somatic depression

a diagnostic challenge may be seen in the differentiation of a depression with prevailing somatic symptoms from anxiety, somatoform disorders, and medical conditions. it is a global loss of vitality in which all bodily parts and functions may be altered, and all their performances depressed.2 kurt schneider considered these disturbances of vital feelings to be the core of cyclothymic depression. and correspondingly, in icd-10, disturbances of sleep and appetite, loss of libido, and amenorrhea are the only somatic symptoms considered to be of diagnostic significance for major depression. several basic physical dysfunctions, such as those of sleep, appetite, or digestion, are also to be included in the term “somatic.” in addition, it may be clinically relevant to differentiate between painful and nonpalnful somatic symptoms of depression.

the role and significance of somatic symptoms for the diagnosis of depression in medically ill patients have been a controversial issue in the scientific literature. symptoms of somatic anxiety and various painful conditions seem be especially common in states of incomplete remission.115 residual symptoms which are not treated must effectively be considered as a negative risk factor with respect to earlier relapse, and a more severe and chronic future course of illness.116-119 the clinical significance of somatic symptoms in depression may best be illustrated with the relationship between depression and painful physical conditions. the various painful somatic symptoms in depression may essentially be associated with serotonergic and noradrenergic pathways descending from brain stem centers to the spinal cord. targeting both serotonin and norepinephrine in those neuronal circuits that mediate somatic symptoms is the most widely employed strategy to reduce painful and nonpainful somatic symptoms in depression.90 in comparison with selective serotonin reuptake inhibitors, antidepressants with a dual action on both the serotonin and norepinephrine system were significantly superior in alleviating these somatic symptoms and achieving full symptomatic remission of depression.

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. more than 80 pertinent papers relating to somatic symptoms in depression were identified by this approach and form the basis of this review. khan and colleagues43 made similar observations in a sample of 289 primary care patients with somatic symptoms; 48% of the symptoms were deemed to be of psychological or unknown origin. indeed, depression is less likely to be recognized in patients who present with somatic symptoms than in patients who present with predominantly psychological symptoms (figure 3).6,8,51 in 1985, bridges and goldberg10 reported that primary care physicians misdiagnosed more than 50% of psychiatric patients who presented with somatic symptoms.

papakostas and colleagues66 showed that somatic symptoms were present in 95% of patients with treatment-resistant depression (n = 40) who had enrolled in a 6-week treatment study. even if depression is recognized in patients with somatic symptoms, the focus on and severity of somatic symptoms can detract from a patient’s willingness to comply with treatment.59 improved awareness of the importance of somatic symptoms in depression among primary care physicians, refined interviewing techniques, and training schemes that focus on teaching patients to reattribute somatic causality may help. depressed patients with somatic symptoms usually feel a greater burden of disease and consequently tend to rely heavily on primary care services. prevalence of psychological and somatic symptoms in patients with depression during the depression research in european society ii study (n = 1884)a

created for family members of people with alcohol abuse or drug abuse problems. answers questions about substance abuse, its symptoms, different a diagnostic challenge may be seen in the differentiation of a depression with prevailing somatic symptoms from anxiety, somatoform disorders, and medical articles concerning somatic symptoms in depressed patients with organic diseases, such as cancer or arthritis, and patients with the clinical diagnosis of, .

depression is the most common psychiatric disorder worldwide. the burden of disease for depression goes beyond functioning and quality of learn about symptoms, causes and treatment for this disorder, which is linked with major emotional distress and impairment. somatic symptom disorder is diagnosed when a person has a significant focus on physical symptoms, such as pain, weakness or shortness of breath, to a level, .

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