Multiple pain complaints in patients with major depressive disorder.
OBJECTIVE
To characterize the co-existence of multiple pain-related complaints in patients enrolled in a series of pharmaceutical company drug trials for the treatment of Major Depressive Disorder (MDD).


METHODS
Pooled 'blinded' data from 2191 patients enrolled in randomized, multicenter, double-blind placebo-controlled studies for the treatment of MDD were analyzed. Painful symptoms were assessed using the seven pain symptoms subset of the Somatic Symptoms Inventory: 'Headache,' 'Pain in lower back,' 'Neck pain,' 'Pain in joints,' 'Soreness in muscles,' 'Pain in heart or chest,' and 'Pain or cramps in abdomen.' The 17-item Hamilton Depression Rating Scale (HAMD) was used to assess severity of depression.


RESULTS
Of those meeting the study entry criteria (total HAMD score >or=15), 25% reported no pain complaints and 18% reported 1 pain compliant; the majority (57%) of patients reported the co-existence of multiple pain-related complaints, with 14%, 12%, 11%, 11%, 7%, and 3% of patients reporting 2, 3, 4, 5, 6 and 7 different pain symptoms, respectively. The number of pain-related symptoms experienced was moderately related to severity of depression (r = 0.35), with the most common pain symptom combinations being among headaches, lower back pain, neck pain, pain in joints, and soreness in muscles.


CONCLUSIONS
This study supports pain as a component feature of MDD. The number of comorbid pain-related complaints, which generally increased as a function of depressive severity, should be considered in the diagnosis of depression, planning of treatment strategies, and measurement of treatment outcome.
Vaccarino
Anthony L
AL
Ontario Cancer Biomarker Network, MaRS Centre, South Tower, 101 College Street, Suite 200, Toronto, Ontario, Canada. avaccarino@ocbn.ca
Sills
Terrence L
TL
Evans
Kenneth R
KR
Kalali
Amir H
AH
D015746:Abdominal Pain / Q000453:epidemiology; D000328:Adult; D018771:Arthralgia / Q000453:epidemiology; D001416:Back Pain / Q000453:epidemiology; D002637:Chest Pain / Q000453:epidemiology; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000453:epidemiology* / Q000503:physiopathology; D004311:Double-Blind Method; D005260:Female; D006261:Headache / Q000453:epidemiology; D006801:Humans; D008297:Male; D008959:Models, Neurological; D015337:Multicenter Studies as Topic / Q000706:statistics & numerical data; D009135:Muscular Diseases / Q000453:epidemiology; D019547:Neck Pain / Q000453:epidemiology; D018377:Neurotransmitter Agents / Q000172:deficiency / Q000502:physiology; D010146:Pain / Q000453:epidemiology* / Q000503:physiopathology; D015995:Prevalence; D016032:Randomized Controlled Trials as Topic / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D016037:Single-Blind Method
D018377:Neurotransmitter Agents