title: Quality of life in major depressive disorder: the role of pain and pain catastrophizing cognition.
abstract: OBJECTIVE
  Pain symptoms are frequent complaints in patients with major depressive disorder (MDD). Although it is known that pain intensity and pain-related cognition predict quality of life (QOL) in patients with chronic pain, limited studies have examined their roles in MDD. The study aimed to determine whether pain and pain catastrophizing were independent predictors of QOL in MDD after accounting for the impact of anxiety and depression.
  
  
  METHODS
  This is a prospective, naturalistic follow-up study. Ninety-one Chinese patients were enrolled during an acute episode of MDD, 82 of them were reassessed 3 months later using the same assessment on pain, anxiety, depression, and QOL. Pain intensity was evaluated using a verbal rating scale and a visual analog scale. Quality of life was assessed using the 36-item Short Form Health Survey. Pain-related cognition was assessed at baseline with the Pain Catastrophizing Scale.
  
  
  RESULTS
  There was significant improvement in pain, anxiety, depression, and QOL from baseline to 3-month follow-up. Hierarchical regression analyses showed that pain intensity was significantly associated with QOL at baseline and 3 months. Pain complaint was more important than anxiety and depressive symptoms in predicting changes in both physical and psychosocial domains of QOL. After controlling for the severity of pain, anxiety, and depression, Pain Catastrophizing Scale score was independently associated with QOL in MDD.
  
  
  CONCLUSIONS
  The study supports the specific role of pain and pain-related cognition in predicting QOL in depressed patients. Further studies targeting pain-related cognition for improving the outcome of MDD are necessary.
authors.affiliation: Department of Psychiatry, The University of Hong Kong, Hong Kong SAR, China. kfchung@hkucc.hku.hk
authors.forename: Ka-Fai
authors.initials: KF
authors.lastname: Chung
authors.forename: Kwok-Chu
authors.initials: KC
authors.lastname: Tso
authors.forename: Wing-Fai
authors.initials: WF
authors.lastname: Yeung
authors.forename: Wei-Hui
authors.initials: WH
authors.lastname: Li
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001007:Anxiety / Q000150:complications / Q000523:psychology; D058443:Catastrophization / Q000150:complications / Q000523:psychology*; D003863:Depression / Q000150:complications / Q000523:psychology; D003865:Major Depressive Disorder / Q000150:complications / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000150:complications / Q000523:psychology*; D010147:Pain Measurement; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*