To explore health-related quality of life (HRQoL) outcomes of patients with depression and moderate/severe pain compared to depressed patients with no/mild pain.

FINDER was a 6-month prospective, observational study to investigate HRQoL of 3,468 depressed outpatients receiving antidepressant treatment. Patients completed ratings on pain severity using Visual Analogue Scales (VAS) at the beginning of treatment, 3 and 6-months. Overall VAS pain severity ratings ?30mm were defined as 'no/mild pain', and >30mm as 'moderate/severe pain.' Pain response was defined as rating >30mm at baseline, changing to ?30mm at 6-months. Patients also completed the Short-Form-Health-Survey (SF-36) and European-Quality-of-Life-5-Dimensions (EQ-5D) questionnaire.

56% of patients with depression experienced moderate/severe pain at baseline, and 70% of these had no physical explanation. Those with depression and pain at baseline reported poorer HRQoL on the SF-36 physical component score (but not mental component score) and EQ-5D scores at baseline and 6-months. 47% (n=685) of those with depression and pain at baseline had moderate/severe pain at 6-months. Pain response was highest for those with greater baseline depression. Several socio-demographic, psychiatric and medical history characteristics were associated with decreased pain response according to logistic regression, as was baseline level of pain. In addition, those using analgesics, particularly opioids, were less likely to respond.

There was considerable comorbidity between pain and depression. Almost half of such patients did not demonstrate a pain response within the observation period and may represent a specific subgroup.

FINDER was supported by Eli Lilly and Company Limited & Boehringer Ingelheim GmbH.