and worry” that is difficult to control	Anxiety (Lucchetti et al., 2013; Simons et al., 2012b)
		Catastrophizing (Sullivan et al., 2001)
		Pain-related anxiety/fear (Vlaeyen and Linton, 2012)
	1. Feeling wound-up, tense, or restless	Anxiety sensitivity (Ocanez et al., 2010; Payne et al., 2013)
	2. Easily becoming fatigued or worn-out	#6 above
	3. Concentration problems	#8 above
	4. Irritability	#1 above
	5. Significant tension in muscles	Muscle tension (Klinger et al., 2010)
	6. Difficulty with sleep	#4 above

^*To meet DSM-IV-TR diagnostic criteria must have 5 of 9 symptoms for MDD and 3 of 6 symptoms (1 of 6 for children) for GAD.