Somatic Symptom Scores Research Articles

Impact of Somatic Symptoms on Identification of Depression among General Outpatients by Family Physicians in North-Western Nigeria

In many places in the world, General Practitioners are only able to identify depression in a small fraction of depressed patients presenting to general outpatient department. The effect of somatic symptoms on its recognition was investigated. The study determines the identification rate of depression by general practitioners among outpatients with somatic symptoms and those without somatic symptoms. This descriptive cross sectional study was conducted in Family Medicine Department, Aminu Kano Teaching Hospital, Kano, Nigeria. The Hospital Anxiety and Depression Scale (HADS) was used to screen selected participants. Forms were used by GPs to itemize medical and psychiatric symptoms elicited as well as medical and psychiatric diagnoses made. Schedule for Clinical Assessment in Neuropsychiatry (SCAN) version 2.1, was used to confirm the diagnosis of depression. Hamilton Depression Rating Scale (HDRS) was used for severity using items 11-14 of Hamilton Depression Rating Scale. Those with somatic symptoms score of 1-3 were rated as having low and those with 4-10 were rated as having high. Of the 410 outpatients recruited, 402 participated in the study. Two hundred and thirteen were screened depressed (HADS). Two hundred were confirmed depressed using SCAN (49.8%). The GPs identified 31.3% of those participants diagnosed depressed without somatic symptoms compared to 15.2% of those who were diagnosed depressed with somatic symptoms. However, no significant association was found between GPs ability to identify depression in the presence or absence of somatic symptoms (p = 0.09). This study found no association between GPs ability to identify depression and presence or absence of somatic symptoms (χ2 = 2.75, p = 0.09). However, this study found that the higher the level of somatic symptoms the more unlikely it’s for GPs to identify depression. To reduce the burden of depression by early detection and treatment, continuing medical education of GPs should include skills in identification of depression.

The relationship between somatic and cognitive-affective depression symptoms and error-related ERPs

BackgroundThe symptoms that contribute to the clinical diagnosis of depression likely emerge from, or are related to, underlying cognitive deficits. To understand this relationship further, we examined the relationship between self-reported somatic and cognitive-affective Beck׳s Depression Inventory-II (BDI-II) symptoms and aspects of cognitive control reflected in error event-related potential (ERP) responses. MethodsTask and assessment data were analyzed within 51 individuals. The group contained a broad distribution of depressive symptoms, as assessed by BDI-II scores. ERPs were collected following error responses within a go/no-go task. Individual error ERP amplitudes were estimated by conducting group independent component analysis (ICA) on the electroencephalographic (EEG) time series and analyzing the individual reconstructed source epochs. Source error amplitudes were correlated with the subset of BDI-II scores representing somatic and cognitive-affective symptoms. ResultsWe demonstrate a negative relationship between somatic depression symptoms (i.e. fatigue or loss of energy) (after regressing out cognitive-affective scores, age and IQ) and the central–parietal ERP response that peaks at 359ms. The peak amplitudes within this ERP response were not significantly related to cognitive-affective symptom severity (after regressing out the somatic symptom scores, age, and IQ). LimitationsThese findings were obtained within a population of female adults from a maximum-security correctional facility. Thus, additional research is required to verify that they generalize to the broad population. ConclusionsThese results suggest that individuals with greater somatic depression symptoms demonstrate a reduced awareness of behavioral errors, and help clarify the relationship between clinical measures of self-reported depression symptoms and cognitive control.

Positive effects of a healthy snack (fruit) versus an unhealthy snack (chocolate/crisps) on subjective reports of mental and physical health: a preliminary intervention study.

Background/Aims: Recent research has shown associations between type of snack and wellbeing. These studies have been cross-sectional and the aim of the present research was to examine this topic using an intervention study.Methods: A between-subjects intervention study was carried out. Volunteers (100 students, mean age = 19.00 years; 27 male, 73 female) completed online questionnaires measuring anxiety and depression, fatigue, somatic symptoms, cognitive difficulties, and distress at baseline. They were then randomly assigned to one of two snacking conditions – chocolate/crisps or fruit. Volunteers consumed one snack item in the mid-afternoon each day for 10 days. At the end of the intervention, the volunteers completed the questionnaires again.Results: Analyses of the baseline data confirmed that consumption of chocolate was associated with greater emotional eating and depression. Analyses of covariance, with the baseline data as covariates, were carried out on the post-intervention responses. The results showed that consumption of fruit was associated with lower anxiety, depression, and emotional distress than consumption of crisps/chocolate. Similarly, scores for somatic symptoms, cognitive difficulties, and fatigue were greater in the crisps/chocolate condition.Conclusion: These results extend findings from cross-sectional studies and give a clearer indication of causal effects of different types of snacks on wellbeing.

Abstract MP86: Depressive Symptoms are Associated with Mental Stress-Induced Myocardial Ischemia After Acute Myocardial Infarction

Objectives: Previous studies indicated that depressed mood may act as a trigger of acute coronary syndromes, although the mechanisms are not clear. We aimed to examine the association between depression and mental stress-induced myocardial ischemia in young survivors of a myocardial infarction (MI), and the possible differential association of somatic and cognitive depressive symptom dimensions. Hypothesis: Higher levels of depressive symptoms are associated with a higher propensity to develop myocardial ischemia with mental stress. Methods: We studied 98 patients (49 women and 49 men) age 38-59 years who were hospitalized for acute MI in the previous 6 months. Patients underwent myocardial perfusion imaging with [99mTc]sestamibi single-proton emission computed tomography at rest, after mental stress (speech task), and after exercise treadmill stress. If unable to exercise (N=16), patients underwent pharmacological stress test with regadenoson. Myocardial perfusion defect scores were obtained with observer-independent software. A summed difference score, the difference between stress and rest perfusion defect scores, was used to quantify myocardial perfusion defects due to ischemia under both stress conditions. The Beck Depression Inventory-II (BDI-II) was used to measure depressive symptoms. Two separate scores of somatic and cognitive depressive symptoms were calculated. Multivariate linear regression models were used in the analysis. Results: There was a significant and graded positive association between depressive symptoms and summed difference score with mental stress. After adjustment for demographical and lifestyle factors, severity of coronary heart disease and medications, each incremental depressive symptom was associated with 0.14 higher ischemia perfusion defect score [β=0.14, 95% CI: (0.03, 0.24), p=0.01]. When somatic and cognitive depressive symptoms were examined separately, both somatic symptoms [β=0.17, 95% CI: (0.04, 0.30), p=0.01] and cognitive symptoms [β=0.31, 95% CI: (0.07, 0.56), p=0.01] showed a significant association with mental stress-induced ischemia. Depressive symptoms were not associated with ischemia induced by exercise or pharmacological stress. Conclusion: Among young post-MI patients, higher levels of both cognitive and somatic depressive symptoms are associated with a higher propensity to develop myocardial ischemia with mental stress, but not with exercise/pharmacological stress. Future studies should explore whether mental stress-induced ischemia explains the poorer prognosis associated with depressive symptoms in post-MI patients.

Total somatic symptom score as a predictor of health outcome in somatic symptom disorders

The diagnosis of somatisation disorder in DSM-IV was based on 'medically unexplained' symptoms, which is unsatisfactory. To determine the value of a total somatic symptom score as a predictor of health status and healthcare use after adjustment for anxiety, depression and general medical illness. Data from nine population-based studies (total n = 28 377) were analysed. In all cross-sectional analyses total somatic symptom score was associated with health status and healthcare use after adjustment for confounders. In two prospective studies total somatic symptom score predicted subsequent health status. This association appeared stronger than that for medically unexplained symptoms. Total somatic symptom score provides a predictor of health status and healthcare use over and above the effects of anxiety, depression and general medical illnesses.

Depressive symptoms are associated with allostatic load among community-dwelling older adults

The allostatic load model has been used to quantify the physiological costs of the body's response to repeated stressful demands and may provide a useful, integrative perspective on the various correlates of late-life depressive symptoms. We interviewed 125 Rochester, NY adults, ranging in age from 67 to 94years. We employed an allostatic load score as a measure of multisystem dysfunction in hypothalamic–pituitary–adrenal axis function, immune function, anabolic activity, and cardiovascular activity. Overall, affective, and somatic depressive symptom scores were computed using the 20-item Center for Epidemiologic Studies Depression Scale. Multiple linear regression models were used to estimate associations between allostatic load scores and affective, somatic, and overall depressive symptoms. Among our sample of mean age 76.1years, the one-week prevalence of clinically significant depressive symptoms was 12.8%. In models adjusting for demographic, socioeconomic, and health-related factors, higher allostatic load scores were associated with elevated scores for overall, affective, and somatic depressive symptoms: beta=1.21 (95% CI=0.38, 2.05); beta=0.14 (95% CI=0.040, 0.24); beta=0.60 (95% CI=0.23, 0.97), respectively. Our results suggest that allostatic load measure is associated with late-life depressive symptoms. This association appears to be of clinical significance, as the magnitude of the effect size was comparable (but opposite in direction) to that of antidepressant use. Future research should examine the inter-relationships of allostatic load, psychological stress, and late-life depressive symptoms.

Impact of fat distribution on metabolic, cardiovascular and symptomatic aspects in postmenopausal women

The aim of this study was to investigate the anthropometric, metabolic, cardiovascular and symptomatic profile in gynoid and android postmenopausal women. Forty five postmenopausal women aged 50 to 60 years were divided into two groups according to fat distribution [waist-to-hip ratio (WHR)]: gynoid group (WHR between 0.68 and 0.8; N = 13) and android group (WHR > 0.8; N = 32). Body composition, skinfold thickness, serum/plasma estradiol, creatinine, urea, lipid profile, glucose and insulin, maximal exercise testing and menopause rating scale (MRS) were evaluated. The android group when compared to the gynoid group showed (P < 0.05): (i) higher values of body mass, BMI, waist circumference, body fat, lean mass and skinfold thickness; (ii) higher values of estradiol, triglycerides, very low-density lipoprotein (VLDL) and insulin levels with lower insulin sensitivity (%S) and greater insulin resistance (%IR) index; (iii) higher blood pressure (BP) during rest and lower maximal heart rate (HRmax) during maximal exercise testing and; (iv) higher scores of the somatic and urogenital-sexual symptoms. This study suggests that android postmenopausal women develop features that can lead to metabolic syndrome (MetS) and future cardiovascular disease (CVD), and these women may present higher scores of somatic and urogenital-sexual symptoms.

Quality of Life in Depressed Patients in UK Primary Care: The FINDER Study.

ObjectivesTo investigate the impact of depression and its treatment on health-related quality of life (HRQoL) in a naturalistic, primary care setting in the UK.MethodsThe Factors Influencing Depression Endpoints Research (FINDER) study was a European, 6-month, prospective, observational study designed to estimate HRQoL in patients with a clinical diagnosis of depression. This paper examines primary care patients recruited in the UK. HRQoL was measured at baseline and at 3 and 6 months after starting antidepressant therapy using the Short Form 36 Health Status Survey and the European Quality of Life-5 Dimensions (EQ-5D). Regression analysis was used to identify baseline and treatment variables independently and significantly associated with HRQoL. Further analyses included the effect of caseness for depression on HRQoL, the effect of moderate/severe pain at baseline on HRQoL, changes in overall pain, pain interference scores, and the use of different antidepressants by pain cohort.ResultsA total of 608 patients was recruited from 58 centres and mean HRQoL was significantly below reported population norms at baseline. Most improvement in HRQoL was seen at 3 months for EQ-5D, with small additional improvement at 6 months. Worse HRQoL outcomes at 6 months were associated with higher somatic symptoms score, duration of depression at baseline, and switching within antidepressant classes. Patients meeting the criteria for caseness for depression, or with significant pain at baseline showed less improvement in HRQoL scores at 6 months.ConclusionPatients presenting with depression in primary care show reduced HRQoL compared to population norms. HRQoL improves during antidepressant treatment particularly within the first 3 months. Nonpainful somatic symptoms, socioeconomic factors, depression variables and switching within antidepressant class predict poor HRQoL outcome. Pain is a common symptom in depressed patients and remains after 6 months’ treatment. Pain and somatic symptoms should be assessed in all patients with depression in primary care.

Migraine predicts physical and pain symptoms among psychiatric outpatients

BackgroundNo study has been performed to compare the impacts of migraine and major depressive episode (MDE) on depression, anxiety and somatic symptoms, and health-related quality of life (HRQoL) among psychiatric outpatients. The aim of this study was to investigate the above issue.MethodsThis study enrolled consecutive psychiatric outpatients with mood and/or anxiety disorders who undertook a first visit to a medical center. Migraine was diagnosed according to the International Classification of Headache Disorders, 2nd edition. Three psychometric scales and the Short-Form 36 were administered. General linear models were used to estimate the difference in scores contributed by either migraine or MDE. Multiple linear regressions were employed to compare the variance of these scores explained by migraine or MDE.ResultsAmong 214 enrolled participants, 35.0% had migraine. Bipolar II disorder patients (70.0%) had the highest percentage of migraine, followed by major depressive disorder (49.1%) and only anxiety disorder (24.5%). Patients with migraine had worse depression, anxiety, and somatic symptoms and lower SF-36 scores than those without. The estimated differences in the scores of physical functioning, bodily pain, and somatic symptoms contributed by migraine were not lower than those contributed by MDE. The regression model demonstrated the variance explained by migraine was significantly greater than that explained by MDE in physical and pain symptoms.ConclusionsMigraine was common and the impact of migraine on physical and pain symptoms was greater than MDE among psychiatric outpatients. Integration of treatment strategies for migraine into psychiatric treatment plans should be considered.

The Influence of Somatic Symptoms on Beck Depression Inventory Scores in Hospitalized Postmyocardial Infarction Patients

The Beck Depression Inventory (BDI) has been used more than any other self-report questionnaire in research on depression in cardiovascular disease. However, no studies have examined whether BDI scores may be influenced by somatic symptoms common after myocardial infarction (MI) that may overlap with symptoms of depression. The objective of this study was to examine whether BDI scores of post-MI patients may be influenced by somatic symptoms that commonly occur after MI, but may not be related to depression. Post-MI patients and psychiatric outpatients were matched on BDI cognitive-affective symptom scores, sex, and age, and their BDI somatic symptom scores were compared using independent samples t tests. Somatic symptoms accounted for 57% of BDI total scores for 296 post-MI patients (mean total BDI = 8.8), compared with 50% for 296 matched psychiatric outpatients (mean total BDI = 7.6). Overall, BDI somatic scores of post-MI patients were 1.3 points higher than for psychiatric outpatients (95% CI 0.68 to 1.82; P < 0.001), equivalent to 14% of total scores of post-MI patients. The relative influence of somatic symptoms on BDI total scores was higher for post-MI patients than for psychiatric outpatients matched on cognitive-affective scores, sex, and age. This finding stands in contrast to that from a previous study that used similar methods and sample comparisons and found that post-MI and psychiatric outpatients did not differ in their endorsement of somatic symptoms on the BDI-II. The BDI-II may be preferable to the BDI in post-MI patients.

Irritable Bowel Syndrome Demonstrates a Birth-Cohort Phenomenon

Purpose: To investigate if there is a birth-cohort phenomenon for irritable bowel syndrome (IBS). Background: Functional gastrointestinal disorders (FGIDs) are very common. There is growing interest in identifying potential early life risk factors that may contribute to the development of FGIDs later in life. Many studies suggest that early life factors may play a role in the eventual pathogenesis of FGIDs but something that has not been investigated is if there is a birth-cohort phenomenon (as seen with peptic ulcer disease and ulcerative colitis) associated with FGIDs. Methods: Validated self-report questionnaires were sent out to randomly selected cohorts of Olmsted County, Minnesota, residents during three calendar periods. The surveys recorded gastrointestinal symptoms required for the diagnosis of many FGIDs. The respondents were then classified into symptom groups based on their responses to each of the questionnaires. Birth cohorts were chosen based on historical trends in birth weights using 10-year increments. Odds ratios were created adjusting for age, gender, somatic symptom score (SSC), and calendar period the survey was completed in. Results: A total of 4,893 surveys were completed and returned for analysis. The average response rate over the three surveys was 58%. The overall prevalence of IBS was found to be 16%. The prevalence was highest during birth years 1963-1972 (29.3%) (Corresponding to the lowest birth weight years) as seen in Table 1 and had an odds ratio of 2.6 during this interval (95% CI 0.97-7.0).Table: [1732] Percentage of patients with IBS across age groups and birth cohortsConclusion: These data suggest IBS demonstrates a birth cohort effect which could result in an increased frequency of IBS in the future. This implies that exposures to risk factors of disease earlier in life may be more important than factors that occur later in life or around the time of diagnosis.

Multisystem physiological dysfunction is associated with depressive symptoms in a population‐based sample of older adults

To evaluate the association between multisystem physiological dysfunction and depressive symptom severity in the US older adults. We examined 2405 adults of age 60 years and older by using the data from the 2005-2008 National Health and Nutrition Examination Survey. We constructed a summary score of "physiological dysfunction," encompassing cardiovascular function, glucose regulation, liver function, and renal function. Overall depressive symptoms were obtained from the 9-item Patient Health Questionnaire depression scale, and factor analysis was used to derive affective and somatic symptom scores. We employed multiple linear regression models to estimate associations between physiological dysfunction scores and affective, somatic, and overall depressive symptoms, while adjusting for demographic, socioeconomic factors, and other potentially confounding factors. Greater multisystem physiological dysfunction scores were associated with an increased severity of overall, affective, and somatic depressive symptoms. These associations persisted after adjusting for all covariates: beta = 0.23 (95% confidence interval (CI) = 0.13, 0.32); beta = 0.08 (95% CI = 0.04, 0.11); beta = 0.12 (95% CI = 0.06, 0.18), respectively. Our results suggest that the multisystem physiological dysfunction is associated with late-life depressive symptoms. Additional longitudinal studies of links between allostatic load, psychosocial stress events throughout the life course, and late-life depressive symptoms may shed further light on this association.

Job demands as a potential modifier of the association between testosterone deficiency and andropause symptoms in Japanese middle-aged workers: A cross-sectional study

ObjectiveThe present study investigated whether job demands modify the association between low levels of testosterone and andropause symptoms. Study designParticipants were Japanese middle-aged workers in a middle-size company. Blood samples were drawn to determine serum levels of testosterone. Participants completed a self-report questionnaire that included 5 items from the Job Content Questionnaire (JCQ) that assesses job demands, the Aging Males’ Symptoms (AMS) scale as well as questions regarding health behaviors and history of disease. Analysis of data was limited to the 183 men who completed all components of the questionnaire and provided blood samples (mean age=51.9 years, SD=7.7, age range 34–67 years). Main outcome measuresThe AMS which comprises three symptom sub-scales: somatic, psychological, and sexual. ResultsMen with low testosterone levels (<349ng/dL) had more psychological andropause symptoms than those with high levels. In men with high psychological job demands, compared to men with low job demands, testosterone levels were positively associated with the total score for andropause symptoms and scores for somatic and psychological symptoms. ConclusionsLevel of job demands may intensify the effect of testosterone deficiency on andropause symptoms.

Reproducibility and validity of a satisfaction questionnaire on hypoglycemic agents: the Oral Hypoglycemic Agent Questionnaire (OHA-Q)

In order to assess satisfaction with treatment using oral hypoglycemic agents among patients with type 2 diabetes mellitus, we developed the Oral Hypoglycemic Agent Questionnaire (OHA-Q), a patient-administered questionnaire composed of 20 questions. We enrolled 597 outpatients with type 2 diabetes mellitus who had been treated with a single oral hypoglycemic agent for 1 month or longer at 45 institutions in Japan. Their physicians provided background information on the patients, etc., in the physician-filled forms, and the patients answered both OHA-Q and the Diabetes Treatment Satisfaction Questionnaire (DTSQ) twice in 1 week. After patients with incomplete forms, etc., had been excluded, statistical analyses were performed on 483 patients for the validity assessment and on 419 patients for the reproducibility assessment. Based on factor analysis of the OHA-Q item scores, a simple structure was obtained by three-factor varimax rotation, and three subscale scores were identified as the “treatment convenience score,” “somatic symptom score” and “satisfaction score.” All intraclass correlation coefficients for the subscale scores were 0.7 or higher, showing high reproducibility. A correlation of 0.4 or higher was observed between the subscale scores and the DTSQ satisfaction score. Moreover, an expected association was observed between the subscale scores and patient background factors. Based on these results, OHA-Q may have adequate reproducibility and validity as an assessment scale for satisfaction with treatment using oral hypoglycemic agents in patients with type 2 diabetes mellitus.

Influence of somatic symptoms on patient health questionnaire‐9 depression scores among patients with systemic sclerosis compared to a healthy general population sample

Depression symptom measures that include somatic symptoms may inflate severity estimates among medically ill patients, including patients with systemic sclerosis (SSc; scleroderma). The 9-item Patient Health Questionnaire (PHQ-9) is increasingly used to assess depressive symptoms in medical settings, but it is not known whether PHQ-9 scores are influenced by somatic symptoms common in medical illness. The objective was to assess whether SSc patients had higher somatic symptom scores on the PHQ-9 than non-medically ill respondents from the general population matched on cognitive/affective scores. SSc patients from the Canadian Scleroderma Research Group Registry were matched with respondents from a random population survey of Alberta, Canada residents who were without chronic disease on total PHQ-9 cognitive/affective scores (5 items), sex, and, as close as possible, age. PHQ-9 somatic scores (4 items) were compared between SSc patients and healthy Alberta survey respondents using t-tests for unadjusted analyses and analysis of covariance to adjust for age differences that remained after matching. Somatic symptoms accounted for 64% of the total PHQ-9 scores for 762 matched SSc patients (n = 837 total) compared to 56% for 762 matched Alberta population survey respondents (n = 3,304 total), a mean difference of 1.0 point, or 19% of the total scores for the SSc patients (Hedges's g = 0.38). After adjusting for age, the mean difference increased to 1.4 points, reflecting 25% of the SSc patients' total scores (Hedges's g = 0.55). PHQ-9 scores among patients with SSc may include a small to moderate amount of variance from somatic symptoms that are not necessarily related to depression.

Abstract 2657: Younger age correlates with depression but not adaptive maturity in adult cancer patients

Abstract Background: In a previous study, we found that Immature adaptive mechanism (ego defense mechanism) endorsement independently predicted 5-year survival in adult cancer patients. Depression symptom severity, however, did not predict survival in the same sample. While empirical evidence suggests that adaptive maturity increases with age in the general population, the influence of age on depression in cancer patients remains unclear. In this investigation, we hypothesized that increased age would be associated with 1) mature adaption and with 2) fewer depression symptoms. Methods: Participants in this IRB approved study included adult cancer outpatients at the University of Colorado Cancer Center (N=293). All participants provided informed consent and demographic data, and completed the Defense Style Questionnaire (DSQ) and Beck Depression Inventory (BDI). Exclusion criteria were extreme pain, delirium, and neuroendocrine neoplasm that could mimic depression. Additional data collected included gender, cancer type and stage, time since diagnosis, treatment modality, psychiatric history, current medications, and current antidepressant use. For analysis, we used Spearman's correlation statistic with probability set at p&amp;lt;0.05. Results: Data analysis indicated no statistical association between age and adaptive maturity. By contrast, age correlated significantly and negatively with total BDI scores (r= −0.23, p&amp;lt;0.0001), as well as BDI sub-scale mood symptom scores (r= −0.26, p&amp;lt;0.0001), and somatic symptom scores (r= −0.12, p=0.037). Factors associated with BDI mood symptom scores included self-reported current medications that affect mood (r= 0.21, p&amp;lt;0.001), psychiatric history (r= 0.15, p=0.009), current antidepressants (r= 0.14, p=0.02), and ratio of Mature/Immature DSQ scores (r= −0.24, p&amp;lt;0.0001). Gender, cancer stage, time since diagnosis, and treatment modality did not reach correlation significance with age, adaptive maturity, or BDI score. Conclusion: These data suggest that depression symptoms may occur more frequently in younger rather than older cancer patients, and that age does not appear associated with adaptive maturity in this clinical sample. Mood symptoms of depression stood out as highly and inversely correlated with age. Possible variables that may affect this relationship include medications that affect mood, as well as measured adaptive maturity level, with probable contributions from previous psychiatric history and current antidepressant use. Unexpectedly, antidepressant use appeared associated with more, rather than fewer, depressive mood symptoms. Further prospective research should focus on investigating the factors that affect depression in younger adult cancer patients. For example, antidepressant treatment in this age group will require trials to establish an age specific clinical improvement. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 2657. doi:1538-7445.AM2012-2657

Revisiting gender differences in somatic symptoms of depression: much ado about nothing?

BackgroundWomen have a higher prevalence of Major Depressive Disorder (MDD) and report more severe depressive symptoms than men. Several studies have suggested that gender differences in depression may occur because women report higher levels of somatic symptoms than men. Those studies, however, have not controlled or matched for non-somatic symptoms. The objective of this study was to examine if women report relatively more somatic symptoms than men matched on cognitive/affective symptoms.MethodsMale and female patients receiving treatment for MDD in outpatient psychiatric clinics in New Jersey and Pennsylvania, USA were matched on Beck Depression Inventory-II (BDI-II) cognitive/affective symptom scores. Male and female BDI-II somatic symptom scores were compared using independent samples 2-tailed t-tests.ResultsOf 472 male and 1,026 female patients, there were 470 male patients (mean age = 40.1 years, SD = 15.1) and 470 female patients (mean age = 43.1 years, SD = 17.2) successfully matched on BDI-II cognitive/affective symptom scores. Somatic symptoms accounted for 35% of total BDI-II scores for male patients versus 38% for matched female patients. Female patients had somatic symptom scores on average 1.3 points higher than males (p<.001), equivalent to 4% of the total BDI-II scores of female patients. Only 5% of male patients and 7% of female patients scored 2 or higher on all BDI-II somatic symptom items.ConclusionsGender differences in somatic scores were very small. Thus, differences in the experience and reporting of somatic symptoms would not likely explain gender differences in depression rates and symptom severity.

The Influence of Optimistic Expectations and Negative Life Events on Somatic Symptoms among Adolescents: A One-Year Prospective Study

This study prospectively examined the main effect of optimism on subsequent somatic symptomatology as well as optimism as moderating factors in the link between negative life events and somatic symptoms in a sample of 198 (111 females, 87 males) students in a Norwegian senior high school. Results from the longitudinal multivariate analyses, indicated that the scores for optimism and negative life events were significantly associated with scores of somatic symptoms at time-point two (T2). Moreover, a significant Optimism × Negative life events interaction was found in predicting somatic symptoms. Implications of these findings are discussed.

Grief and physical health outcomes in U.S. soldiers returning from combat

Few studies have measured the burden of physical health problems after Iraq/Afghanistan deployment, except in association with post-traumatic stress disorder (PTSD) or mild traumatic brain injury (mTBI). Grief, a correlate of health problems in the general population, has not been systematically examined. We aimed to identify the prevalence of post-deployment physical health problems and their association with difficulty coping with grief. Infantry soldiers (n=1522) completed anonymous surveys using validated instruments six months following deployment in November-December 2008. Multiple logistic regression was used to assess the association of difficulty coping with grief and physical health. The most frequent physical health symptoms reported were: sleep problems (32.8%), musculoskeletal pain (32.7%), fatigue (32.3%), and back pain (28.1%). Difficulty coping with grief over the death of someone close affected 21.3%. There was a dose-response relationship between level of difficulty coping with grief and principal physical health outcomes (ps<.002). Controlling for demographics, combat experiences, injuries, PTSD, depression, and other factors, grief significantly and uniquely contributed to a high somatic symptom score (adjusted odds ratio (AOR)=3.6), poor general health (AOR=2.0), missed work (AOR=1.7), medical utilization (AOR=1.5), difficulty carrying a heavy load (AOR=1.7), and difficulty performing physical training (AOR=1.6; all 95% confidence intervals>1). Data are cross-sectional and grief was measured with one item. Over 20% of soldiers reported difficulty coping with grief. This difficulty was significantly associated with physical health outcomes and occupational impairment. Clinicians should be aware of the unique role grief plays in post-deployment physical health when treating patients.

POSTER PRESENTATIONS

POSTER PRESENTATIONS