News in brief - Sept. 27, 2004

Depressed patients' physical symptoms persist after treatment - Pneumococcal vaccine reduces mild, moderate illness

Depressed patients' physical symptoms persist after treatment

Patients with depression treated with selective serotonin reuptake inhibitors frequently have an improvement of their mental health. Their physical symptoms such as headaches or stomach trouble, however, don't go away quite as easily, according to a study published in the August Journal of General Internal Medicine.

Researchers recruited more than 500 patients diagnosed with depression. Subjects were randomized to receive one of three SSRIs and surveyed five times over a nine-month period. Depression improved continually. The minor ailments, which are widely believed to be a sign of depression, improved significantly in the first month of treatment but then hit a plateau. For example, after nine months of treatment nearly a third of subjects were still bothered significantly by fatigue and 20% still had sleep problems.

The authors of the paper concluded that patients who do not have a resolution of their physical complaints may need a different treatment strategy for their depression.

"It is important to ask patients with depression about physical symptoms at the start of treatment and, when assessing improvement, ask about physical as well as emotional symptoms," said Kurt Kroenke, MD, lead author and professor of medicine in the division of general internal medicine and geriatrics at Indiana University.

Pneumococcal vaccine reduces mild, moderate illness

Children who receive the pneumococcal shot have a decreased likelihood of getting ear infections and pneumonia, according to a study published in the September Pediatrics.

The vaccine has been given to children routinely since 2000 in order to reduce severe illnesses such as bacterial meningitis and bacteremia. This is the first study to show that it can impact less serious infections as well.

"[This] reinforces its importance in our public health efforts," said Kathy Poehling, MD, MPH, lead author and assistant professor of pediatrics at Vanderbilt University Medical Center in Tennessee.

Dr. Poehling and her research team analyzed administrative data from Tennessee Medicaid and three commercial insurers in New York state. After the introduction of the vaccine, emergency department visits for pneumonia declined 18% in Tennessee, and, in New York, outpatient visits declined 34%. Physician visits for otitis media declined 19% in New York but only 4% in Tennessee.