Depression can cause emotional symptoms as well as physical symptoms. The physical symptoms of depression can include headaches, back pain, chronic aches and pains, chest pain, digestive problems, exhaustion, sleep problems, change in appetite and/or weight, and dizziness. Patients complaining of pain are nearly three times more likely to report symptoms of depression. Now research reports that depressed patients with pain may be more likely to have a poor response to antidepressant therapy.
The study, published in the journal Psychosomatic Medicine, examined the association of pain on depression treatment response and health-related quality of life. Researchers at the Indiana University School of Medicine in Indianapolis compared the data of 573 clinically depressed patients treated with one of three selective serotonin reuptake inhibitor (SSRI) antidepressants: fluoxetine, paroxetine, or sertraline. The subjects were followed in 37 primary care clinics and were participants in the ARTIST study. The researchers evaluated the participants' depression with the Symptom Checklist-20 (SCL-20).
The researchers found that more than two thirds of depressed patients reported pain at the beginning of the study, with 25 percent of participants reporting mild pain, 30 percent reporting moderate pain and 14 percent reporting severe pain. Furthermore, 24 percent of the pain group had a poor depression treatment response after three months of antidepressant therapy. The severity of pain also adversely affected health-related quality of life.
The study suggests that physical pain associated with depression may adversely affect antidepressant therapy. "Pain is present in two thirds of depressed primary care patients begun on antidepressant therapy, and the severity of pain is a strong predictor of poor depression and health-related quality of life outcomes at 3 months," the study authors conclude. "Better recognition, assessment, and treatment of comorbid pain may enhance outcomes of depression therapy."
REFERENCES:
1. Bair MJ et al. Impact of pain on depression treatment response in primary care. Psychosom Med 2004 Jan-Feb;66(1):17-22.
Posted by Elaine Gavalas on August 1, 2006 02:03 PM
