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
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
in lower back,' ‘Neck 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 ≥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
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.
MDD = Major Depressive Disorder; SSI = Somatic Symptoms Inventory; HAMD = Hamilton Depression Rating Scale; DSM-IV-TR = Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision; ICD-10 = International Classification of Diseases, 10th Revision.