Can We Determine Depressive Conditions on the Basis of Somatic Symptoms? A Cross-sectional Study of Depressive Conditions among Japanese Patients at a University Hospital General Medicine Clinic

Published on Jan 1, 2012in Internal Medicine1.005
· DOI :10.2169/INTERNALMEDICINE.51.7328
Akiko Aoki3
Estimated H-index: 3
(TMU: Tokyo Medical University),
Akiko Aoki8
Estimated H-index: 8
(TMU: Tokyo Medical University)
+ 5 AuthorsTatsuto Ashizawa9
Estimated H-index: 9
(TMU: Tokyo Medical University)
Objective We evaluated the relationship between somatic symptoms and depressive conditions among patients visiting the general medicine clinic of a university hospital. Methods We distributed interview forms to 332 consecutive patients who visited our clinic for the first time between March and July 2011. Somatic symptoms were rated using a symptom checklist, and depressive conditions were evaluated using the Zung Self-Rating Depression Scale (SDS). We categorized and compared 2 groups of patients: patients with an SDS score of more than 48 (depressive group) and patients with an SDS score of less than 48 (non-depressive group). Results A total of 284 (85.5%) patients returned the forms. The SDS scores were obtained from the forms of 182 patients (64.1%). The average age of these 182 patients was 46.5±18.04 years. The mean number of checked symptoms was 4.3±3.03, and the most common symptom was general fatigue (n=106; 58.2%). The number of checked symptoms in the survey was higher in the depressive group patients than in the non-depressive group patients. Multiple logistic regression analysis indicated that general fatigue, headache, and sleeping problems were significant dependent variables which were related to depressive conditions. We defined these 3 symptoms as depression-related somatic symptoms (DRSS). On a receiver-operating characteristic curve, the optimal cutoff scores were 2 of 3 DRSS and 4 of 20 somatic symptoms. Conclusion General physicians should consider possible depressive conditions when patients have 2 or more DRSS or 4 or more somatic symptoms.
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