title: Effectiveness of antidepressants in the treatment of major depressive disorder in Latin America.
abstract: Objective. Painful physical symptoms occur frequently in patients with major depressive disorder (MDD), and although numerous studies report the effect of antidepressants on emotional aspects of depression, few focus on their effect on physical symptoms. This observational study was conducted, in a clinical practice setting, to determine antidepressant treatment decisions and their outcome on the physical and emotional symptoms of MDD. Methods. Patients with a mean score ≥2 for pain-related items on the Somatic Symptom Inventory (SSI) were classified with painful physical symptoms (PPS +) and differentiated from the remaining patients (PPS -). Severity of depression and physical pain were determined using the 17-item Hamilton Depression Rating Scale (HAMD17) and Clinical Global Impressions of Severity Scale (CGI-S), and Visual Analog Scale (VAS), respectively. Results. At baseline, 72.6% of patients were PPS+. Compared to PPS- patients, PPS +patients were, on average, significantly more depressed at baseline (mean difference [95% CI]: HAMD17 4.6 [3.6, 5.5] and CGI-S 0.3 [0.2, 0.4]; all p<0.0001), and remained more depressed and in greater pain at endpoint (HAMD17p=0.0074, CGI-S P =0.0151, and VAS P <0.0001). In addition, fewer PPS+ patients (65.8%) achieved remission (total HAMD17≤7) compared to PPS- patients (74.6%, P =0.0180). Conclusions. Painful physical symptoms are prevalent in MDD patients, highlighting the importance of addressing both the physical and emotional symptoms of depression.
authors.affiliation: Eli Lilly and Company, Mexico.
authors.forename: Héctor J
authors.initials: HJ
authors.lastname: Dueñas
authors.forename: Trisha
authors.initials: T
authors.lastname: Dwight
authors.forename: Margaret E
authors.initials: ME
authors.lastname: McBride
authors.forename: Alan J M
authors.initials: AJ
authors.lastname: Brnabic
authors.forename: Luis A
authors.initials: LA
authors.lastname: Semper
authors.forename: Dagmar
authors.initials: D
authors.lastname: Holmgren
authors.forename: Angela M A
authors.initials: AM
authors.lastname: Miranda-Scippa
authors.forename: Hernán G
authors.initials: HG
authors.lastname: Rincón
authors.forename: Héctor
authors.initials: H
authors.lastname: Aguilera
authors.forename: Adrian
authors.initials: A
authors.lastname: Vargas
keywords: Major depressive disorder; antidepressants; observational study; painful physical symptoms