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. 2005;7(4):167-76.
doi: 10.4088/pcc.v07n0405.

The importance of somatic symptoms in depression in primary care

André Tylee  1 , Paul Gandhi
Affiliations

The importance of somatic symptoms in depression in primary care

André Tylee et al. Prim Care Companion J Clin Psychiatry. 2005.

Abstract

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 (1985-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, under-recognition; diagnosis, underdiagnosis; acknowledgment, under-acknowledgment; treatment, undertreatment AND primary care, ambulatory care; primary physician; office; general practice; attribution, re-attribution; 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 re-attribute these symptoms should help to improve the recognition of depression in primary care.

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Figures

Figure 1.
Figure 1.
3-Year Incidence of 10 Common Somatic Symptoms and Proportion of Symptoms With a Suspected Organic Origin (N = 1000)a
Figure 2.
Figure 2.
Prevalence of Somatic Symptoms and Organic Conditions in 748 Individuals With Major Depressive Disorder in Primary Carea
Figure 3.
Figure 3.
Effect of Clinical Presentation on Primary Care Physicians' Recognition of True Psychiatric Casesa
See this image and copyright information in PMC

Comment in

  • Somatic symptoms and depression: a double hurt.
    Kroenke K. Kroenke K. Prim Care Companion J Clin Psychiatry. 2005;7(4):148-9. doi: 10.4088/pcc.v07n0401. Prim Care Companion J Clin Psychiatry. 2005. PMID: 16163396 Free PMC article. No abstract available.

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