Multiple pain complaints in patients with major depressive disorder

• Published in: Psychosomatic medicine Vol. 71; no. 2; pp. 159 - 162
• Main Authors: Vaccarino, Anthony L, Sills, Terrence L, Evans, Kenneth R, Kalali, Amir H
• Format: Journal Article
• Language: English
• Published: United States Lippincott Williams & Wilkins Ovid Technologies 01-02-2009
• Subjects: Abdominal Pain - epidemiology; Adult; Arthralgia - epidemiology; Back Pain - epidemiology; Chest Pain - epidemiology; Clinical trials; Comorbidity; Complaints; Depressive Disorder, Major - epidemiology; Depressive Disorder, Major - physiopathology; Depressive personality disorders; Double-Blind Method; Female; Headache - epidemiology; Humans; Male; Mental disorders; Models, Neurological; Multicenter Studies as Topic - statistics & numerical data; Muscular Diseases - epidemiology; Neck Pain - epidemiology; Neurotransmitter Agents - deficiency; Neurotransmitter Agents - physiology; Pain; Pain - epidemiology; Pain - physiopathology; Patients; Prevalence; Psychosomatic medicine; Randomized Controlled Trials as Topic - statistics & numerical data; Severity; Severity of Illness Index; Single-Blind Method; Somatic symptoms; Studies; Symptoms
• ISSN: 0033-3174; 1534-7796
• DOI: 10.1097/PSY.0b013e3181906572

To characterize the co-existence of multiple pain-related complaints in patients enrolled in a series of pharmaceutical company drug trials for the treatment of Major Depressive Disorder (MDD).
Pooled 'blinded' data from 2191 patients enrolled in randomized, multicenter, double-blind placebo-controlled studies for the treatment of MDD were analyzed. Painful symptoms were assessed using the seven pain symptoms subset of the Somatic Symptoms Inventory: 'Headache,' 'Pain in lower back,' 'Neck pain,' 'Pain in joints,' 'Soreness in muscles,' 'Pain in heart or chest,' and 'Pain or cramps in abdomen.' The 17-item Hamilton Depression Rating Scale (HAMD) was used to assess severity of depression.
Of those meeting the study entry criteria (total HAMD score >or=15), 25% reported no pain complaints and 18% reported 1 pain compliant; the majority (57%) of patients reported the co-existence of multiple pain-related complaints, with 14%, 12%, 11%, 11%, 7%, and 3% of patients reporting 2, 3, 4, 5, 6 and 7 different pain symptoms, respectively. The number of pain-related symptoms experienced was moderately related to severity of depression (r = 0.35), with the most common pain symptom combinations being among headaches, lower back pain, neck pain, pain in joints, and soreness in muscles.
This study supports pain as a component feature of MDD. The number of comorbid pain-related complaints, which generally increased as a function of depressive severity, should be considered in the diagnosis of depression, planning of treatment strategies, and measurement of treatment outcome.