title: Improving outcomes in depression: a focus on somatic symptoms.
abstract: BACKGROUND
  It is hypothesized that somatic symptom alleviation is a significant predictor of overall outcome in depressed primary care patients.
  
  
  METHODS
  Depressed primary care patients (N=205) meeting DSM-IV-TR criteria received open-label antidepressant therapy. The primary symptom measurement tool used was the 17-item Hamilton Depression Rating Scale (HAMD-17), with the Montgomery-Asberg Depression Rating Scale (MADRS) and the Clinical Global Impression Improvement/Severity (CGI-I/S) used as secondary measures. As proxies for somatic symptoms, 8 items from the HAMD-17 (HAMD-S) and 3 items from the MADRS (MADRS-S) that measure somatic symptoms were identified and extracted.
  
  
  RESULTS
  There was a significant correlation between improvement on the HAMD-S score and overall reduction on the MADRS total score (r=.766, P<.001), response (r=.594, P<.001), and remission (r=.552, P<.001). Improvement on the MADRS-S also correlated with overall HAMD-17 improvement (r=.782, P<.001), along with response (r=.649, P<.001) and remission (r=.539, P<.001) rates. Both the HAMD-S and the MADRS-S correlated with global improvement as measured by the CGI-I/S (P<.001).
  
  
  CONCLUSIONS
  A reciprocal interaction between somatic symptoms and other depressive-symptom domains is implied by this analysis. Clinicians are encouraged to identify, track, and target the somatic symptoms of depressive illnesses.
authors.affiliation: Department of Psychiatry, University of Toronto, Toronto, ON, Canada. roger.mcintyre@uhn.on.ca
authors.forename: Roger S
authors.initials: RS
authors.lastname: McIntyre
authors.forename: Jakub Z
authors.initials: JZ
authors.lastname: Konarski
authors.forename: Deborah A
authors.initials: DA
authors.lastname: Mancini
authors.forename: Mateusz
authors.initials: M
authors.lastname: Zurowski
authors.forename: Peter
authors.initials: P
authors.lastname: Giacobbe
authors.forename: Joanna K
authors.initials: JK
authors.lastname: Soczynska
authors.forename: Sidney H
authors.initials: SH
authors.lastname: Kennedy
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D011320:Primary Health Care / Q000379:methods; D012074:Remission Induction; D013001:Somatoform Disorders / Q000175:diagnosis* / Q000523:psychology*
chemical_list: D000928:Antidepressive Agents