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Painful physical symptoms (PPS) are prevalent among elderly patients with depression. We describe the impact of PPS on depression outcomes and quality of life (QOL) of elderly Asian patients with major depressive disorder (MDD).
This post hoc analysis of data from a three-month prospective observational study of East Asian MDD in- or out-patients focused on elderly patients aged ≥60 years. Depression severity was evaluated using the Hamilton depression (HAMD-17) and clinical global impression of severity (CGI-S) scales, while QOL was measured using EuroQOL (EQ-5D and EQ-VAS) instruments. PPS were rated using the modified somatic symptom inventory (SSI).
At baseline, depression was moderate to severe and 49% of the 146 elderly patients were painful physical symptom positive (PPS+). Bivariate analysis showed significant correlations between PPS and depression severity and QOL at baseline. Linear regression models showed the baseline factor most significantly associated with depression severity at three months was baseline PPS status. PPS+ patients had a mean increase of 2.87 points in their HAMD-17 rating and 0.77 points in their CGI-S score. Response and remission were significantly lower in PPS+ patients; response was 60% and remission was 40% in PPS+ patients while 82% and 66% in painful physical symptom negative (PPS−) patients. QOL at endpoint was lower in PPS+ patients.
PPS are common in elderly Asian patients with MDD and negatively influence depression outcomes and QOL. Patients with PPS had lower QOL at baseline, lower response and remission rates, higher severity of depression, and lower QOL after three months of treatment.
Evidence suggests that schizophrenia may have a better outcome for
individuals living in low- and middle-income countries compared with
To determine the frequency of symptom and functional remission in
out-patients with schizophrenia in different regions of the world.
Using data from the Worldwide-Schizophrenia Outpatient Health Outcomes
(W-SOHO) study we measured clinical and functional remission in
out-patients with schizophrenia in different regions of the world, and
examined sociodemographic and clinical factors associated with these
outcomes. The 11 078 participants analysed from 37 participating
countries were grouped into 6 regions: South Europe, North Europe,
Central and Eastern Europe, Latin America, North Africa and Middle East,
and East Asia.
In total, 66.1% achieved clinical remission during the 3-year follow-up
(range: 60.1% in North Europe to 84.4% in East Asia) and 25.4% achieved
functional remission (range: 17.8% in North Africa and Middle East to
35.0% in North Europe). Regional differences were not explained by
participants' clinical characteristics. Baseline social functioning,
being female and previously untreated were consistent predictors of
remission across regions.
Clinical outcomes of schizophrenia seem to be worse in Europe compared
with other regions. However, functional remission follows a different
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