Body pain and treatment response in late-life depression.
OBJECTIVE
The authors investigated the influence of body pain on 1) time to treatment response and 2) suicidal ideation, in late-life depression. They hypothesized that higher levels of body pain would predict a longer time to and lower likelihood of response, and increased levels of suicidal ideation.


METHODS
Subjects (N=187) were older adult outpatients (age > or =69 years), with current episodes of major depression, who were openly treated with paroxetine up to 40 mg daily and weekly interpersonal psychotherapy. Response was defined as 3 consecutive weeks of Hamilton Rating Scale for Depression at < or =10. Body pain was measured with the Bodily Pain Index of the SF-36 quality-of-life assessment. Authors used survival-analysis models on the responder sample to test the effect of body pain on response, after controlling for severity of depression.


RESULTS
Overall response rate was 75.4%. Nonresponders reported more severe pain at baseline. After covarying for severity of baseline depression, no effect was found for physical pain on time-to-response or degree of suicidality. Bodily pain remained stable during acute treatment for responders, independent of depression response to combination psychotherapy and antidepressant treatment.


CONCLUSIONS
Older adult patients with higher levels of physical pain can still respond to antidepressant treatment; however, reported bodily pain may be associated with a more difficult-to-treat depression.
Karp
Jordan F
JF
Western Psychiatric Institute and Clinic, 3811 O'Hara St., Pittsburgh, PA 15213, USA. karpjf@upmc.edu
Weiner
Debra
D
Seligman
Karen
K
Butters
Meryl
M
Miller
Mark
M
Frank
Ellen
E
Stack
Jacqueline
J
Mulsant
Benoit H
BH
Pollock
Bruce
B
Dew
Mary Amanda
MA
Kupfer
David J
DJ
Reynolds
Charles F
CF
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003865:Major Depressive Disorder / Q000523:psychology* / Q000628:therapy; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D010146:Pain / Q000523:psychology*; D059408:Pain Management; D010147:Pain Measurement; D017374:Paroxetine / Q000627:therapeutic use; D011613:Psychotherapy; D013405:Suicide / Q000523:psychology; D013997:Time Factors
D018687:Antidepressive Agents, Second-Generation; D017374:Paroxetine