Frequency of painful physical symptoms with major depressive disorder in asia: relationship with disease severity and quality of life.
OBJECTIVE
Patients with major depressive disorder (MDD) frequently report concomitant painful physical symptoms, which may negatively impact diagnosis and treatment. The purpose of this study was to estimate the frequency of painful physical symptoms in Asian patients treated for an acute episode of MDD and to describe the associated demographics, clinical status, treatment patterns, and socioeconomic burden.


METHODS
This multicountry, observational study enrolled 909 patients with MDD (DSM-IV-TR or ICD-10 criteria) in the psychiatric care setting from June 14, 2006, to February 15, 2007. Patients were classified as positive for painful physical symptoms (PPS+) if they achieved a mean score >or= 2 on the modified Somatic Symptom Inventory. The Clinical Global Impressions-Severity of Illness scale (CGI-S) and 17-item Hamilton Rating Scale for Depression (HAM-D(17)) determined depression severity, and the EuroQoL Questionnaire-5 dimensions (EQ-5D) assessed subjective well-being.


RESULTS
Overall, 51.8% of patients were classified as PPS+. PPS+ patients were more likely to be female (72.2% vs. 65.1%, p = .022), had relatively more medical comorbidity (29.7% vs. 21.0% with >or= 1 comorbidity, p = .003), were more significantly depressed (CGI-S mean [SE] score = 4.84 [0.03] vs. 4.63 [0.04], p < .001; HAM-D(17) mean [SE] score = 24.80 [0.26] vs. 22.39 [0.27], p < .001), and reported a lower quality of life (EQ-5D health state mean [SE] score = 42.96 [0.92] vs. 52.92 [0.95], p < .001) than PPS- patients. PPS+ and PPS- patients did not differ markedly, however, in terms of MDD medications prescribed or MDD-related disability at work.


CONCLUSIONS
Painful physical symptoms are experienced by approximately half of patients with MDD in Asia and are associated with poor clinical status and perceived quality of life.
Lee
Phil
P
Taiwan Medical Affiliate, Eli Lilly and Co, Taipei, Taiwan.
Zhang
Mingyuan
M
Hong
Jin Pyo
JP
Chua
Hong-Choon
HC
Chen
Kuang-Peng
KP
Tang
Siu Wa
SW
Chan
Benjamin T M
BT
Lee
Min Soo
MS
Lee
Bobbie
B
Gallagher
Gabrielle L
GL
Dossenbach
Martin
M
D000328:Adult; D001210:Asia, Southeastern; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D005202:Asia, Eastern; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000453:epidemiology* / Q000523:psychology; D010147:Pain Measurement; D010555:Personality Inventory / Q000706:statistics & numerical data; D011446:Prospective Studies; D011594:Psychometrics; D011788:Quality of Life / Q000523:psychology