Department of Psychiatry, Korea University College of Medicine, Seoul, Korea.
Psychiatry Investig. 2009 Dec;6(4):255-63. doi: 10.4306/pi.2009.6.4.255. Epub 2009 Dec 8.
This paper aims to examine the association between painful physical symptoms (PPS) and major depressive disorder (MDD) in a naturalistic clinical practice setting within a Korean population.
Patients with acute MDD that joined a multicountry, observational, three-month study in six Asian countries and regions were classified as PPS+ (mean score >/=2) and PPS- (mean score <2) using the modified Somatic Symptom Inventory. In this analysis, we report the results from the Korean subset, where depression severity was assessed using the Clinical Global Impression of Severity (CGI-S) scale and 17-item Hamilton Depression Rating Scale (HAMD(17)). Pain severity was measured using a visual analogue scale (VAS), while the EuroQoL (EQ-5D) assessed patient well-being.
Of 198 patients, 45.96% (91/198) of patients were classified as PPS+, of which 78.02% (71/91) were women. PPS+ patients had significantly more severe depression at baseline {CGI-S score, mean [standard deviation (SD)], PPS+: 5.09 [0.79]; PPS-: 4.63 [0.76]; p<0.001; HAMD(17) total score, mean [SD], PPS+: 24.34 [5.24]; PPS-: 20.76 [5.12]; p<0.001} and poorer quality of life [EQ-5D overall health state, mean (SD), PPS+: 39.37 (20.52); PPS-: 51.27 [20.78]; p<0.001] than PPS- patients. Both groups improved significantly (p<0.001) in depression and pain severity outcomes, as well as quality of life by endpoint, but no significant within-group baseline-to-endpoint change wase observed.
The frequency of PPS was common in Korean patients with MDD, and was associated with more severe depression, poorer quality of life, and a trend towards poorer clinical outcome.
本研究旨在考察韩国自然临床环境下,疼痛性躯体症状(PPS)与重度抑郁症(MDD)之间的关联。
参与多国、观察性、为期 3 个月的亚洲六国/地区研究的急性 MDD 患者,使用改良躯体症状清单,分为 PPS+(平均得分≥2)和 PPS-(平均得分<2)。本分析报告了韩国亚组的结果,使用临床总体印象严重程度量表(CGI-S)和 17 项汉密尔顿抑郁量表(HAMD(17))评估抑郁严重程度,疼痛严重程度采用视觉模拟量表(VAS),患者健康状况采用欧洲五维健康量表(EQ-5D)评估。
198 例患者中,45.96%(91/198)为 PPS+,其中 78.02%(71/91)为女性。基线时,PPS+患者的抑郁严重程度显著更重{CGI-S 评分,均值[标准差],PPS+:5.09[0.79];PPS-:4.63[0.76];p<0.001;HAMD(17)总分,均值[标准差],PPS+:24.34[5.24];PPS-:20.76[5.12];p<0.001},生活质量更差[EQ-5D 整体健康状况,均值(标准差),PPS+:39.37(20.52);PPS-:51.27(20.78);p<0.001]。两组患者在抑郁和疼痛严重程度方面的结局均显著改善(p<0.001),健康状况也有所改善,但终点时无显著的组内基线-终点变化。
韩国 MDD 患者 PPS 的发生频率较高,且与更严重的抑郁、较差的生活质量和临床结局不良趋势相关。