The impact of the duration of an untreated episode on improvement of depression and somatic symptoms

Figures & data

Table 1 Demographic variables and mean scores of psychometric scales at baseline

Demographic variable	Total sample (N=155)	Treatment group (N=85)	Withdrawal group (N=70)
Age (years)	30.3±8.0	29.5±7.3	31.2±8.7
Number of years of education	13.4±2.5	13.6±2.7	13.1±2.2
Sex (female %)	68.4	63.5	74.3
Married (%)	38.7	38.8	38.6
Employed (%)	59.4	56.5	62.9
Age at first episode (years)	27.4±8.5	26.3±7.5	28.6±9.4
First major depressive episode (yes %)	76.1	74.1	78.6
Duration of an untreated episode (months)	16.9±24.0	19.9±27.3	13.2±18.9
HAMD score	23.4±4.0	23.2±3.9	23.6±4.1
DS score	25.6±5.4	25.3±5.7	25.9±5.1
SS score	16.1±6.6	16.3±6.7	15.9±6.6
PS score	7.6±3.8	7.9±3.7	7.2±3.9
NPSS score	8.6±3.4	8.5±3.5	8.7±3.3

Notes: Data presented as mean ± standard deviation or percentage. There were no significant differences in these demographic variables or severities of depression and somatic symptoms between the treatment and withdrawal groups.

Abbreviations: HAMD, Hamilton Depression Rating Scale; DSSS, Depression and Somatic Symptoms Scale; DS, depression subscale of the DSSS; SS, somatic subscale of the DSSS; PS, pain subscale of the DSSS; NPSS, nonpain somatic subscale of the DSSS.

Table 2 Improvement percentages of the two scales and subscales in groups after 4 weeks of treatment

IPs in different groups	Number	HAMD	DS	SS	NPSS	PS
IP for the full treatment group	85	45.2±26.2	44.6±29.9	49.4±36.5	48.2±36.6	46.9±44.9
IP in patients with anxiety comorbidity	43	45.0±25.8	42.1±30.2	45.1±33.2	43.9±33.6	44.1±38.7
IP in patients without anxiety comorbidity	42	45.4±26.9	47.1±29.7	53.8±39.5	52.9±39.3	50.0±51.4
IP in patients experiencing a first episode	63	45.9±27.2	44.4±31.1	47.3±38.2	47.3±38.4	42.1±47.8
IP in patients with multiple episodes	22	43.4±23.7	45.0±26.8	55.5±31.0	50.9±31.5	59.7±33.6
IP in male patients	31	50.9±25.7	48.3±25.1	50.2±39.2	48.0±39.2	45.7±53.0
IP in female patients	54	42.0±26.2	42.4±32.3	48.9±35.2	48.4±35.4	47.5±40.2
IP in patients currently employed	48	47.1±27.2	48.1±27.8	52.1±35.9	51.0±34.2	50.7±47.8
IP in patients currently unemployed	37	42.8±25.1	40.0±32.2	45.8±37.4	44.6±39.7	41.9±40.9
IP in married patients	33	48.5±25.7	46.5±26.5	53.2±34.6	49.7±31.7	53.4±44.3
IP in unmarried patients	52	43.2±26.6	43.3±31.4	46.9±37.8	47.3±39.7	42.6±45.2

Note: Data presented as mean ± standard deviation.

Abbreviations: IP, improvement percentage; HAMD, Hamilton Depression Rating Scale; DSSS, Depression and Somatic Symptoms Scale; DS, depression subscale of the DSSS; SS, somatic subscale of the DSSS; PS, pain subscale of the DSSS; NPSS, nonpain somatic subscale of the DSSS.

Table 3 The improvement percentage at different durations of an untreated episode

Duration of untreated episode	Number	HAMD	DS	SS	NPSS	PS
<1 month
Yes	9	63.9±21.1*,#	72.7±23.7*,#	81.1±32.5**	84.9±32.5**	69.8±35.6
No	76	43.0±26.0	41.2±28.9	45.6±32.3	43.9±34.7	44.4±45.3
<2 months
Yes	24	51.5±24.2	57.8±22.4*,#	60.3±39.1	60.4±36.9	49.3±53.0
No	61	42.7±26.8	39.3±31.0	45.1±34.8	43.4±35.6	46.0±42.2
<3 months
Yes	30	53.9±22.9*,#	57.2±22.8*,#	61.2±35.4*	60.3±33.8*	54.2±48.2
No	55	40.5±26.9	37.7±31.2	42.9±35.8	41.9±36.6	43.2±43.2
<4 months
Yes	36	53.1±21.7*,#	55.3±21.3*,#	61.4±33.5**	60.4±32.2**	57.5±45.6
No	49	39.5±27.9	36.7±32.9	40.6±36.4	39.6±37.3	39.9±43.5
<5 months
Yes	37	52.7±21.5*,#	54.8±21.2*,#	61.0±33.1**	59.3±32.4**	57.9±44.9
No	48	39.4±28.2	36.6±33.2	40.5±36.8	40.0±37.6	39.3±43.7
<6 months
Yes	41	52.0±23.6*,#	53.8±24.0*,#	60.0±34.1**	58.9±32.5**	55.6±47.8
No	44	38.9±27.2	36.0±32.4	39.5±36.2	38.5±37.7	39.5±41.4

Notes: Data presented as mean ± standard deviation.

* P<0.05.

** Significance (P<0.017) after Bonferroni corrections for independent t-test in SS, PS, and NPSS.

# Significance (P<0.025) after Bonferroni corrections for independent t-test in the HAMD and DS.

Abbreviations: HAMD, Hamilton Depression Rating Scale; DSSS, Depression and Somatic Symptoms Scale; DS, depression subscale of the DSSS; SS, somatic subscale of the DSSS; PS, pain subscale of the DSSS; NPSS, nonpain somatic subscale of the DSSS.

Table 4 Independent variables predicting the improvement percentages after 4 weeks of treatment in patients experiencing a major depressive episode

IPs of different scales	Regression model	Independent variable	β	Adjusted R^2	t	P-value
IP of HAMD score	I	None	NA	NA	NA	NA
	II	DUE <4 months	0.26	0.06	2.43	0.02
IP of DS score	I	DUE	−0.29	0.07	−2.75	<0.01
	II	DUE <1 month	0.33	0.10	3.14	<0.01
IP of SS score	I	DUE	−0.25	0.05	−2.38	0.02
	II	DUE <1 month	0.30	0.08	2.88	<0.01
IP of NPSS score	I	DUE	−0.23	0.04	−2.11	0.04
	II	DUE <1 month	0.35	0.11	3.38	<0.01
IP of PS score	I	None	NA	NA	NA	NA
	II	None	NA	NA	NA	NA

Abbreviations: IP, improvement percentage; HAMD, Hamilton Depression Rating Scale; DS, depression subscale of the Depression and Somatic Symptoms Scale (DSSS); DUE, duration of an untreated episode; SS, somatic subscale of the DSSS; PS, pain subscale of the DSSS; NA, not applicable; NPSS, nonpain somatic subscale of the DSSS.