Symptom cluster: Depression and pain.

Pain and depression are two frequently associated aspects in oncology. The reciprocal influence of both pathologies is discussed under both the point of view of the underlying biological mechanisms as well as its emotional and cognitive aspects. Mood depression somatic symptoms include pain, just as chronic pain emotional aspects are strictly related to anxiety and depressed mood. Pharmacological treatment for pain with antidepressant drugs (ADs) is discussed, since such drugs offer a direct and an indirect mitigating action on pain perception, and also allow positive changes in the cognitive attitude toward pain. The social and emotional aspects of pain are also discussed bringing evidences of how combined antalgic therapies (analgesics, antidepressants, psychotherapies among others), especially on elderly oncological patients, are more effective than each treatment alone. Copyright 2009 Elsevier Ltd. All rights reserved.