Symptoms of somatization as a rapid screening tool for mitochondrial dysfunction in depression

Abstract

AimsSomatic symptomatology is common in depression, and is often attributed to the Freudian-inspired concept of "somatization". While the same somatic symptoms and depression are common in mitochondrial disease, in cases with concurrent mood symptoms the diagnosis of a mitochondrial disorder and related therapy are typically delayed for many years. A short screening tool that can identify patients with depression at high risk for having underlying mitochondrial dysfunction is presented.MethodsSix items of the Karolinska Scales of Personality (KSP) were found to differentiate among 21 chronically-depressed Swedish subjects with low versus normal muscle ATP production rates. A screening tool consisting of the six KSP questions was validated in the relatives of American genetics clinic patients, including in 24 matrilineal relatives in families with maternally inherited mitochondrial disease and in 30 control relatives.ResultsAmong the depressed Swedish patients, the screening tool was positive in 13/14 with low and 1/7 with normal mitochondrial function (P = 0.0003). Applied to the American relatives of patients, the screening tool was positive in 13/24 matrilineal relatives and in 1/30 control relatives (P = 2 × 10-5).ConclusionOur preliminary data suggest that a small number of specific somatic-related questions can be constructed into a valid screening tool for cases at high risk for having a component of energy metabolism in their pathogenesis.

Mitochondrial DNA and gastrointestinal motor and sensory functions in health and functional gastrointestinal disorders

“…Furthermore, the present association of 3010A with nonspecific abdominal pain is consistent with the Boles group's previously reported association of this SNP with both migraine and CVS, conditions in which abdominal pain/discomfort is common. Although prior work has reported an association between mitochondrial dysfunction (as measured by ATP production rate in biopsied muscle) and the presence of somatic symptoms in general (19,20), in the present study, we found no association between the three mtDNA SNPs studied and the overall somatic symptom score. Further research is needed to better understand these findings.…”

A review of lifestyle factors that contribute to important pathways associated with major depression: Diet, sleep and exercise

“…Depressed patients presenting with somatic complaints also have low ATP production rates in biopsied muscles Boles, 2008a, Gardner andBoles, 2008b). In addition, rates of depression are increased in patients with mitochondrial disorders (Fattal et al, 2007, Koene et al, 2009).…”

Increased nuclear factor-κB and loss of p53 are key mechanisms in Myalgic Encephalomyelitis/chronic fatigue syndrome (ME/CFS)

“…Physio-somatic symptoms are commonly encountered in mitochondrial disorders and quite often show a waxing and waning pattern [105][106][107]. Disorders in mitochondria may cause many different symptoms, from mild photophobia and muscle complaints to cerebellar ataxia and neonatal death [105,106,[108][109][110][111].…”