title: Early reduction in painful physical symptoms is associated with improvements in long-term depression outcomes in patients treated with duloxetine.
abstract: BACKGROUND
  To investigate the association of the change of painful physical symptoms (PPS) after 4 weeks, with the 6-month treatment outcomes of depressive symptoms in patients treated with duloxetine in clinical practice.
  
  
  METHODS
  Multicenter, prospective, 6-month, non-interventional study in adult outpatients with a depressive episode and starting treatment with duloxetine. Depression severity was assessed by the clinician (Inventory for Depressive Symptomatology [IDS-C]) and patient (Kurz-Skala Stimmung/Aktivierung [KUSTA]). Somatic symptoms and PPS were assessed using the patient-rated Somatic Symptom Inventory (SSI) and visual analog scales (VAS) for pain items. Association of change in PPS with outcomes of depressive symptoms was analyzed based on mean KUSTA scores (mean of items mood, activity, tension/relaxation, sleep) and achievement of a 50% reduction in the total IDS-C score after 6 months using linear and logistic regression models, respectively.
  
  
  RESULTS
  Of the 4,517 patients enrolled (mean age: 52.2 years, 71.8% female), 3,320 patients (73.5%) completed the study. 80% of the patients had moderate to severe overall pain (VAS > 30 mm) at baseline. A 50% VAS overall pain reduction after 4 weeks was associated with a 13.32 points higher mean KUSTA score after 6 months, and a 50% pain reduction after 2 weeks with a 6.33 points improvement. No unexpected safety signals were detected in this naturalistic study.
  
  
  CONCLUSIONS
  Pain reduction after 2 and 4 weeks can be used to estimate outcomes of long-term treatment with duloxetine. PPS associated with depression have a potential role in predicting remission of depressive symptoms in clinical practice.
authors.affiliation: Lilly Deutschland GmbH, Medical Department, Bad Homburg, Germany. schneider_edith@lilly.com
authors.forename: Edith
authors.initials: E
authors.lastname: Schneider
authors.forename: Michael
authors.initials: M
authors.lastname: Linden
authors.forename: Harald
authors.initials: H
authors.lastname: Weigmann
authors.forename: Thomas
authors.initials: T
authors.lastname: Wagner
authors.forename: Deborah
authors.initials: D
authors.lastname: Quail
authors.forename: Hans-Peter
authors.initials: HP
authors.lastname: Hundemer
authors.forename: Ulrich
authors.initials: U
authors.lastname: Hegerl
mesh_terms: D000928:Antidepressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D003863:Depression / Q000150:complications / Q000188:drug therapy*; D000068736:Duloxetine Hydrochloride; D005260:Female; D006801:Humans; D038801:International Classification of Diseases / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010045:Outpatients / Q000523:psychology; D010146:Pain / Q000150:complications / Q000188:drug therapy*; D010147:Pain Measurement / Q000187:drug effects / Q000379:methods; D011446:Prospective Studies; D012720:Severity of Illness Index; D013876:Thiophenes / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D000928:Antidepressive Agents; D013876:Thiophenes; D000068736:Duloxetine Hydrochloride