Relationship of Somatic Symptoms With Depression Severity, Quality of Life, and Health Resources Utilization in Patients With Major Depressive Disorder Seeking Primary Health Care in Spain (original) (raw)
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Prevalence and association of somatic symptoms in patients with Major Depressive Disorder
Journal of Affective Disorders, 2008
Background: Painful and non-painful somatic symptoms are often reported in patients with depressive disorder. The proper identification of depression-relevant somatic symptoms is important for the accurate diagnosis of depression, development of treatment strategies and measurement of outcome. The objective of this study was to characterize the relationship between somatic symptoms and depression in patients diagnosed with Major Depressive Disorder (MDD), using data from randomized drug trials carried out by a pharmaceutical company. Methods: Pooled 'blinded' data from 2191 patients enrolled in randomized, multicenter, double-blind placebo-controlled studies for the treatment of MDD were analyzed. Somatic symptoms were assessed using the Somatic Symptoms Inventory (SSI) and the Hamilton Depression Rating Scale (HAMD) was used to assess symptoms of depression. Results: The most common somatic symptom reported by patients with MDD was 'feeling fatigued, weak, or tired all over', with 78% of patients reporting 'moderate' levels or above. This was followed by 'feeling that not in as good physical health as most of your friends' (59%), 'not feeling well most of the time in the past few years' (54%), and 'feeling weak in parts of body' (45%). 'Headache' was the most common pain-related symptom with 43% reporting 'moderate' or above. Pearson's product-moment correlations revealed that somatic symptoms generally increased as a function of overall depressive (r = 0.43), with 'feeling fatigued, weak, or tired all over' (r = 0.50), 'feeling that not in as good physical health as most of your friends' (r = 0.42), 'feeling weak in parts of body' (r = 0.41), 'heavy feeling in arms and legs' (r = 0.34), 'not feeling well most of the time in the past few years' (r = 0.32), and 'headache' (r = 0.31) showing the strongest correlation with overall HAMD scores. Non-parametric item response analyses showed that many somatic symptoms demonstrate good relationship between item response and the overall severity of depression. In particular, 'feeling fatigued, weak, or tired all over' exhibited good discriminative properties across the full range of severity for depression. Limitations: The analysis utilized data from a 'restricted' patient population in drug trials sponsored by a pharmaceutical company. Conclusions: These results demonstrate a high prevalence and association of somatic symptoms in patients with MDD, including feelings of fatigue, physical malaise and pain-related symptoms, which could be potentially useful in the assessment of depression and in the evaluation of treatment strategies.
The relationship between somatic symptoms and depression
Neuro endocrinology letters, 2014
We investigated the influence of somatic symptoms on the severity and clinical outcomes in female Korean patients with major depressive disorder (MDD) in routine practice. Two hundred and seven female patients with MDD were prospectively recruited. Patients with somatic symptoms (PSS) was defined as a total score ≥ 10 on the Patient Health Questionnaire-15 (PHQ-15), others were classified as non PSS (NPSS). The PHQ-9 for de-pression, the Generalized Anxiety Disorder Scale (GAD-7) for anxiety, the Clinical Global Impression-Severity (CGI-S) for clinical status, and the Visual Analogue Scale (VAS) for health status were utilised. Of 207 participants, 126 (60.9%) were PSS and 81 (39.1%) were classified as NPSS. The proportion of patients showing severe symptoms (65.1% vs. 24.7%) and recurrence of depression (74.6% vs. 49.4%), the CGI-S (4.6 vs. 4.1), the PHQ-9 (16.8 vs. 11.1), and the GAD-7 (8.3 vs 6.7) scores were significantly higher in PSS than in NPSS, while the VAS (39.4 vs. 51.2)...
Journal of Affective Disorders, 2010
Background: Few studies have simultaneously compared the ability of depression, anxiety, and somatic symptoms to predict the outcome of major depressive disorder (MDD). This study aimed to compare the MDD outcome predictive ability of depression, anxiety, and somatic severity at 6-month and 2-year follow-ups. Methods: One-hundred and thirty-five outpatients (men/women = 34/101) with MDD were enrolled. Depression and anxiety were evaluated by the Hamilton Depression Rating Scale, Hospital Anxiety and Depression Scale, and depression subscale of the Depression and Somatic Symptoms Scale (DSSS). Somatic severity was evaluated by the somatic subscale of the DSSS. Subjects undergoing pharmacotherapy in the follow-up month were categorized into the treatment group; the others were categorized into the no-treatment group. Multiple linear regressions were used to identify the scales most powerful in predicting MDD outcome. Results: Among the 135 subjects, 119 and 106 completed the 6-month and 2-year follow-ups, respectively. Somatic severity at baseline was correlated with the outcomes of the three scales at the two follow-ups. After controlling for demographic variables, somatic severity independently predicted most outcomes of the three scales at the two follow-ups in the notreatment group and the cost of pharmacotherapy and DSSS score at the 6-month follow-up in the treatment group. Limitations: Division of the subjects into treatment and no-treatment groups was not based on randomization and bias might have been introduced. Conclusions: Somatic severity was the most powerful index in predicting MDD outcome. Psychometric scales with appropriate somatic symptom items may be more accurate in predicting MDD outcome.
Indian Journal of Mental Health, 2020
Background: Functional somatic symtpoms are common in patients with major depressive disorder. The aim of the research was to study the prevalence and typology of Functional Somatic Symptoms (FSS) in patients with depression. Methodology: A total of 50 patients participated in the study. They were assessed on Bradford Somatic Symptom inventory for Functional Somatic Symptoms (FSS), Beck Depression Inventory (BDI) for severity of depression, and Comprehensive Psychopathological Rating Scale-anxiety index (CPRS-AI) for anxiety symptoms. Results: The mean age of the study sample was 41.36 years (SD-12.79). Gender distribution was gender distribution (male-60% vs. females 40%). Majority of the symptoms were found in married (84%), Hindus (92%), and from nuclear family (58%). A more than half of the patients were from urban background (76%). The mean duration of illness at the time of assessment was 36 months. As per BDI severity score 36% have mild, 38% have moderate and 26% have severe depression. Total mean CPRS-AI is (8.78±4.46).The more common FSS as assessed on Bradford Somatic Inventory were severe headache (88%), feeling tired when not working (86%), lack of energy (weakness) much of the time (84%), pain in legs (82%), aches and pains all over the body (72%), mouth or throat getting dry (72%), head feeling heavy (70%), head feeling hot or burning (68%), pain or tension in neck and shoulder (66%), low back trouble (66%) and sweating a lot (64%). The prevalence and typology of FSS was to a certain extent influenced by the sociodemographic variables and severity of depression. Conclusion: Functional somatic symptoms are highly prevalent in depressed patients and hence deserve more attention while diagnosing depression.
Somatic symptoms in depression
Dialogues in Clinical Neuroscience, 2006
Both painful and nonpainful somatic symptoms essentially characterize clinical states of depressive mood. So far, this well-established psychopathological knowledge has been appreciated only insufficiently by the official diagnostic systerms of the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text Revision (DSM-IV TR) and the ICD-10 Classification of Mental and Behavioral Disorders. Clinical Descriptions and Diagnostic Guidelines (ICD-10). From a perspective of primary care services, this unmet diagnostic need is deplorable, as the main mode of presenting a depression is by reporting somatic symptoms. This somatic form of presentation, however, significantly contributes to low rates of recognition in primary care. A diagnostic challenge may be seen in the differentiation of a depression with prevailing somatic symptoms from anxiety, somatoform disorders, and medical conditions. When somatic symptoms, particularly painful physical conditions, accompany the alre...
Prevalence and type of functional somatic complaints in patients with first-episode depression
East Asian Archives of Psychiatry 2012; 22: 146-153
Objective: To study the prevalence and type of functional somatic complaints in patients with firstepisode depression. Methods: A total of 164 patients attending the outpatient department of a general hospital psychiatric unit were evaluated using the Patient Health Questionnaire–15 (PHQ-15) and Hamilton Depression Rating Scale (HDRS). Results: More than half of the sample were male (n = 85; 52%) and most of the subjects were married (n = 128; 78%). The mean (standard deviation) HDRS score was 19.9 (5.4). All patients had at least 1 functional somatic complaint, and that the mean (range) number of functional somatic complaints per patient on the PHQ-15 was 8 (1-15). The most common functional somatic complaints included feeling tired or having little energy (93%); trouble sleeping (80%); nausea, gas and indigestion (68%); headache (68%); pain in arms, legs, or joints (66%); and feeling the heart racing (65%). Total PHQ-15 scores indicated the presence of moderate-to-severe severity of functional somatic complaints. Back pain, as well as pain in arms, legs, or joints, were found to be more common in females. The number and severity of functional somatic complaints did not differ significantly in relation to other socio-demographics (locality, marital status, age, education, income) and clinical variables (duration, physical co-morbidity, and atypical features). Conclusion: Functional somatic complaints are quite prevalent in subjects with first-episode depression. Hence, clinicians should routinely evaluate patients with depression for these symptoms.
The Psychometric Evaluation of Somatic Symptom Scale-8 in Patients With Major Depressive Disorder
Practice in Clinical Psychology, 2022
Objective: Somatic Symptom Disorder (SSD) is characterized by somatic symptoms that are very distressing or cause considerable functional disability. SSD is associated with various medical and psychiatric conditions and imposes high costs on the health care system. Therefore, early diagnosis and treatment of SSD are crucial. The somatic symptom scale-8 (SSS-8) is a valuable and brief self-report questionnaire to assess somatic symptom burden. The current study determined the psychometric properties of the Persian version of SSS-8 in depressed samples. Methods: The study data were collected from a clinical setting with individuals diagnosed with major depressive disorder (MDD, n=122). The convergent validity of SSS-8 was examined by assessing its correlation with the hospital anxiety and depression scale (HADS), the Whiteley index (WI-14), and somatic symptom disorder-B criteria scale (SSD-12) questionnaires. Results: The Cronbach α results confirmed the reliability of SSS-8. Reliabi...
Practice in Clinical Psychology, 2022
Somatic Symptom Disorder (SSD) is characterized by somatic symptoms that are very distressing or cause considerable functional disability. SSD is associated with various medical and psychiatric conditions and imposes high costs on the health care system. Therefore, early diagnosis and treatment of SSD are crucial. The somatic symptom scale-8 (SSS-8) is a valuable and brief self-report questionnaire to assess somatic symptom burden. The current study determined the psychometric properties of the Persian version of SSS-8 in depressed samples. Methods: The study data were collected from a clinical setting with individuals diagnosed with major depressive disorder (MDD, n=122). The convergent validity of SSS-8 was examined by assessing its correlation with the hospital anxiety and depression scale (HADS), the Whiteley index (WI-14), and somatic symptom disorder-B criteria scale (SSD-12) questionnaires. Results: The Cronbach α results confirmed the reliability of SSS-8. Reliability assessment with test-retest showed excellent reliability for scale. The confirmatory factor analysis also approved the SSS-8 single-factor structure. The results of construct validity analysis of the questionnaire showed that SSS-8 has a positive and significant relationship with depression, anxiety, WI, and SSS-12. Conclusion: The Persian version of the SSS-8 is an 8-item self-report questionnaire that health professionals and researchers can use to assess and screen somatic symptoms in individuals diagnosed with MDD.
Predictors of somatic symptoms in depressive disorder
General Hospital Psychiatry, 2003
We explored the relative contribution of potential psychological predictors of somatic symptoms in outpatients with major depressive disorder, including; 1) severity of depression; 2) general anxiety; 3) hypochondriacal worry; 4) somatosensory amplification; and, 5) alexithymia by sampling 100 consecutive outpatients with DSM-IV diagnoses of major depressive disorder attending the psychiatry clinics of general hospitals in Turkey. The subjects were rated by clinicians on depressive symptomatology (Hamilton Depression Rating Scale), and anxiety (Hamilton Anxiety Scale), and completed self-report measures of Hypochondriacal worry (7-item version of the Whiteley Index), the Somatosensory Amplification Scale, and the Toronto Alexithymia Scale. Multivariate models tested the independent contribution of each of the scales to the level of somatic symptoms as measured by a modified version of the SCL-90 somatization scale. At the bivariate level, somatic symptoms were associated with female gender and lower educational level, as well as the Hamilton Depression and Anxiety scales, the Whitely Index, and the Somatosensory Amplification and Alexithymia scales. In multiple regression models incorporating all variables, female gender and higher scores on the anxiety, somatosensory amplification and alexithymia scales all made independent contributions to the level of somatic symptoms and accounted for 54% of the variance. Therefore, somatic symptoms in depression are related to concomitant anxiety, tendency to amplify somatic distress, and difficulty identifying and communicating emotional distress. However, these factors do not account for the tendency for women to report more somatic symptoms.