Patients with depression often experience physical pain

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Patients with depression often experience physical pain

25 Aug 2004

Physical symptoms are nearly as common as emotional ones in patients

suffering from depression, according to Indiana University School of

Medicine research published in the August issue of the Journal of General

Internal Medicine.

Patients with depression frequently talk to their physicians about symptoms

such as headache, back or muscle pain, stomach ache and dizziness instead of

symptoms more commonly associated with depression such as fatigue, lack of

motivation and moodiness, says Kurt Kroenke, M.D., professor of medicine in

the Division of General Internal Medicine and Geriatrics at IU and a

research scientist at the Regenstrief Institute, Inc.

" Depression is a risk factor for symptoms of pain, " he said. " The most

reports of pain ­ such as muscle pain, headaches, leg pain ­ are two or

three times more common in people with depression. "

Physical symptoms also may serve as a barometer for physicians to gauge the

effectiveness of common antidepressant treatments, he said.

" Physical symptoms may not respond to common antidepressant treatment as

much as the emotional symptoms, " says Dr. Kroenke. " Even though the physical

symptoms may be related to or aggravated by the depression, they can linger

longer than the emotional symptoms. "

In his article " The Outcome of Physical Symptoms with Treatment of

Depression, " Dr. Kroenke cautions it is important to monitor physical

symptoms when assessing patients with depression. If the physical symptoms

persist, additional medical assessments may be needed.

The study examined the prevalence, impact on quality of life and outcome of

physical symptoms in patients with depression during nine months of

antidepressant therapy. A total of 573 depressed primary care patients at 37

clinic settings were assessed at one, three, six and nine months.

In more than a third of the patients, the physical symptoms persisted longer

than the depression symptoms.

" While physical symptoms showed, on average, some improvement with

antidepressant treatment, the improvement was typically less than was

reported for emotional symptoms, " he said. " Most of the improvement for the

physical symptoms occurred within the first month of treatment, while the

emotional symptoms continued to improve over a nine-month period. "

A related study by Dr. Kroenke also revealed a correlation between the

severity of pain as reported by the patient and the success of treatment for

depression. The more severe the pain at the beginning of treatment, the less

responsive depression is to antidepressant medication.