Journal of Psychosomatic Research
Volume 58, Issue 2 , Pages 145-151, February 2005

Somatized depression in primary care attenders

  • Enric Aragonès

      Affiliations

    • Constantí Primary Care Centre, Catalan Health Institute, Spain
    • Corresponding Author InformationCorresponding author. Centre d'Atenció Primària de Constantí, 6 C/dels Horts, Constantí (Tarragona) 43120, Spain. Tel.: +34 977 521515; fax: +34 977 521873.
  • ,
  • Antonio Labad

      Affiliations

    • University Psychiatric Hospital “Institut Pere Mata”, Reus, Spain
    • Unit of Psychiatry, Rovira i Virgili University, Reus, Spain
  • ,
  • Josep Ll. Piñol

      Affiliations

    • Reus-Altebrat Primary Health Care Service, Catalan Health Institute, Spain
  • ,
  • Carme Lucena

      Affiliations

    • Constantí Primary Care Centre, Catalan Health Institute, Spain
  • ,
  • Yolanda Alonso

      Affiliations

    • University Psychiatric Hospital “Institut Pere Mata”, Reus, Spain

Received 16 December 2003; accepted 21 July 2004.

Abstract 

Objective

The aim of this study is to determine, within the context of primary care, the frequency of the various ways in which depression is presented with respect to somatic symptoms and to compare depressed patients who present their distress somatically with those with psychological complaints.

Method

In the two-phase cross-sectional study, first, we screened 906 consecutive patients, and second, we interviewed in detail 306 selected patients.

Results

The prevalence of depression was 16.8% (CI 95%: 13.4–20.2). There were 59 cases with psychological presentation, 45 somatizers and 16 had organic disorders with depressive comorbidity. Somatizers had lower level of education, and somatized depression was less serious and caused less repercussion. Detection, antidepressive treatment and psychiatric care were lower for somatizers than for psychologizers.

Conclusions

Somatization is a frequent way to present depression in primary care. For somatizers, depression is less severe and is associated with less repercussion. Somatization is associated with the underdetection of the underlying psychiatric process.

Keywords: Depressive disorder, Dysthymic disorder, Primary health care, Somatization

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PII: S0022-3999(04)00588-4

doi:10.1016/j.jpsychores.2004.07.010

Journal of Psychosomatic Research
Volume 58, Issue 2 , Pages 145-151, February 2005