Regional origin and decrease of pain in patients with depressive symptoms under treatment with venlafaxine.
OBJECTIVE
Patient's language, tradition, conventions, and customs may all determine integration into a society and are also part of the doctor-patient relationship that influences diagnostic and therapeutic outcome. Language barrier and sociocultural disparity of Eastern and Southern European patients may hamper recovery from pain and depression compared to Middle European patients in Switzerland.


METHODS
In a prospective naturalistic observational trial we investigated the influence of regional origin on treatment outcome in 420 pain sufferers with depressive symptoms from all over Switzerland who were treated with venlafaxine by 122 physicians in primary care. Physicians rated severity of depressive symptoms using the clinical global impression severity scale and pain intensity by means of visual analogue scales. We hypothesized that in Eastern and Southern European patients the magnitude of pain reduction under treatment with venlafaxine is less compared to Middle European patients.


RESULTS
Three months after study entry, Middle European patients were found to profit more from treatment with venlafaxine in terms of severity of depression and pain intensity than patients from Eastern Europe and Southern Europe.


CONCLUSIONS
Regional origin may contribute to the magnitude of pain reduction in patients with depressive symptoms under treatment with venlafaxine. Our results provide a rational for care provider educational programs aimed at improving capacities in treating patients from different regional origin with psychosomatic complaints such as depression and comorbid pain.
Begré
Stefan
S
Division of Psychosomatic Medicine, Department of General Internal Medicine, University Hospital/Inselspital, 3010, Bern, Switzerland. stefan.begre@insel.ch
Traber
Martin
M
Gerber
Martin
M
von Känel
Roland
R
D000069:Acculturation; D000328:Adult; D000700:Analgesics / Q000627:therapeutic use*; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use; D002908:Chronic Disease; D015897:Comorbidity; D003469:Culture; D003511:Cyclohexanols / Q000627:therapeutic use*; D003863:Depression / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D005006:Ethnicity / Q000523:psychology*; D005060:Europe / Q000453:epidemiology; D005061:Europe, Eastern / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D010147:Pain Measurement; D010821:Physicians, Family / Q000706:statistics & numerical data; D011602:Psychophysiologic Disorders / Q000175:diagnosis / Q000188:drug therapy / Q000523:psychology; D012720:Severity of Illness Index; D013557:Switzerland / Q000453:epidemiology; D016896:Treatment Outcome; D000069470:Venlafaxine Hydrochloride
D000700:Analgesics; D018687:Antidepressive Agents, Second-Generation; D003511:Cyclohexanols; D000069470:Venlafaxine Hydrochloride