Somatic complaints among pregnant women cared for in obstetrics: normal pregnancy or depressive and anxiety symptom amplification revisited?
Despite the extensive research documenting the significance of medically unexplained somatic symptoms in primary care patients, few studies have examined somatic symptoms as a predictor of depressive and anxiety disorders among pregnant women cared for in Obstetrics. We utilized the Primary Care Evaluation of Mental Disorders Patient Health Questionnaire (PHQ) to assess current depressive and anxiety disorders and self-reported somatic symptoms among 186 women receiving prenatal care. We examined the bivariate relationships between depressive and anxiety disorders and mean number of somatic symptoms. Linear regression analyses assessed the unique association between maternal depression, anxiety and somatic symptoms, while controlling for selected demographics and maternal medical risk. Twenty three percent (N=43) of women met screening criteria for depressive and/or anxiety disorders. Women with depression and/or anxiety were significantly more likely to report somatic symptoms (mean=7.1, SD=2.6) compared to women without depression or anxiety (mean=5.0, SD=2.6) [t(df)=4.54(184), P<.001]. This association persisted in multivariate models. Our findings suggest that antenatal depressive and anxiety disorders are associated with an amplification of physical symptoms of pregnancy. Eliciting and tracking somatic symptoms during prenatal visits could potentially improve detection of depressive and anxiety disorders in the obstetrical sector.
Kelly
R H
RH
University of Washington, Department of Psychiatry and Behavioral Sciences, University of Washington Medical Center, Box 356560, 1959 NE Pacific Street, 98195-6560, Seattle, WA, USA. rhkelly@u.washington.edu
Russo
J
J
Katon
W
W
D000328:Adult; D000704:Analysis of Variance; D001007:Anxiety / Q000150:complications* / Q000175:diagnosis / Q000523:psychology*; D003866:Depressive Disorder / Q000150:complications* / Q000175:diagnosis / Q000523:psychology*; D005260:Female; D006801:Humans; D016014:Linear Models; D009774:Obstetrics; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000523:psychology*; D011320:Primary Health Care; D011569:Psychiatric Status Rating Scales; D011602:Psychophysiologic Disorders / Q000175:diagnosis / Q000209:etiology*; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000150:complications / Q000175:diagnosis / Q000523:psychology; D011795:Surveys and Questionnaires