Major depressive disorder in Latin America: The relationship between depression severity, painful somatic symptoms, and quality of life

Abstract 

Background

We report on two multi-center, prospective, observational studies (H6U-BC-LRAG and H6U-BL-LRAH) to determine the clinical profile of Latin American outpatients with major depressive disorder (MDD) and the relationship between depression severity, painful somatic symptoms, and quality of life.

Method

Patients (n=989) with MDD were classified according to the presence (SS+) or absence (SS−) of painful somatic symptoms using the Somatic Symptom Inventory (SSI). Visual Analogue Scale (VAS) quantified pain severity, HAMD₁₇ and CGI-S determined depression severity, while the Quality of Life in Depression Scale (QLDS) quantified subjective well-being.

Results

At baseline, patients had an average CGI score of 4.5 (±0.8) and HAMD₁₇ score of 24.9 (±7.2). Of the patients studied, 72.6% reported painful somatic symptoms (95% CI: 69.8, 75.4), with women 2.7 times more likely to be SS+ than men (p<0.0001). Adjusted mean HAMD₁₇ (26.79) and CGI-S (4.53) scores for SS+ patients were significantly (p<0.0001) higher than for SS− patients (HAMD₁₇: 22.87; CGI-S: 4.28). SS+ patients had greater severity of pain across all VAS measures (p<0.0001). The presence of somatic symptoms had a significantly deleterious effect on quality of life (p<0.0001).

Conclusion

Greater severity of painful somatic symptoms was associated with increased depression severity and reduced quality of life. We concluded that both emotional and physical manifestations of MDD must be addressed for successful treatment.

Keywords: Major depressive disorder, Painful somatic symptoms, Quality of life, Somatic symptom inventory, HAMD₁₇