813 – Somatization as central manifestation of depression in iranian culture

Abstract

Introduction:In some cultures, including ours, direct explanation of inner psychic world is inhibited and stigmatized, therefore finding alternative modes of expression.Aims and objectives:The aim of this cross-sectional study was to reach to an estimation of the frequency of somatization in the depressed patients.Method:500 patients with major depressive disorder referred to the outpatient clinic of Shiraz University of Medical Sciences were recruited and diagnosed based on DSM-IV-TR. Through psychiatric interview, we assessed the presenting complaints of these patients. the presenting symptoms were divided into three main categories namely: mental symptoms, pain, and physical symptoms other than pain. Statistical analysis (chi-square and logistic regression) were performed to assess the relationship between presenting symptoms and some demographic variables such as age, gender, marital status, educational level and cultural background.Results:Physical symptoms other than pain in 193 (38.6%), mental symptoms in 186 (37.2%) and pain in 121 (24.2%) of the patients were seen. Pain and physical complaints were more common in patients with rural cultural background, lower education, women and the married ones. Headache (15.2%), irritability (10.6%) and pain in other areas of the body (10.4%) were the most frequent chief complaints the patients had stated. the symptoms of hypochondriasis, suicidal idea, crying, irritability and insomnia were significantly associated with the complaint of somatization.Conclusion:Somatic symptoms, especially pain, have a significant weight in the chief complaints of depressed patients. Physicians need to pay proper attention to this important issue in order to better understand their patients.