The need for long-term surveillance of recovery of psychiatric patients with somatic complaints

Abstract

Objective: Treatment of psychiatric patients with psychosomatic or somatic symptoms needs special attention. Methods: We examined correlates, change and recovery from depression among psychiatric patients (n = 150) during the assessment of their work ability. Patients were referred to an open psychiatric ward during 8/2004-9/2005. Psychiatric diseases were diagnosed with the ICD-10 by the psychiatrist, but also the Structured Clinical Interview for DSM-IV (SCID I and II) was conducted. The patients replied to questionnaires after admission and before discharge including questions on life changes, somatic health, psychosocial and health-related factors as well as psychometric scales for depression (BDI), life satisfaction (LS) and general psychopathology (SCL). RESULTS. At baseline, 75% of the patients reported clinically significant depression (BDI > 15) and a quarter of them experienced their depression as severe (BDI ≥ 30). Whereas, according to ICD-10 guidelines, 91% of the patients suffered from depressive disorder and 66% of them from major depression. The average duration of inpatient evaluation was 24 (SD 9, 4) days. Baseline poor general health, life dissatisfaction, psychosomatic symptoms, bodily pains as well as poor financial situation and adverse life events predicted prevailing depression at discharge. Clinical symptoms improved significantly, especially among younger patients, recovery could not be reached by the time of discharge. Conclusions: Psychiatric patients with somatic complaints tended to under-rate their depression. To enhance their recovery, long-term and individually planned out-patient treatment and surveillance are needed