title: Musculoskeletal Pain in Melancholic and Atypical Depression.
abstract: Pain and depressive disorders often present together, but little is known about the prevalence of pain in depression subgroups. The objective of this study was to examine the possible differences in the prevalence of musculoskeletal pain between participants in melancholic and atypical depression subgroups.
  
  
  
  Cross-sectional study.
  
  
  
  Depression nurse case managers where depression patients receive treatment in primary health care.
  
  
  
  Participants included 413 depression patients and 401 controls.
  
  
  
  Depressive symptoms were determined with the Beck Depression Inventory (BDI-21), and diagnosis of depression was confirmed with the Mini-International Neuropsychiatric Interview (MINI). The participants were dichotomized into subgroups with melancholic depression (n = 269), atypical depression (n = 144), and controls (n = 401). Musculoskeletal pain was identified during last four weeks. Participants were enrolled in the study between 2008 and 2009.
  
  
  
  The prevalence of pain was 37% in controls, 57% in atypical depression, and 71% in melancholic depression (P < 0.001, after adjusting for sex and age). A logistic regression model showed that the odds ratio of pain after adjusting for confounding factors was 2.35 (1.56 to 3.56) with atypical depression compared with controls (P < 0.001) and 4.38 (3.03 to 6.33) with melancholic depression compared with atypical depression (P = 0.006). BDI scores were higher for those with melancholic depression than for those with atypical depression (P < 0.001).
  
  
  
  Melancholic depression showed to be associated with a higher prevalence of musculoskeletal pain in comparison with atypical depression. This finding highlights the need for further studies about the mechanisms behind the association, particularly in melancholic depression.
authors.affiliation: Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
authors.forename: Katariina
authors.initials: K
authors.lastname: Korniloff
authors.affiliation: Saarikka Primary Care Public Utility, Saarijärvi, Finland.
authors.forename: Satu
authors.initials: S
authors.lastname: Kotiaho
authors.affiliation: Primary Health Care Unit, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland.|Primary Health Care Unit, Central Finland Central Hospital, Jyväskylä, Finland.
authors.forename: Mauno
authors.initials: M
authors.lastname: Vanhala
authors.affiliation: Primary Health Care Unit, Kuopio University Hospital, Kuopio, Finland.|Department of General Practice, University of Helsinki, Helsinki, Finland.|Unit of Primary Health Care, Helsinki University Central Hospial, Helsinki, Finland.
authors.forename: Hannu
authors.initials: H
authors.lastname: Kautiainen
authors.affiliation: Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: Hannu
authors.initials: H
authors.lastname: Koponen
authors.affiliation: Primary Health Care Unit, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland.
authors.forename: Pekka
authors.initials: P
authors.lastname: Mäntyselkä
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D059352:Musculoskeletal Pain / Q000453:epidemiology*; D015995:Prevalence
keywords: Depression Characteristics; Depressive Disorder; Musculoskeletal Pain