Hostname: page-component-cd9895bd7-jn8rn Total loading time: 0 Render date: 2024-12-25T04:51:45.544Z Has data issue: false hasContentIssue false
  • English
  • Français

Impact of painful physical symptoms on depression outcomes in elderly Asian patients

Published online by Cambridge University Press:  04 November 2014

Diego Novick ,
William Montgomery ,
Jordan Bertsch ,
Xiaomei Peng ,
Roberto Brugnoli  and
Josep Maria Haro
Diego Novick
Affiliation:
Eli Lilly and Company, Windlesham, Surrey, UK
William Montgomery
Affiliation:
Eli Lilly Australia Pty Ltd, West Ryde, Australia
Jordan Bertsch
Affiliation:
Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Barcelona, Spain
Xiaomei Peng
Affiliation:
Eli Lilly and Company, Indianapolis, Indiana, USA
Roberto Brugnoli
Affiliation:
Department of Neuroscience, School of Medicine, Sapienza University of Rome, Rome, Italy
Josep Maria Haro*
Affiliation:
Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Barcelona, Spain
*
Correspondence should be addressed to: Josep Maria Haro, Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Dr Antoni Pujadas, 42, 08830 Sant Boi de Llobregat (Barcelona), Spain. Email: [email protected].
Get access

Abstract

Background:

Painful physical symptoms (PPS) are prevalent among elderly patients with depression. We describe the impact of PPS on depression outcomes and quality of life (QOL) of elderly Asian patients with major depressive disorder (MDD).

Methods:

This post hoc analysis of data from a three-month prospective observational study of East Asian MDD in- or out-patients focused on elderly patients aged ≥60 years. Depression severity was evaluated using the Hamilton depression (HAMD-17) and clinical global impression of severity (CGI-S) scales, while QOL was measured using EuroQOL (EQ-5D and EQ-VAS) instruments. PPS were rated using the modified somatic symptom inventory (SSI).

Results:

At baseline, depression was moderate to severe and 49% of the 146 elderly patients were painful physical symptom positive (PPS+). Bivariate analysis showed significant correlations between PPS and depression severity and QOL at baseline. Linear regression models showed the baseline factor most significantly associated with depression severity at three months was baseline PPS status. PPS+ patients had a mean increase of 2.87 points in their HAMD-17 rating and 0.77 points in their CGI-S score. Response and remission were significantly lower in PPS+ patients; response was 60% and remission was 40% in PPS+ patients while 82% and 66% in painful physical symptom negative (PPS−) patients. QOL at endpoint was lower in PPS+ patients.

Conclusions:

PPS are common in elderly Asian patients with MDD and negatively influence depression outcomes and QOL. Patients with PPS had lower QOL at baseline, lower response and remission rates, higher severity of depression, and lower QOL after three months of treatment.

Keywords

painphysical symptomsdepressionelderlyAsian
Type
Research Article
Information
International Psychogeriatrics , Volume 27 , Issue 2 , February 2015 , pp. 305 - 312
Copyright
Copyright © International Psychogeriatric Association 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Ahlström, A., Tallgren, M., Peltonen, S., Räsänen, P. and Pettilä, V. (2005). Survival and quality of life of patients requiring acute renal replacement therapy. Intensive Care Medicine, 31, 1222–1228.CrossRefGoogle ScholarPubMed
Ang, Q. Q. et al. (2009). Association between painful physical symptoms and clinical outcomes in East Asian patients with major depressive disorder: a 3-month prospective observational study. International Journal of Clinical Practice, 63, 1041–1049.Google Scholar
Arnow, B. A. et al. (2006). Comorbid depression, chronic pain and disability in primary care. Psychosomatic Medicine, 68, 262–268.Google Scholar
Arola, H. M., Nicholls, E., Mallen, C. and Thomas, E. (2010). Self-reported pain interference and symptoms of anxiety and depression in community-dwelling older adults: can a temporal relationship be determined? European Journal of Pain, 14, 966–971.Google Scholar
Bahk, W. M., Park, S., Jon, D. I., Yoon, B. H., Min, K. J. and Hong, J. P. (2011). Relationship between painful physical symptoms and severity of depressive symptomatology and suicidality. Psychiatry Research, 189, 357–361.CrossRefGoogle ScholarPubMed
Bair, M. J., Robinson, R. L., Katon, W. and Kroenke, K. (2003). Depression and pain comorbidity. Archives of Internal Medicine, 163, 2433–2445.CrossRefGoogle ScholarPubMed
Bair, M. J., Robinson, R. L., Eckert, G. J., Stang, P. E., Croghan, T. W. and Kroenke, K. (2004). Impact of pain on depression treatment response in primary care. Psychosomatic Medicine, 66, 17–22.Google Scholar
Brooks, R., Rabin, R. and de Charro, F. (2003). The Measurement and Valuation of Health Status using EQ-5D: A European Perspective. Dordrecht, The Netherlands: Kluwer Academic Publishers.CrossRefGoogle Scholar
Chen, X., Cheng, H G, Huang, Y., Liu, Z. and Luo, X. (2012). Depression symptoms and chronic pain in the community population in Beijing, China. Psychiatry Research, 200, 313–317.Google Scholar
Chou, K. and Chi, I. (2005). Reciprocal relationship between pain and depression in elderly Chinese primary care patients. International Journal of Geriatric Psychiatry, 20, 945–952.Google Scholar
Drayer, R. A. et al. (2005). Somatic symptoms of depression in elderly patients with medical comorbidities. International Journal of Geriatric Psychiatry, 20, 973–982.Google Scholar
Egede, L. E. (2007). Major depression in individuals with chronic medical disorders: prevalence, correlates and association with health resource utilization, lost productivity and functional disability. General Hospital Psychiatry, 29, 409–416.Google Scholar
Fu, A. Z. and Kattan, M. W. (2006). Racial and ethnic differences in preference-based health status measure. Current Medical Research and Opinion, 22, 2439–2448.CrossRefGoogle ScholarPubMed
Gambassi, G. (2009). Pain and depression: the egg and the chicken story revisited. Archives of Gerontology and Geriatrics, 1 (Suppl.), 103–112.Google Scholar
Gayman, M. D., Brown, R. L. and Cui, M. (2011). Depressive symptoms and bodily pain: the role of physical disability and social stress. Stress and Health, 27, 52–63.Google Scholar
Gerhards, S. A., Huibers, Theunissen, M. J., de Graaf, K. A., Widdershoven, L. E., Evers, G. A., , S. M. (2011). The responsiveness of quality of life utilities to change in depression: a comparison of instruments (SF-6D, EQ-5D, and DFD). Value in Health, 14, 732–739.Google Scholar
Hawker, G. A. et al. 2011. A longitudinal study to explain the pain-depression link in older adults with osteoarthritis. Arthritis Care & Research, 63, 1382–1390.CrossRefGoogle ScholarPubMed
Herdman, M. et al. (2011). Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L). Quality of Life Research, 20, 1727–1736.Google Scholar
Iqbal, J., Francis, L., Reid, J., Murray, S. and Denvir, M. (2010). Quality of life in patients with chronic heart failure and their carers: a 3-year follow-up study assessing hospitalization and mortality. European Journal of Heart Failure, 12, 1002–1008.CrossRefGoogle ScholarPubMed
Jansson, K. Å. and Granath, F. (2011). Health-related quality of life (EQ-5D) before and after orthopedic surgery. Acta Orthopaedica, 82, 82–89.CrossRefGoogle ScholarPubMed
Ji, J. L. and Zhang, H. F. (2002). Help-seeking behavior of depressive patients presented with somatic complaints. Chinese Mental Health Journal, 16, 605–608 [in Chinese].Google Scholar
Kapfhammer, H. -P. (2006). Somatic symptoms in depression. Dialogues in Clinical Neuroscience, 8, 227–239.Google Scholar
Karp, J. F., Scott, J., Houck, P., Reynolds, C. F. 3rd, Kupfer, D. J. and Frank, E. (2005). Pain predicts longer time to remission during treatment of recurrent depression. Journal of Clinical Psychiatry, 66, 591–597.Google Scholar
Kil, S. Y., Oh, W. O., Koo, B. J. and Suk, M. H. (2010). Relationship between depression and health-related quality of life in older Korean patients with chronic obstructive pulmonary disease. Journal of Clinical Nursing, 19, 1307–1314.Google Scholar
Lee, P. et al. (2009). Frequency of painful physical symptoms with major depressive disorder in Asia: relationship with disease severity and quality of life. Journal of Clinical Psychiatry, 70, 83–91.CrossRefGoogle ScholarPubMed
Leucht, S., Fennema, H., Engel, R., Kaspers-Janssen, M., Lepping, P. and Szegedi, A. (2013). What does the HAMD mean? Journal of Affective Disorders, 148, 243–248.CrossRefGoogle ScholarPubMed
Maxwell, C. J. et al. (2008). The prevalence and management of current daily pain among older home care clients. Pain, 138, 208–216.Google Scholar
McDougall, F. A. et al. (2007). Medical research council cognitive function and ageing study. Prevalence of depression in older people in England and Wales: the MRC CFA study. Psychological Medicine, 37, 1787–1795.Google Scholar
Meeks, T. W. et al. (2008). Chronic pain and depression among geriatric psychiatry inpatients. International Journal of Geriatric Psychiatry, 23, 637–642.Google Scholar
Muñoz, R. A. et al. (2005). Major depressive disorder in Latin America: the relationship between depression severity, painful somatic symptoms, and quality of life. Journal of Affective Disorders, 86, 93–98.Google Scholar
Novick, D. et al. (2013). Which somatic symptoms are associated with an unfavorable course in Asian patients with major depressive disorder? Journal of Affective Disorders, 149, 182–188.Google Scholar
Ohayon, M. M. and Schatzberg, A. F. (2003). Using chronic pain to predict depressive morbidity in the general population. Archives of General Psychiatry, 60, 39–47.Google Scholar
Reichardt, P. et al. (2012). Quality of life and utility in patients with metastatic soft tissue and bone sarcoma: the sarcoma treatment and burden of Illness in North America and Europe (SABINE) study. Sarcoma, 2012, 740279.CrossRefGoogle ScholarPubMed
Sapin, C., Fantino, B., Nowicki, M.-L. and Kind, P. (2004). Usefulness of EQ-5D in assessing health status in primary care patients with major depressive disorder. Health and Quality of Life Outcomes, 2, 20.CrossRefGoogle ScholarPubMed
Sheehan, B., Lall, R. and Bass, C. (2005). Does somatization influence quality of life among older primary care patients? International Journal of Geriatric Psychiatry, 20, 967–72.Google Scholar
Snowden, M., Steinman, L. and Frederick, J. (2008). Treating depression in older adults: challenges to implementing the recommendations of an expert panel. Preventing Chronic Diseases, 5, A26.Google ScholarPubMed
Trivedi, M. H. (2004). The link between depression and physical symptoms. Primary Care Companion to the Journal of Clinical Psychiatry, 6 (Suppl. 1), 12–16.Google Scholar
Williams, L. J., Jacka, F. N., Pascoe, J. A., Dodd, S. and Berk, M. (2006). Depression and pain: an overview. Acta Neuropsychiatrica, 18, 79–87.CrossRefGoogle ScholarPubMed