title: Which somatic symptoms are associated with an unfavorable course in Chinese patients with major depressive disorder?
abstract: BACKGROUND
  This was an analysis of the impact of somatic symptoms on the severity and course of depression in Chinese patients treated for an acute episode of major depressive disorder (MDD).
  
  
  METHODS
  Data were extracted from a 3-month prospective observational study which enrolled 909 patients with MDD in psychiatric care settings; this analysis focused on the Chinese patients (n=300). Depression severity was assessed using the Clinical Global Impression of Severity (CGI-S) and 17-item Hamilton Depression Rating Scale (HAMD-17); somatic symptoms were assessed using the patient-rated 28-item Somatic Symptom Inventory (SSI). Cluster analysis using baseline SSI scores grouped patients into three clusters with no/mild, moderate, or severe somatic symptoms. Four SSI factors (pain, autonomic symptoms, energy, and central nervous system) were defined, and regression analyses identified which factors were associated with remission at 3 months.
  
  
  RESULTS
  More than 70% of the patients had moderate or severe somatic symptoms. Baseline depression severity (HAMD-17 and CGI-S scores) was associated with more severe somatic symptoms. Remission rates differed between clusters of patients: 84.1%, 72.0%, and 55.3% for no/mild, moderate, and severe somatic symptoms, respectively (P=0.0034). Pain symptoms were the somatic symptoms more strongly associated with lower remission rates at 3 months.
  
  
  CONCLUSIONS
  Somatic symptoms are associated with greater clinical severity and lower remission rates. Among somatic symptoms, pain symptoms have the greatest prognostic value and should be taken into account when treating patients with depression.
authors.affiliation: Eli Lilly and Company, Windlesham, Surrey, UK.
authors.forename: Diego
authors.initials: D
authors.lastname: Novick
authors.affiliation: Eli Lilly Australia Pty Ltd, Sydney, NSW, Australia.
authors.forename: William S
authors.initials: WS
authors.lastname: Montgomery
authors.affiliation: Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Barcelona, Spain.
authors.forename: Jaume
authors.initials: J
authors.lastname: Aguado
authors.affiliation: Eli Lilly and Company, Indianapolis, IN, USA.
authors.forename: Xiaomei
authors.initials: X
authors.lastname: Peng
authors.affiliation: Università di Roma "Sapienza", Rome, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Brugnoli
authors.affiliation: Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Barcelona, Spain.
authors.forename: Josep Maria
authors.initials: JM
authors.lastname: Haro
mesh_terms: D000328:Adult; D001342:Autonomic Nervous System Diseases / Q000453:epidemiology*; D002493:Central Nervous System Diseases / Q000453:epidemiology*; D002681:China; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000453:epidemiology* / Q000628:therapy; D005221:Fatigue / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006723:Hong Kong; D006801:Humans; D008296:Malaysia; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D010146:Pain / Q000453:epidemiology*; D056910:Republic of Korea; D012720:Severity of Illness Index; D012846:Singapore; D013624:Taiwan
keywords: Chinese; depression; outcome; pain; somatic symptom