Vaccarino Anthony L, Sills Terrence L, Evans Kenneth R, Kalali Amir H
Ontario Cancer Biomarker Network, MaRS Centre, South Tower, 101 College Street, Suite 200, Toronto, Ontario, Canada.
Psychosom Med. 2009 Feb;71(2):159-62. doi: 10.1097/PSY.0b013e3181906572. Epub 2008 Dec 10.
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 (MDD).
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 Inventory: 'Headache,' 'Pain in lower back,' 'Neck pain,' '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 >or=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, 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.
对参与一系列制药公司治疗重度抑郁症（MDD）药物试验的患者中多种疼痛相关主诉的共存情况进行特征描述。
分析了来自2191名参与治疗MDD的随机、多中心、双盲安慰剂对照研究患者的汇总“盲态”数据。使用躯体症状量表的七个疼痛症状子集评估疼痛症状：“头痛”“下背痛”“颈部疼痛”“关节疼痛”“肌肉酸痛”“心脏或胸部疼痛”以及“腹部疼痛或痉挛”。使用17项汉密尔顿抑郁评定量表（HAMD）评估抑郁严重程度。
在符合研究纳入标准（HAMD总分≥15）的患者中，25%报告无疼痛主诉，18%报告有1种疼痛主诉；大多数（57%）患者报告存在多种疼痛相关主诉，分别有14%、12%、11%、11%、7%和3%的患者报告有2、3、4、5、6和7种不同的疼痛症状。经历的疼痛相关症状数量与抑郁严重程度呈中度相关（r = 0.35），最常见的疼痛症状组合是头痛、下背痛、颈部疼痛、关节疼痛和肌肉酸痛。
本研究支持疼痛是MDD的一个组成特征。在抑郁症的诊断、治疗策略规划和治疗结果测量中，应考虑共病疼痛相关主诉的数量，其通常随抑郁严重程度增加。
