Comorbid painful physical symptoms and depression: Prevalence, work loss, and help seeking

Background: Painful physical symptoms (PPS) are frequent in patients with Major Depressive Episode (MDE). Here, the 12-month prevalence and sociodemographic characteristics of PPS were examined taking into account somatic comorbidity; quantitative and qualitative aspects of MDE with or without PPS were investigated as well as their impact on work loss days (WLD). Finally, help seeking and delay in help seeking were explored. Methods: In a cross-sectional, population-based study, a representative random sample of non-institutionalised adults from Belgium, France, Germany, Italy, the Netherlands and Spain (N=21,425) was interviewed using the World Mental Health Composite Diagnostic Interview (CIDI 3.0 of the WHO). Results: PPS were reported by 29% of respondents without MDE and by 50% in those with MDE. Female gender, higher age and lower educational level were predictive of PPS. PPS were more frequent in more severely depressed patients but no qualitative differences were found in MDE with and MDE without PPS. An additive effect of MDE and PPS was found on the WLD score. Whether a comorbid somatic disorder was present or not did not change the findings. Finally, respondents with MDE and PPS had lower rates of help seeking for emotional reasons and show a trend to delay their help seeking longer. Limitations: The most important limitation of this study was its reliance on self-report data about somatic disorders. Conclusion: Approximately one in two persons with a mood disorder also reported the presence of PPS. MDE and PPS result in decreased productivity and in lower rates of help seeking. (c) 2006 Elsevier B.V. All rights reserved.