Somatic symptoms in treatment-resistant depression

George I. Papakostas, Timothy Petersen, John Denninger, Shamsah B. Sonawalla, Yasmin Mahal, Jonathan E. Alpert, Andrew A. Nierenberg, Maurizio Fava

Research output: Contribution to journalArticlepeer-review

47 Scopus citations


The purpose of this work was to study the prevalence of somatic symptoms in patients with treatment-resistant depression (TRD) and their impact on the response to antidepressant treatment. Somatic symptoms were assessed during the screen visit with the Symptom Questionnaire (SQ) somatic symptom (SQ-SS) and somatic well-being sub-scales (SQ-SWB) in 40 patients with TRD enrolled in a 6-week open trial of nortriptyline. A logistic regression was used to test whether SQ-SS or SQ-SWB scores predicted clinical response to nortriptyline. Ninety-five percent of patients reported at least one somatic symptom. Higher SQ-SS scores during the screen visit predicted poorer response to nortriptyline. There was a trend for lower SQ-SWB scores to predict poor response to nortriptyline. None of the patients with SQ-SS scores above the mean for the sample responded to nortriptyline. The overwhelming majority of patients with TRD presented with somatic symptoms. In addition, a greater number of somatic symptoms during the screen visit placed patients at risk for further treatment resistance.

Original languageEnglish (US)
Pages (from-to)39-45
Number of pages7
JournalPsychiatry Research
Issue number1
StatePublished - May 1 2003
Externally publishedYes


  • Antidepressants
  • Nortriptyline
  • Response prediction
  • Symptom Questionnaire

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry


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