Presence and predictors of pain in depression: results from the FINDER study.
BACKGROUND
Patients with depression often experience pain. There is limited understanding of the relation between pain and other symptoms (depressive, anxious and non-painful somatic symptoms). This exploratory study assesses pain severity and interference of pain with functioning in a clinically depressed population and investigates the relation between the different groups of symptoms.


METHODS
FINDER was a 6-month prospective, observational study investigating health-related quality of life of outpatients with depression initiating antidepressant treatment. Patients completed ratings on the Hospital Anxiety and Depression Scale (HADS), Somatic Symptom Inventory (SSI-28), and overall pain severity and interference of pain with functioning using Visual Analogue Scales (VAS) at baseline and at 3 and 6 months. Regression analyses identified factors associated with overall pain severity and interference of pain with functioning, at baseline and over the observation period.


RESULTS
Of 3468 eligible patients at baseline, 56.3% experienced moderate to severe pain and 53.6% had moderate to severe pain-related interference with functioning. At 6 months of follow-up, these proportions decreased to 32.5% and 28.1%, respectively. Higher baseline SSI-somatic scores (non-painful) were strongly associated with greater pain severity and greater pain-related interference with functioning at baseline and over 6 months. Certain socio-demographic (increasing age, being unemployed) and depression-related factors (more previous episodes, longer duration of current episode) were also significantly associated with greater pain severity and interference over 6 months, while higher baseline severity of depression (HADS-D) and further education were associated with less severe pain or pain-related interference with functioning over 6 months.


CONCLUSIONS
Over half of depressed patients in this study experienced moderate to severe pain. Painful somatic symptoms appear to be closely related to non-painful somatic symptoms, more than to depressive or anxious symptoms suggesting that painful and non-painful somatic symptoms can be considered as one group of 'somatic symptoms,' all of them associated with depressive and anxious symptoms.
Demyttenaere
K
K
Univerity Psychiatric Centre, KuLeuven, Campus Leuven, Herestraat 49, 3000 Leuven, Belgium. Koen.Demyttenaere@med.kuleuven.ac.be
Reed
C
C
Quail
D
D
Bauer
M
M
Dantchev
N
N
Montejo
A L
AL
Monz
B
B
Perahia
D
D
Tylee
A
A
Grassi
L
L
D000328:Adult; D000700:Analgesics / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000627:therapeutic use; D001008:Anxiety Disorders / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology; D015897:Comorbidity; D003866:Depressive Disorder / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology*; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000453:epidemiology / Q000523:psychology*; D010147:Pain Measurement; D010342:Patient Acceptance of Health Care / Q000523:psychology; D010555:Personality Inventory / Q000706:statistics & numerical data; D011320:Primary Health Care; D011446:Prospective Studies; D011594:Psychometrics; D011788:Quality of Life / Q000523:psychology; D013001:Somatoform Disorders / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology*
D000700:Analgesics; D000928:Antidepressive Agents