Depressed patients may need treatment for both physical and emotional symptoms

Sep 8 2004

Physical symptoms (such as headache, back pain, stomach problems, joint or muscle pains, and dizziness) are nearly as common in depression as emotional symptoms and are the predominant complaint depressed patients present with in the primary care setting.

A study published in the Journal of General Internal Medicine examined the prevalence, impact on quality of life, and outcome of physical symptoms in depressed patients during nine months of antidepressant therapy. While physical symptoms showed, on average, some improvement with antidepressant treatment, the improvement was typically less than for emotional symptoms. The physical symptoms showed the greatest improvement during the initial month of treatment.

In contrast, depression continued to show gradual improvements over the 9-month period. Unlike depression, however, improvement in physical symptoms typically plateaus with minimal resolution in subsequent months.

Therefore, it is important to recognize the physical symptoms that commonly co-exist with depression and, if they fail to improve during the first month of treatment, to consider additional therapies. Corresponding author, Dr. Kroenke states, “It is important to ask patients with depression about physical symptoms at the start of treatment and when assessing improvement ask about physical as well as emotional symptoms.”

http://www.blackwellpublishing.com/jgi