pain [67] and headaches [68] more often than do other children. The co-occurrence of depression and chronic pain in adults has been associated with greater pain-evoked neuronal activation in brain regions associated with affective pain processing [69], which may in turn alter pain tolerance. Thirdly, PDEP children may be insensitive to the analgesic properties of sucrose because the opioid-mediated analgesia [70] relies on a functional serotonergic system [71,72], which might be altered in depressed individuals [57]. Finally, the greater sweet food liking by depressed children may lead to more frequent indulgences in sweets [73]. Animal model studies have shown that excessive sugar intake alters the efficacy of sucrose as an analgesic [70]. Whether the rewarding properties of fats are also altered in these children is an important area for future research (see [74]).
