Somatization in major depression--clinical features and genetic associations

Acta Psychiatr Scand. 2011 Oct;124(4):317-28. doi: 10.1111/j.1600-0447.2011.01743.x. Epub 2011 Aug 13.

Abstract

Objective: To identify clinical variables and genetic variations within monoaminergic genes known to be implicated in pain perception that are associated with the occurrence of somatization symptoms in patients with major depression.

Method: Somatization was evaluated using the respective subscale of the Symptom Checklist SCL-90-R. Six monoaminergic genes were identified showing an involvement in pain perception and somatization according to the literature: COMT, HTR2A, SLC6A2, SLC6A4, DRD4, and TPH1. One hundred and eighteen single nucleotide polymorphisms (SNPs) within these genes were genotyped using Illumina BeadChips in a sample of 398 at least moderately to severely depressed in-patients participating in the Munich Antidepressant Response Signature (MARS) project.

Results: Thirty SNPs exhibit nominally significant associations with somatization. One SNP (rs9534505) located in intron 2 of the HTR2A gene withstood correction for multiple testing. Clinical data provide further evidence for strong impact of somatization on the presentation of depressive symptoms and description of a patient subgroup with unfavorable clinical outcome.

Conclusion: Our results demonstrate the influence of a HTR2A polymorphism on aspects of somatization in major depression, which co-occurs with an unfavorable antidepressant treatment outcome. These results confirm and expand previous findings on somatization as a risk factor for treatment outcome in major depression.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antidepressive Agents / therapeutic use
  • Catechol O-Methyltransferase / genetics
  • Depressive Disorder, Major / complications
  • Depressive Disorder, Major / drug therapy
  • Depressive Disorder, Major / genetics*
  • Depressive Disorder, Major / psychology
  • Female
  • Genotype
  • Humans
  • Male
  • Middle Aged
  • Norepinephrine Plasma Membrane Transport Proteins / genetics
  • Pain Perception
  • Polymorphism, Single Nucleotide / genetics
  • Psychiatric Status Rating Scales
  • Receptor, Serotonin, 5-HT2A / genetics
  • Receptors, Dopamine D4 / genetics
  • Somatoform Disorders / etiology
  • Somatoform Disorders / genetics*
  • Somatoform Disorders / psychology
  • Treatment Outcome
  • Tryptophan Hydroxylase / genetics
  • Young Adult

Substances

  • Antidepressive Agents
  • DRD4 protein, human
  • Norepinephrine Plasma Membrane Transport Proteins
  • Receptor, Serotonin, 5-HT2A
  • SLC6A2 protein, human
  • Receptors, Dopamine D4
  • TPH1 protein, human
  • Tryptophan Hydroxylase
  • Catechol O-Methyltransferase