The association between somatic symptoms and suicidal ideation in Chinese first-episode major depressive disorder

Background: Somatic symptoms are prevalent in patients with major depressive disorder (MDD) and often associated with a high risk of suicide. However, which somatic symptoms display as significant risk factors for suicidal ideation (SI) is still poorly understood in MDD. Methods: Two thousand and seventeen Chinese patients with first-episode MDD from the National Survey on Symptomatology of Depression were included in this study. A doctor-rating assessment questionnaire was constructed to evaluate depression related somatic symptoms, and stepwise logistic regression analysis was performed to explore the relationship between somatic symptoms and SI. Results: Our results showed a high prevalence of current SI in first-episode MDD (50.87%), while no significant gender differences (53.32% vs. 49.26%, P = 0.076) were observed. In addition, patients who have more somatic symptoms would be at the higher risk to elicit SI, and stepwise logistic regression analysis indicated that age (beta = -0.020, P < 0.001), Pre-verbal physical complaints (beta = 0.356, P = 0.001), Sensory system complaints (beta = 0.707, P = 0.000), Other pain conditions (beta = 0.434, P < 0.001), Late insomnia (beta = 0.267, P = 0.008), Hypersomnia (beta= 0.936, P < 0.001), Weight loss (beta = 0.272, P = 0.006), Hyposexuality (beta = 0.513, P = P < 0.001) were strongly associated with current SI in first-episode Chinese major depression. Conclusions: Somatic symptoms are strongly associated with SI in first-episode MDD. It is suggestive for clinicians to show concerns for patients' somatic symptoms in practice.