Comparison of symptoms in Japanese and American depressed primary care patients

Waza, Kazuhiro; Graham, Antonnette V.; Zyzanski, Stephen J.; Inoue, Kazuo

doi:10.1093/fampra/16.5.528

Cited by 60 publications

(50 citation statements)

References 22 publications

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“…31 Interestingly, the specific types of somatic symptoms reported by patients differ between cultures, reflecting cultural patterns of symptom significance-for example, abdominal distress, headaches, and neckaches are reported more frequently by patients with depression from Japan than those from the United States. 33 The high prevalence of somatic symptoms in depression poses the question, "Can somatic symptoms be considered to be clinical predictors of underlying depression in primary care?" It is known that patients with somatic symptoms have a greater risk of developing depression.…”

Section: Somatic Symptoms Are Prevalent In Depression In Primary Carementioning

confidence: 99%

The Importance of Somatic Symptoms in Depression in Primary Care

Gandhi¹

2005

Prim. Care Companion CNS Disord.

241

186

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Objective:Patients with depression present with psychological and somatic symptoms, including general aches and pains. In primary care, somatic symptoms often dominate. A review of the literature was conducted to ascertain the importance of somatic symptoms in depression in primary care.Data sources and extraction: MEDLINE, EMBASE, and PsychLIT/PsychINFO databases ( -January 2004 were searched for the terms depression, depressive, depressed AND physical, somatic, unexplained symptoms, complaints, problems; somatised, somatized symptoms; somatisation, somatization, somatoform, psychosomatic; pain; recognition, underrecognition; diagnosis, underdiagnosis; acknowledgment, underacknowledgment; treatment, undertreatment AND primary care, ambulatory care; primary physician; office; general practice; attribution, reattribution; and normalising, normalizing. Only English-language publications and abstracts were considered.Study selection: More than 80 papers related to somatic symptoms in depression were identified using the content of their titles and abstracts.Data synthesis: Approximately two thirds of patients with depression in primary care present with somatic symptoms. These patients are difficult to diagnose, feel an increased burden of disease, rely heavily on health care services, and are harder to treat. Patient and physician factors that prevent discussion of psychological symptoms during consultations must be overcome.Conclusions: Educational initiatives that raise awareness of somatic symptoms in depression and help patients to reattribute these symptoms should help to improve the recognition of depression in primary care.( 3 Despite improved awareness of the condition in primary care, depression remains difficult to diagnose initially, and the majority of cases are only recognized at subsequent consultations, sometimes several years after the patient's initial visit. 4 In primary care, physicians require sophisticated consulting skills to enable them to differentiate a wide range of symptoms from a complex narrative in a short period of time. Symptoms of depression include classic psychological symptoms, such as low mood, loss of interest, poor concentration, and associated anxiety, and somatic symptoms, such as changes in appetite, lack of energy, sleep disturbance, and general aches and pains. 5,6 The suspicion of depression is usually raised by the presence of psychological symptoms. However, in approximately two thirds of patients with depression, the clinical picture is dominated by somatic symptoms, such as lack of energy and general aches and pains, 7,8 which patients frequently attribute to normalizing causes. As a result, many physicians become preoccupied with lengthy investigations into possible underlying organic disease rather than considering depression as a diagnosis.9 Indeed, depression is mostly difficult to recognize in patients who present with chiefly somatic complaints. 8,10 We conducted a review of the recent literature to ascertain the importance of somatic symptoms in depress...

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Section: Somatic Symptoms Are Prevalent In Depression In Primary Carementioning

confidence: 99%

The Importance of Somatic Symptoms in Depression in Primary Care

Gandhi¹

2005

Prim. Care Companion CNS Disord.

241

186

View full text Add to dashboard Cite

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“…Consistent with previous research (Ryder et al, 2008;Waza et al, 1999), Study 1 showed that Chinese emphasized somatic symptoms relative to Westerners in the communication of depression symptoms. We also found evidence of greater somatization to the extent that Chinese participants endorsed the normative expectations of collectivism.…”

Section: Discussionsupporting

confidence: 84%

Understanding depression across cultures: a social identity perspective

Chang¹

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There is now considerable evidence showing that culture shapes psychological processes, and this extends to depression and psychopathology more generally. In particular, an understanding of the processes and mechanisms through which culture influences depression is important not only to clinical practice, but also in the designing of interventions to promote resilience to depression. For example, such cultural understanding helps therapists to determine whether and when clients will be influenced by culture and its norms, and accordingly, the impact on their expression, assessment, diagnosis, and treatment of depression. The present thesis adopts a social identity perspective to advance research on the cultural underpinnings of depression in three research streams that investigate (a) the symptomatic presentation of depression, (b) cultural factors associated with vulnerability, and (c) resilience, to depression.Much of the work on the relationship between culture and the expression of depression has centered on Asians" tendency to emphasize somatic symptoms of the condition over psychological symptoms. However, despite extensive investigation of Asian somatization, there has been little progress in explaining how and when culture affects depression expression. To address this gap, the studies in Chapter 2 drew on social identity principles and processes to explain when culture and its norms would affect somatization.Three studies were conducted to investigate the role of cultural identity on somatization; predicting that norm endorsement would occur only when individuals identified with their culture. The key finding was that among Asians, normative expectations of collectivism predicted somatization, but only when participants strongly identified with Asian culture.These findings highlight the centrality of identification processes to cultural influence on depression.Investigations of culture and depression expression tend to conceptualize the Western perspective as the frame of reference or norm. That is, Asian somatization is commonly viewed as dysfunctional in Western contexts, whereby Asians and their emphasis on somaticizing depression is often portrayed as "that which needs to be explained". In Chapters 3 and 4, we shifted focus to studying the effect of Western culture on depression, an arguably neglected area of research. More importantly still, the socially potent nature of cultural norms in exerting influence tends to be overlooked in the literature of this field. Hence, the studies in these chapters drew on a norm-based approach to characterize cultural influence, and investigated the effects of specific collective-level cultural factors (i.e., social norms) associated with vulnerability to depression among Westerners.iii Along these lines, the study reported in Chapter 3 examined whether and why social norms communicating the value of happiness (that happiness is desirable) could potentially make individuals feel worse (i.e., more depressed). We also investigated differences in these effect...

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“…Depression is a global problem associated with multiple social and health issues (1). Medical treatment of depression is mostly unsatisfactory, as exemplified by a recent re-analysis demonstrating the ineffectiveness of a highly promoted class of drugs used for treating depression (2).…”

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confidence: 99%

Antidepressant-Like Effect of 1α-Hydroxyvitamin D<sub>3</sub> on Mice in the Forced Swimming Test

Kawaura

Kitamura

Tanida³

et al. 2017

J Nutr Sci Vitaminol

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SummaryWe examined the effect of 1a-hydroxyvitamin D3 [1a(OH)D3] on mice in the forced swimming test. Intragastric administration of 1.0 mg/kg of 1a(OH)D3 reduced immobility time in the forced swimming test. At all concentrations tested (0.5, 1.0, 2.0 mg/kg), 1a(OH)D3 had no effect on locomotor activity, compared with controls. These results suggest that 1a(OH)D3 may have antidepressant-like activity. Key Words 1a-hydroxyvitamin D3, forced swimming test, glial cell line-derived neurotrophic factor, brain-derived neurotrophic factor Depression is a global problem associated with multiple social and health issues (1). Medical treatment of depression is mostly unsatisfactory, as exemplified by a recent re-analysis demonstrating the ineffectiveness of a highly promoted class of drugs used for treating depression (2). A more effective drug not belonging to the antidepressant class is expected in the near future. The relationship between depression and vitamin D has become a topic of research interest in recent years.The likelihood of depression in subjects with vitamin D deficiency is significantly higher than in subjects who are vitamin D sufficient (3). Mean 25-hydroxyvitamin D levels were shown to be markedly lower in patients with minor and major depression than in healthy subjects (4). A clear clinical link between vitamin D and depression has not been established, however. Lansdowne and Provost investigated healthy subjects in the winter, when vitamin D is at low concentrations, and confirmed that mood could be improved when a healthy person is given vitamin D at 400 or 800 IU during winter (5). Furthermore, it was reported that a single dose of 300,000 IU of vitamin D decreases the severity of depression in elderly patients who are taking antidepressants (6). The combination of vitamin D and fluoxetine was shown to be significantly more effective for patients with major depressive disorder than fluoxetine alone (7). To date, however, no reports have been published demonstrating the effect of administration of vitamin D alone on patients with major depressive disorder. Therefore, it is necessary to examine the effect of vitamin D on the depressive state. Almost all antidepressant drugs reduce the immobility time of rats in the forced swimming test (8). Following administration, 1a-hydroxyvitamin D3 [1a(OH)D3] is metabolized in the liver to 1a,25-dihydroxyvitamin D3 [1a,25(OH)2D3], which shows an effect through 1a,25(OH)2D3 receptor (vitamin D3 receptor) distributed over the body (9) including the central nervous system (10). Therefore, we examined the effect of 1a(OH)D3 using the depression model described by Porsolt et al. (8). Materials and MethodsA total of 40 male 5-wk-old ICR mice were obtained from Charlies River Laboratory Co., Ltd. (Kyoto, Japan) 1 wk before the experiment. The mice were housed in plastic cages (3 mice/cage) with sterilized wood chips as bedding in an air-conditioned room maintained at 2362˚C and 5565% humidity with a 12-h alternating light and dark cycle. The mice were fed a commercial...

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Comparison of symptoms in Japanese and American depressed primary care patients

Abstract: This study clearly indicates the prominence and importance of physical symptoms in the presentation of depression in Japanese primary care patients. Their physicians must be alerted to the possibility of depression, especially when patient complaints include abdominal, neck or head pain.

Cited by 60 publications

References 22 publications

The Importance of Somatic Symptoms in Depression in Primary Care

The Importance of Somatic Symptoms in Depression in Primary Care

Understanding depression across cultures: a social identity perspective

Antidepressant-Like Effect of 1α-Hydroxyvitamin D<sub>3</sub> on Mice in the Forced Swimming Test

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Comparison of symptoms in Japanese and American depressed primary care patients

Abstract: This study clearly indicates the prominence and importance of physical symptoms in the presentation of depression in Japanese primary care patients. Their physicians must be alerted to the possibility of depression, especially when patient complaints include abdominal, neck or head pain.

Cited by 60 publications

References 22 publications

The Importance of Somatic Symptoms in Depression in Primary Care

The Importance of Somatic Symptoms in Depression in Primary Care

Understanding depression across cultures: a social identity perspective

Antidepressant-Like Effect of 1&alpha;-Hydroxyvitamin D<sub>3</sub> on Mice in the Forced Swimming Test

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Product

Resources

About

Antidepressant-Like Effect of 1α-Hydroxyvitamin D<sub>3</sub> on Mice in the Forced Swimming Test