Depressive and anxiety neuroses are the most common psychiatric disorders associated with back pain. In assessing the connections between back pain and depression, the different forms of depression should be considered. There are some depressed back pain patients with the traditional depressed mood as the principal symptom of mood disorder. It seems, however, that the depression associated with back pain is usually atypical in nature and that signs of depression other than the depressed mood have to be taken into account. Alexithymic features associated with the pain can also mask the depression.