Influence of painful physical symptoms in the treatment of Japanese patients with melancholic major depressive disorder: A prospective cohort study.
The aim of this study was to clarify how painful physical symptoms affect treatment outcomes in patients with melancholic major depressive disorder. The subjects comprised 100 consecutive Japanese outpatients with melancholic major depressive disorder who visited our clinic from October 2011 to October 2014. All subjects were interviewed for Diagnostic and Statistical Manual of Mental Disorders Axis 2, 3, and 4 and family history of major depressive disorder, and then grouped according to the presence of painful physical symptoms. We evaluated painful physical symptoms at baseline and after 12, 24, and 36 weeks of treatment and scores on the 17-item Hamilton Rating Scale for Depression, compared major depressive disorder remission between groups, and assessed responsiveness to antidepressants. The group with painful physical symptoms had a significantly more positive family history of major depressive disorder. The major depressive disorder remission rate was high in both groups, and no significant differences were observed. However, a significant relationship between major depressive disorder and painful physical symptoms remission was observed in the group with painful physical symptoms. A significantly higher number of remitted patients with painful physical symptoms (N=61) were administered serotonin-noradrenaline reuptake inhibitors, with significantly more receiving duloxetine than milnacipran.
The Medical Foundation of Keishin-Kai, Kei-Mental Clinic, Omagari Torimachi 10-8, Daisen City, Akita 014-0027, Japan. Electronic address: sekinedjs1209@xqh.biglobe.ne.jp.
Atsushi
A
Sekine
The Medical Foundation of Keishin-Kai, Kyowa Hospital, Daisen City, Akita, Japan.
Satoshi
S
Hozumi
Department of Psychiatry, Akita University Graduate School of Medicine, Akita City, Akita, Japan.
Tetsuo
T
Shimizu
D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use*; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use; D015897:Comorbidity; D003521:Cyclopropanes / Q000627:therapeutic use; D003866:Depressive Disorder / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology; D003865:Major Depressive Disorder / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004334:Drug Administration Schedule; D000068736:Duloxetine Hydrochloride / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000078764:Milnacipran; D010146:Pain / Q000150:complications / Q000503:physiopathology*; D011446:Prospective Studies; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D000068760:Serotonin and Noradrenaline Reuptake Inhibitors / Q000627:therapeutic use*; D016896:Treatment Outcome
D000928:Antidepressive Agents; D000929:Antidepressive Agents, Tricyclic; D003521:Cyclopropanes; D000068736:Duloxetine Hydrochloride; D000078764:Milnacipran; D017367:Selective Serotonin Reuptake Inhibitors; D000068760:Serotonin and Noradrenaline Reuptake Inhibitors
Duloxetine; Ethnicity; Melancholic features; Serotonin-noradrenalin reuptake inhibitors