Body pain and treatment response in late-life depression

Jordan F. Karp, Debra Weiner, Karen Seligman, Meryl Butters, Mark Miller, Ellen Frank, Jacqueline Stack, Benoit H. Mulsant, Bruce Pollock, Mary Amanda Dew, David J. Kupfer, Charles F. Reynolds

Research output: Contribution to journalArticlepeer-review

52 Scopus citations

Abstract

Objective: The authors investigated the influence of body pain on 1) time to treatment response and 2) suicidal ideation, in late-life depression. They hypothesized that higher levels of body pain would predict a longer time to and lower likelihood of response, and increased levels of suicidal ideation. Methods: Subjects (N = 187) were older adult outpatients (age ≥ 69 years), with current episodes of major depression, who were openly treated with paroxetine up to 40 mg daily and weekly interpersonal psychotherapy. Response was defined as 3 consecutive weeks of Hamilton Rating Scale for Depression at < 10. Body pain was measured with the Bodily Pain Index of the SF-36 quality-of-life assessment. Authors used survival-analysis models on the responder sample to test the effect of body pain on response, after controlling for severity of depression. Results: Overall response rate was 75.4%. Nonresponders reported more severe pain at baseline. After covarying for severity of baseline depression, no effect was found for physical pain on time-to-response or degree of suicidality. Bodily pain remained stable during acute treatment for responders, independent of depression response to combination psychotherapy and antidepressant treatment. Conclusions: Older adult patients with higher levels of physical pain can still respond to antidepressant treatment; however, reported bodily pain may be associated with a more difflcult-to-treat depression.

Original languageEnglish (US)
Pages (from-to)188-194
Number of pages7
JournalAmerican Journal of Geriatric Psychiatry
Volume13
Issue number3
DOIs
StatePublished - Mar 2005
Externally publishedYes

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Psychiatry and Mental health

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