The aims of this study were to determine the presence of painful physical symptoms (PPS) and its impact on depression outcomes in different gender and age groups.

Three hundred in- and out-patients from China presenting with a new or first episode of major depressive disorder were enrolled in a 3- month prospective observational study from Asia (N=909). Hamilton Depression Scale (HAMD-17), Clinical Global Impression Severity (CGI-S), EuroQoL and the pain-related items of the Somatic Symptom Inventory were administered. Patients were classified into three age groups (<40, n=119; =40-<60, n=133; =60, n=48). Linear and logistic regression models were fitted to assess the relationship between PPS at baseline and outcomes.

Older patients had higher HAMD-17 severity at baseline. HAMD score was 25.9 (SD 6.1) in =60 vs. 22.5 (SD 5.0) in <40 and 24.8 (SD 5.2) in =40-<60. There were no statistically significant differences in the proportion of patients with PPS across gender and age groups. During follow-up, depression severity improved. There were no statistically significant differences in the degree of improvement by gender, but there were differences by age group. Mean change in HAMD was -16.4 (95%CI -17.7;-15.1) for those <40, -19.9 (95%CI -21.1;-18.7) in 40-60 and - 20.3 (95%CI -22.6;-17.9) in >60. PPS positive patients had worse clinical and quality of life outcomes across genders and age groups.

The presence of painful physical symptoms is associated with a lower improvement in depression outcomes and a lower quality of life in patients with major depression across different gender and age groups.