A Cross-Sectional Study of Somatic Symptoms and the Identification of Depression Among Elderly Primary Care Patients

Abstract

omatization, the presentation of medically unexplained symptoms, is very common in primary care.Objective: To examine the relationship between somatization and depression as rated by primary care physicians.Method: This study was a cross-sectional survey of 355 older adults with and without significant depressive symptoms. Physicians' ratings of somatization and depression were obtained for 341 of the 355 patients. Patients were sorted into 4 groups on the basis of physician ratings (no depression/no somatization, somatization only, depression only, and both somatization and depression). Data were collected from [2001][2002][2003].Results: Patients who were rated as somatizing were 4.03 (95% CI, 2.52-6.45) times as likely to be rated as depressed as well as somatizing. A comparison of the 4 groups defined by physicians' ratings found that functional status, ethnicity, number of medical conditions, depressive symptoms, and anxiety were statistically significantly different (P < .05). Primary care physicians were 3.95 (95% CI, 1.53-10.16) times more likely to identify older black patients as somatizing only versus depressed and somatizing compared to older white patients among patients above a threshold on a standard depression instrument.Conclusions: Our study fills a gap in the literature by focusing on the primary care physician ratings of depression and somatization, and also specifically on older primary care patients. Blacks are less likely to be rated as depressed, but this may reflect the tendency of doctors to rate them as somatizing.

Structural Relationships Between Depression, Perceived Stress, Sleep Quality, and Quality of Life: Evidence from Iranian Elderly

“…Quality of life is among the debated issues and is one of the indexes measured for determining and improving the needs and health conditions of the elderly (10). A healthy aging life or a higher quality of life requires being free from any illnesses, being active, and improving physical-mental skills (11).…”

Depression in the Elderly–Epidemiology, Diagnosis, Special Aspects, and Treatment Options

“…One should always be aware that somatic diseases such as cancer, neurological diseases, infections, endocrinological or metabolic disorders, or (auto-) immunological diseases also cause some level of depression ("organic or symptomatic psychic disorders"). These diseases are classified according to ICD 10 as F06.3 [12,13]. Somatic diseases including brain affections can cause or mimic almost all kinds of psychiatric disorders, which should also be kept in mind (ICD 10: F04, F05, F06, F07).…”

Culture, Ageing and the Construction of Pain

“…Somatic symptoms sometimes serve as idioms of distress in that somatisation is often defined as a process whereby people express and experience their emotional and psychological distress in terms of physical symptoms and pain [48]. Although a number of authors have also highlighted that somatoform disorders can also be characterized by physical symptoms, for which there are no demonstrable organic causes [49,50,51,52]. Much of the literature on somatisation, suggest that depression and depressive symptoms, are commonly the underlying feature of somatoform disorders, [53].…”