• East Asia;
  • major depressive disorder;
  • pain assessment;
  • quality of life;
  • Taiwan


Introduction: Reports from non-Asian populations indicate that painful physical symptoms are associated with poorer clinical and functional outcomes in patients with Major Depressive Disorder (MDD). This paper shows the changes in disease characteristics and quality of life in Taiwanese MDD patients, with or without painful physical symptoms, over 3 months' observation.

Methods: Taiwanese patients from an observational study of six East Asian countries/regions were classified as painful physical symptom positive (PPS+) or negative (PPS−) based on a mean score of ≥2 or <2, respectively, on the modified Somatic Symptom Inventory. Changes from baseline in outcomes were compared between the groups.

Results: Of 194 patients with MDD, 69% were PPS+ at baseline. These PPS+ patients were more depressed (17-item Hamilton Depression Rating Scale total; mean [SD] 27.1 [6.26] versus 21.8 [5.94] PPS−, P<0.001), in more pain (Visual Analog Scale overall; median [range] 73.5 [9–100] versus 40 [0 to 80] PPS−, P<0.001) and had poorer quality of life at baseline (EuroQoL; mean [SD] 42.9 [18.26] versus 59.8 [18.21] PPS−,P<0.001). At endpoint (n=118), PPS− patients showed greater improvement on depression outcomes (Clinical Global Impression of Severity; P=0.011) and had a higher remission rate (52.8 % versus 14.6% PPS+, P=0.007).

Discussion: Painful physical symptoms were frequently observed in Taiwanese patients with MDD. As PPS are associated with more severe depression, poorer quality of life, and poorer remission outcomes, clinical management should address both the mental and physical symptoms associated with this disorder.