Frequency of painful physical symptoms with major depressive disorder in Asia: Relationship with disease severity and quality of life

Objective: Patients with major depressive disorder (MDD) frequently report concomitant painful physical symptoms, which may negatively impact diagnosis and treatment. The purpose of this study was to estimate the frequency of painful physical symptoms in Asian patients treated for an acute episode of MDD and to describe the associated demographics, clinical status, treatment patterns, and socioeconomic burden. Method: This multicountry, observational study enrolled 909 patients with MDD (DSM-IV-TR or ICD-10 criteria) in the psychiatric care setting from June 14, 2006, to February 15, 2007. Patients were classified as positive for painful physical symptoms (PPS+) if they achieved a mean score ≥ 2 on the modified Somatic Symptom Inventory. The Clinical Global Impressions-Severity of Illness scale (CGI-S) and 17-item Hamilton Rating Scale for Depression (HAM-D₁₇) determined depression severity, and the EuroQoL Questionnaire-5 dimensions (EQ-5D) assessed subjective well-being. Results: Overall, 51.8% of patients were classified as PPS+. PPS+ patients were more likely to be female (72.2% vs. 65.1%, p = .022), had relatively more medical comorbidity (29.7% vs. 21.0% with ≥ 1 comorbidity, p = .003), were more significantly depressed (CGI-S mean [SE] score = 4.84 [0.03] vs. 4.63 [0.04], p < .001; HAM-D₁₇ mean [SE] score = 24.80 [0.26] vs. 22.39 [0.27], p < .001), and reported a lower quality of life (EQ-5D health state mean [SE] score = 42.96 [0.92] vs. 52.92 [0.95], p < .001) than PPS- patients. PPS+ and PPS- patients did not differ markedly, however, in terms of MDD medications prescribed or MDD-related disability at work. Conclusion: Painful physical symptoms are experienced by approximately half of patients with MDD in Asia and are associated with poor clinical status and perceived quality of life.