Impact of pain and remission in the functioning of patients with depression in Mainland China, Taiwan, and Hong Kong.

Abstract

The present study analyzes functioning during the course of treatment of a major depressive disorder in Mainland China, Taiwan, and Hong Kong. Data in this post hoc analysis were taken from a 24-week prospective, observational study in 12 countries worldwide. Of these, 422 patients were included from Mainland China (N=205; 48.6%), Taiwan (N=199; 47.2%), and Hong Kong (N=18; 4.2%). Functioning was measured with the Sheehan Disability Scale, pain with the Somatic Symptom Inventory, and depression severity with the Quick Inventory of Depressive Symptomatology Self Report 16. Patients were classified as having no pain, persistent pain, or remitted pain. A mixed model with repeated measures was fitted to analyze the relationship between pain and functioning, adjusting for severity and other factors. At baseline, 40% of the patients had painful physical symptoms. At 24weeks, 6% of the patients had persistent pain. Sixty percent of the patients achieved remission. Patients with pain had a higher severity of depression score and lower functioning (P<.05) at baseline. At 24weeks, patients with persistent pain had lower functioning (P<.05). The regression model found that clinical remission was associated with higher functioning at endpoint and that patients with persistent pain had lower functioning at endpoint when compared with the no-pain group. Patients presenting with pain had lower functioning at baseline. At 24weeks, pain persistence was associated with significantly lower functioning as measured by the Sheehan Disability Scale. Clinical remission was associated with better functional outcomes. The course of pain was related to achieving remission.