title: Comorbid painful physical symptoms and depression: prevalence, work loss, and help seeking.
abstract: BACKGROUND
  Painful physical symptoms (PPS) are frequent in patients with Major Depressive Episode (MDE). Here, the 12-month prevalence and sociodemographic characteristics of PPS were examined taking into account somatic comorbidity; quantitative and qualitative aspects of MDE with or without PPS were investigated as well as their impact on work loss days (WLD). Finally, help seeking and delay in help seeking were explored.
  
  
  METHODS
  In a cross-sectional, population-based study, a representative random sample of non-institutionalised adults from Belgium, France, Germany, Italy, the Netherlands and Spain (N = 21,425) was interviewed using the World Mental Health Composite Diagnostic Interview (CIDI 3.0 of the WHO).
  
  
  RESULTS
  PPS were reported by 29% of respondents without MDE and by 50% in those with MDE. Female gender, higher age and lower educational level were predictive of PPS. PPS were more frequent in more severely depressed patients but no qualitative differences were found in MDE with and MDE without PPS. An additive effect of MDE and PPS was found on the WLD score. Whether a comorbid somatic disorder was present or not did not change the findings. Finally, respondents with MDE and PPS had lower rates of help seeking for emotional reasons and show a trend to delay their help seeking longer.
  
  
  CONCLUSIONS
  The most important limitation of this study was its reliance on self-report data about somatic disorders.
  
  
  CONCLUSIONS
  Approximately one in two persons with a mood disorder also reported the presence of PPS. MDE and PPS result in decreased productivity and in lower rates of help seeking.
authors.affiliation: Department of Psychiatry, University Hospital Gasthuisberg, Leuven, Belgium. koen.demyttenaere@med.kuleuven.be
authors.forename: Koen
authors.initials: K
authors.lastname: Demyttenaere
authors.forename: Anke
authors.initials: A
authors.lastname: Bonnewyn
authors.forename: Ronny
authors.initials: R
authors.lastname: Bruffaerts
authors.forename: Terry
authors.initials: T
authors.lastname: Brugha
authors.forename: Ron
authors.initials: R
authors.lastname: De Graaf
authors.forename: Jordi
authors.initials: J
authors.lastname: Alonso
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology*; D010147:Pain Measurement; D010342:Patient Acceptance of Health Care; D011159:Population Surveillance / Q000379:methods; D015995:Prevalence; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014478:Unemployment / Q000706:statistics & numerical data*