title: [Masked (atypical) depression in patients with back pain syndrome in outpatient neurological care].
abstract: Affective disorders, mainly depression is fast growing problem in highly civilised communities. The literature reports that 30-40% of patients seeking medical advice from specialists (not psychiatrists) in outpatient departments, suffer from these disorders. Many authors mention also diagnostic difficulties in dealing with atypical depression, and draw attention to the fact that this process is often "masked" by chronic pain. In neurological care we find a remarkable group of outpatients with back pain syndrome, mainly cervical and lumbar, with no corresponding lesions found on examination. This enabled us to assume that in some patients presenting with somatic symptoms and therefore referred to a neurologist, the reason of complaints can be depressive disorders. The aim of the study was to verify this hypothesis and to estimate the frequency of masked depression in neurological care.
  
  
  METHODS
  100 patients were examined in the neurological outpatient department, with the use of the two--Beck and Hamilton--scales of depression evaluation.
  
  
  RESULTS
  A statistical analysis of the data thus obtained, showed that: back pain syndrome, as a symptom of depression, occurred in 14% of all patients referred to a neurologist, whereas in 37%--depressive disorders, not diagnosed before, were detected; in 88,2% they were of mild and moderate type.
  
  
  CONCLUSIONS
  In some patients presenting with somatic symptoms and therefore referred to a neurologist, the reason of complaints are depresive disorders.
authors.affiliation: Uniwersytet Medyczny w Lodzi, Klinika Neurologii i Neurorehabilitacji. beatawrodyck@o2.pl
authors.forename: Beata
authors.initials: B
authors.lastname: Wrodycka
authors.forename: Henryk
authors.initials: H
authors.lastname: Chmielewski
authors.forename: Wojciech
authors.initials: W
authors.lastname: Gruszczyński
authors.forename: Andrzej
authors.initials: A
authors.lastname: Zytkowski
authors.forename: Wiesław
authors.initials: W
authors.lastname: Chudzik
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D001416:Back Pain / Q000175:diagnosis* / Q000453:epidemiology*; D015897:Comorbidity; D003866:Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology* / Q000209:etiology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009462:Neurology / Q000706:statistics & numerical data; D011044:Poland / Q000453:epidemiology; D015995:Prevalence; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D013001:Somatoform Disorders / Q000175:diagnosis / Q000453:epidemiology; D013577:Syndrome