Functional impairment related to painful physical symptoms in patients with generalized anxiety disorder with or without comorbid major depressive disorder: post hoc analysis of a cross-sectional study

Romera, Irene; Montejo, Ángel L.; Caballero, Fernando; Caballero, Luis; Arbesú, José Ángel; Polavieja, Pepa; Desaiah, Durisala; Gilaberte, Inmaculada

doi:10.1186/1471-244x-11-69

Cited by 13 publications

(14 citation statements)

References 43 publications

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“…Results from PADRE also suggest that early improvements in concomitant PPS measured with simple VAS scales should be considered in treatment decisions during the initial 2-4 weeks of a new antidepressive treatment. The results of PADRE could also be important for patients with generalized anxiety disorder with or without comorbid MDD, as the clinical relevance of PPS and resulting functional impairment has been reported [ 43 , 44 ].…”

Section: Discussionmentioning

confidence: 99%

Early reduction in painful physical symptoms is associated with improvements in long-term depression outcomes in patients treated with duloxetine

et al. 2011

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BackgroundTo investigate the association of the change of painful physical symptoms (PPS) after 4 weeks, with the 6-month treatment outcomes of depressive symptoms in patients treated with duloxetine in clinical practice.MethodsMulticenter, prospective, 6-month, non-interventional study in adult outpatients with a depressive episode and starting treatment with duloxetine. Depression severity was assessed by the clinician (Inventory for Depressive Symptomatology [IDS-C]) and patient (Kurz-Skala Stimmung/Aktivierung [KUSTA]). Somatic symptoms and PPS were assessed using the patient-rated Somatic Symptom Inventory (SSI) and visual analog scales (VAS) for pain items. Association of change in PPS with outcomes of depressive symptoms was analyzed based on mean KUSTA scores (mean of items mood, activity, tension/relaxation, sleep) and achievement of a 50% reduction in the total IDS-C score after 6 months using linear and logistic regression models, respectively.ResultsOf the 4,517 patients enrolled (mean age: 52.2 years, 71.8% female), 3,320 patients (73.5%) completed the study. 80% of the patients had moderate to severe overall pain (VAS > 30 mm) at baseline. A 50% VAS overall pain reduction after 4 weeks was associated with a 13.32 points higher mean KUSTA score after 6 months, and a 50% pain reduction after 2 weeks with a 6.33 points improvement. No unexpected safety signals were detected in this naturalistic study.ConclusionPain reduction after 2 and 4 weeks can be used to estimate outcomes of long-term treatment with duloxetine. PPS associated with depression have a potential role in predicting remission of depressive symptoms in clinical practice.

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Section: Discussionmentioning

confidence: 99%

Early reduction in painful physical symptoms is associated with improvements in long-term depression outcomes in patients treated with duloxetine

et al. 2011

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“…Persistent pain, together with the physical impairment often associated with pain conditions, are likely to produce high levels of stress which greatly contribute to anxiety and depression processes (e.g. [ 184 , 185 ]). In addition, depression and anxiety in human patients are often comorbid with sleep disturbances [ 186 ], and this has been repeatedly observed in human pain patients [ 185 , 187 - 190 ].…”

Section: Pain-induced Emotional Dysfunction: Anxiety Depression and mentioning

confidence: 99%

“Bedside-to-Bench” Behavioral Outcomes in Animal Models of Pain: Beyond the Evaluation of Reflexes

Cobos

Portillo‐Salido

2013

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Despite the myriad promising new targets and candidate analgesics recently identified in preclinical pain studies, little translation to novel pain medications has been generated. The pain phenotype in humans involves complex behavioral alterations, including changes in daily living activities and psychological disturbances. These behavioral changes are not reflected by the outcome measures traditionally used in rodents for preclinical pain testing, which are based on reflexes evoked by sensory stimuli of different types (mechanical, thermal or chemical). These measures do not evaluate the impact of the pain experience on the global behavior or disability of the animals, and therefore only consider a limited aspect of the pain phenotype. The development of relevant new outcomes indicative of pain to increase the validity of animal models of pain has been increasingly pursued over the past few years. The aim has been to translate “bedside-to-bench” outcomes from the human pain phenotype to rodents, in order to complement traditional pain outcomes by providing a closer and more realistic measure of clinical pain in rodents. This review summarizes and discusses the most important nonstandard outcomes for pain assessment in preclinical studies. The advantages and drawbacks of these techniques are considered, and their potential impact on the validation of potential analgesics is evaluated.

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“…Migraine and anxiety disorders are often comorbid with each other [ 29 , 30 ]. Anxiety disorders are also comorbid with PPS [ 19 - 21 ]. Therefore, investigation of PPS among depressive and anxiety disorders should consider the impacts of migraine.…”

Section: Discussionmentioning

confidence: 99%

“…Patients with depression are often comorbid with anxiety, which is related to a greater severity and a poorer treatment prognosis [ 17 , 18 ]. Anxiety disorders also interact with PPS [ 19 - 21 ]; for example, a patient with generalized anxiety disorder (GAD) has a greater severity of PPS as compared with a control [ 21 ].…”

Section: Introductionmentioning

confidence: 99%

“…As described above, MDD, migraine, anxiety disorders, and PPS are closely related and interact [ 1 , 2 , 14 , 21 , 22 ]. Although many studies have investigated the impacts of migraine and anxiety disorders on patients with MDD [ 12 , 16 - 18 , 23 ], no study has reported the impacts of migraine and anxiety disorders on PPS among patients with MDD, to the best of our knowledge.…”

Section: Introductionmentioning

confidence: 99%

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The impacts of migraine and anxiety disorders on painful physical symptoms among patients with major depressive disorder

et al. 2014

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BackgroundNo study has simultaneously investigated the impacts of migraine and anxiety disorders on painful physical symptoms (PPS) among patients with major depressive disorder (MDD). The study aimed to investigate this issue.MethodsThis open-label study enrolled 155 outpatients with MDD, who were then treated with venlafaxine 75 mg per day for four weeks. Eighty-five participants with good compliance completed the treatment. Migraine was diagnosed according to the International Classification of Headache Disorders. MDD and anxiety disorders were diagnosed using the Structured Clinical Interview for DSM-IV-TR. The visual analog scale (VAS) was used to evaluate the severity of eight PPS. Multiple linear and logistic regressions were used to investigate the impacts of migraine and anxiety disorders on PPS.ResultsCompared with patients without migraine, patients with migraine had a greater severity of PPS at baseline and post-treatment. After controlling for demographic variables and depressive severity, migraine independently predicted the intensities of eight PPS at baseline and four PPS post-treatment. Moreover, migraine independently predicted poorer treatment responses of chest pain and full remission of pains in the head, chest, neck and/or shoulder. Anxiety disorders predicted less full remission of pains in the abdomen and limbs.ConclusionMigraine and anxiety disorders have negative impacts on PPS among patients with MDD. Integrating the treatment of migraine and anxiety disorders into the management of depression might help to improve PPS and the prognosis of MDD.

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Functional impairment related to painful physical symptoms in patients with generalized anxiety disorder with or without comorbid major depressive disorder: post hoc analysis of a cross-sectional study

Cited by 13 publications

References 43 publications

Early reduction in painful physical symptoms is associated with improvements in long-term depression outcomes in patients treated with duloxetine

Early reduction in painful physical symptoms is associated with improvements in long-term depression outcomes in patients treated with duloxetine

“Bedside-to-Bench” Behavioral Outcomes in Animal Models of Pain: Beyond the Evaluation of Reflexes

The impacts of migraine and anxiety disorders on painful physical symptoms among patients with major depressive disorder

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