Somatic symptoms in treatment-resistant depression
by
Papakostas GI, Petersen T, Denninger J, Sonawalla SB,
Mahal Y, Alpert JE, Nierenberg AA, Fava M.
Department of Psychiatry,
Depression Clinical and Research Program,
Massachusetts General Hospital,
Harvard Medical School, WACC 812,
15 Parkman Street, 02114, Boston, MA, USA
Psychiatry Res 2003 May 1;118(1):39-45

ABSTRACT

The purpose of this work was to study the prevalence of somatic symptoms in patients with treatment-resistant depression (TRD) and their impact on the response to antidepressant treatment. Somatic symptoms were assessed during the screen visit with the Symptom Questionnaire (SQ) somatic symptom (SQ-SS) and somatic well-being sub-scales (SQ-SWB) in 40 patients with TRD enrolled in a 6-week open trial of nortriptyline. A logistic regression was used to test whether SQ-SS or SQ-SWB scores predicted clinical response to nortriptyline. Ninety-five percent of patients reported at least one somatic symptom. Higher SQ-SS scores during the screen visit predicted poorer response to nortriptyline. There was a trend for lower SQ-SWB scores to predict poor response to nortriptyline. None of the patients with SQ-SS scores above the mean for the sample responded to nortriptyline. The overwhelming majority of patients with TRD presented with somatic symptoms. In addition, a greater number of somatic symptoms during the screen visit placed patients at risk for further treatment resistance.

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