Effectiveness of antidepressants in the treatment of major depressive disorder in Latin America

Abstract

Objective. Painful physical symptoms occur frequently in patients with major depressive disorder (MDD), and although numerous studies report the effect of antidepressants on emotional aspects of depression, few focus on their effect on physical symptoms. This observational study was conducted, in a clinical practice setting, to determine antidepressant treatment decisions and their outcome on the physical and emotional symptoms of MDD. Methods. Patients with a mean score ≥2 for pain-related items on the Somatic Symptom Inventory (SSI) were classified with painful physical symptoms (PPS +) and differentiated from the remaining patients (PPS -). Severity of depression and physical pain were determined using the 17-item Hamilton Depression Rating Scale (HAMD17) and Clinical Global Impressions of Severity Scale (CGI-S), and Visual Analog Scale (VAS), respectively. Results. At baseline, 72.6% of patients were PPS+. Compared to PPS- patients, PPS +patients were, on average, significantly more depressed at baseline (mean difference [95% CI]: HAMD17 4.6 [3.6, 5.5] and CGI-S 0.3 [0.2, 0.4]; all p<0.0001), and remained more depressed and in greater pain at endpoint (HAMD17p=0.0074, CGI-S P =0.0151, and VAS P <0.0001). In addition, fewer PPS+ patients (65.8%) achieved remission (total HAMD17≤7) compared to PPS- patients (74.6%, P =0.0180). Conclusions. Painful physical symptoms are prevalent in MDD patients, highlighting the importance of addressing both the physical and emotional symptoms of depression.

Association between painful physical symptoms and clinical outcomes in East Asian patients with major depressive disorder: a 3-month prospective observational study

“…In the same study, patients who achieved remission and partial response in terms of their depressive symptoms also experienced significantly greater improvement than non‐responders in both painful and non‐PPS after 3 months (30). Similar results were observed in a Latin American observational study, where PPS+ patients improved less than PPS− patients on depression and pain outcomes, and were less likely to achieve remission during the 12‐month study period (31). Comparable findings were observed in this study, where PPS+ patients had improved less on depression, pain and quality of life measures after 3 months treatment and, while response rates were statistically similar between PPS groups, fewer PPS+ patients had achieved symptomatic remission during the study.…”

Impact of pain and remission in the functioning of patients with depression in Mainland China, Taiwan, and Hong Kong

“…Another study conducted with a sample of elderly Chinese patients observed that pain at baseline predicted depressive symptoms at the 12‐month follow‐up assessment (Chou & Chi, ). Similar findings have been reported in other regions, eg, in a Latin American observational study (Dueñas et al, ), which reported that patients with pain improved less than patients with no pain in depression outcomes and had a reduced quality of life.…”

Association between painful physical symptoms and clinical outcomes in Taiwanese patients with major depressive disorder: A three‐month observational study

“…Similar observations have been consistently reported across various ethnicities (Muñoz et al 2005;Husain et al 2007). In a Latin American study, PPS1 patients improved less than PPS À patients on depression and pain outcomes over a 12-month period (Dueñas et al 2007). In a randomized clinical trial conducted in the United States, baseline pain severity was a strong predictor of poor antidepressant treatment response and poor quality of life after 3 months of study (Bair et al 2003;Meyer et al 2007).…”

“…2007). In a Latin American study, PPS+ patients improved less than PPS− patients on depression and pain outcomes over a 12‐month period (Dueñas et al . 2007).…”