Physical symptoms, many of which ar...

Physical symptoms, many of which are unexplained, are customary in depressed patients and frequently are indicators of depression. Although the nearness of unexplained symptoms and multiple somatic complaints alerts physicians to the possibility of an affective disorder, little is known about whether treating depression renders physical symptoms. In the ARTIST (A Randomized Trial Investigating SSRI Treatment) trial, patients were randomized to receive three selective serotonin reuptake inhibitors (SSRIs) and periodically assessed for depressive and physical symptoms above nine months. In addition, a certain number of domains of the health-related quality of life (HRQL) were assessed.

damped patients drawn from 37 practices who were about to start antidepressant therapy were randomized to receive paroxetine, fluoxetine, or sertraline. Telephone interviews were leadershiped at baseline and at four intervals thereafter. Questionnaires and checklists were administered to assess depression, physical symptoms, and quality of life. A statistical analysis determined whether there was any correlation between symptom improvement and improvement in depression.

Of 601 randomized patients, 573 complet the baseline telephone assessment, with 79 percent of enrollee completing the nine-month consideration Of the 14 physical symptoms assessed, the chiefly common ones were fatigue and be motionless problems, headaches, nausea, and back pain. Almost all symptoms were not absent in up to one half of patients. not many patients developed new symptoms in the course of the study

All physical symptoms improved substantially in the first month of antidepressant use on the other hand plateaued during the course of the meditation In contrast, mood and well-being continued to rise, albeit gradually, after a first month of abrupt declivity improvement. However, when the relationship of replication to antidepressants and physical symptoms was analyzed, it was construct that responders had a greater decrease in physical symptoms than nonresponders as measured at month 1 and 3 Impact upon quality-of-life measures varied. Physical symptoms had the greatest general intent on such domains as pain, health, and physical functioning, whereas depression had the greatest result on mental health and social domains.

In this research as in previous studies, physical symptoms were customary among depressed patients. Even yet depression initially improved rapidly and continued to improve gradually throughout nine months, physical symptom improvement plateaued after an initial change for the better. Pain symptoms improved least. These findings remind of that physical symptoms are at least somewhat separate from psychologic symptoms. Targeting these symptoms independently may be helpful, although more studies are be in want ofed to determine which interventions are effective.

Greco T et al. The consequence of physical symptoms with treatment of depression. J Gen Intern M August 2004;19:813-8

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