New Data Suggest Painful Physical Symptoms are Common in Depression; Results Highlight Need for More Effective Recognition and Treatment


INDIANAPOLIS--(BUSINESS WIRE)--Aug. 26, 2002--More than eighty percent of people with depression also experience painful physical symptoms as part of their illness, according to an 18-month study of more than 18,000 patients in six countries. These data were shared with physicians and researchers attending the World Psychiatric Association 12th World Congress of Psychiatry in Yokohama, Japan.

"This is one of the largest studies of its kind to date," said Prof. Donald Patrick, Ph.D, MSPH, University of Washington, Seattle. "The study clearly shows a link between emotional and painful physical symptoms since patients with these physical symptoms were nearly three times more likely to also have high depressive symptoms."

The study highlights include:

-- 80 percent of depressed patients experienced pain.

-- Patients with painful physical symptoms were 2.25 to 3.29

times as likely to experience high depressive symptoms.

-- Nearly 40 percent of patients visiting a primary care

physician had symptoms of depression. Of those, 80 percent

also experienced pain.

-- An increase in pain symptoms was associated with an increase

in depressive symptoms.

-- The findings were consistent in all countries.

"This study has confirmed that physical symptoms are very common in depressive disorders. General practitioners and other doctors often don't recognize these disorders, particularly when physical symptoms are prominent in the clinical picture," said Norman Sartorius, M.D., Ph.D., past president of the World Psychiatric Association. "This was a large study carried out in different countries and continents that provided important data about depressive disorders and their outcome. This data could be very valuable in developing training and service programs to address the needs of many patients with physical symptoms who are not currently receiving the treatments they need."

Recent medical literature suggests that relief of certain depressive symptoms, including aches and pains, require the combination of two neurotransmitters in the brain - both serotonin and norepinephrine. An imbalance of these neurotransmitters may explain the presence of painful physical symptoms in patients with depression. The descending serotonin and norepinephrine pathways, in the brain and spinal cord, regulate the painful physical symptoms of depression.(1)

Methodology

The data arise from the Longitudinal Investigation of Depression Outcomes (LIDO) study administered at six international primary care centers in Australia, Brazil, Israel, Spain, the Russian Federation and the United States. In the 18-month study, 18,456 patients were screened for depression using the Center for Epidemiological Studies Depression Scale. The CES-D is a 20-item scale with a range from 0 to 60. Higher scores indicate a greater severity of depression. Scores greater than or equal to 16 constituted highly depressive symptoms. Pain was reported by patients using a Likert-type item on the interference of pain. Patients were asked to report how much their pain interfered with their normal work and functioning.

Patients were excluded if they were currently receiving medication for depression or had received treatment for depression within the last three months. Furthermore, patients were also excluded if they had been previously diagnosed with a major psychiatric disorder or psychoses or diagnosed with a disorder such as Alzheimer's disease that would interfere with the study objectives.

Study Information

Eli Lilly and Company sponsored the LIDO study and Health Research Associates, Inc. served as the study administrator. LIDO's primary objective was to assess the quality of life and economic correlates of major clinical depression in primary care settings.

Current medical literature shows that only one third of the patients taking today's most widely prescribed antidepressants achieve complete remission of their symptoms. Lilly continues its search to pursue answers for the unmet medical needs that still exist in depression.

Lilly Information

Lilly, a leading innovation-driven corporation, is developing a growing portfolio of best-in-class pharmaceutical products by applying the latest research from its own worldwide laboratories and from collaborations with eminent scientific organizations. Headquartered in Indianapolis, Ind., Lilly provides answers - through medicines and information - for some of the world's most urgent medical needs. Additional information about Lilly is available at www.lilly.com.
(1) Stahl SM, Journal of Clinical Psychiatry; 2002

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SOURCE: Eli Lilly and Company