Symptoms of physical pain can indicate a current depressive episode. The study aimed to assess pain symptoms among physically ill general hospital patients and to explore if pain symptoms are more prevalent among physically ill patients with a depressive episode than among those without a depressive episode.

Pain symptoms were assessed by a modified version of the Patient Questionnaire (Spitzer et al1). Diagnosis of a current depressive episode was made by psychiatrists with the Composite International Diagnostic Interview (CIDI; ICD-10 version2).

Of the 290 patients included in the study 247 (85.2%) indicated at least one pain symptom. About a fifth of the patients suffered from a current depressive episode. Physically ill patients with depression suffered significantly more often from pain and reported significantly more often three or more symptoms of pain than those without depression.

Headaches, stomach pain and chest pain were significant independent predictor variables for depression in a multiple logistic regression analysis controlled for age, gender and primary somatic diagnosis.

Patients in general hospital who suffer from pain symptoms should be checked physically and psychologically in order to detect a comorbid depressive episode.

1Spitzer RL, Williams JB, Kroenke K, Linzer M, deGruy FV 3rd, Hahn SR, Brody D, Johnson JG. Utility of a new procedure for diagnosing mental disorders in primary care. The PRIME-MD 1000 study. JAMA 1994;272:1749-56.

2Wittchen, H.U., Pfister, H., 1997. DIA-X-Interviews. Manual für Screening-Verfahren und Interview; PC-Programm zur Durchführung des Interviews (Längs- und Querschnittuntersuchung); Auswertungsprogramm. Frankfurt, Swets & Zeitlinger.