title: Relationship of somatic symptoms with depression severity, quality of life, and health resources utilization in patients with major depressive disorder seeking primary health care in Spain.
abstract: OBJECTIVE
  To investigate the relationship between the characteristics of somatic symptoms and depression severity, quality of life (QOL), and health resources utilization in patients with major depressive disorder (MDD) in primary care setting.
  
  
  METHODS
  This cross-sectional, nationwide epidemiologic study, carried out in 1150 primary care patients with DSM-IV-defined MDD, evaluated the characteristics of somatic symptoms by means of the Standardized Polyvalent Psychiatric Interview. Depression severity and QOL were evaluated by means of the Zung Self-Rating Depression Scale (SDS) and the Physical and Mental Component Summaries of the Medical Outcomes Study 12-item Short-Form Health Survey. Health resources utilization was measured in terms of doctor consultations and hospitalizations. The associations were assessed by means of adjusted analyses. The study was carried out from April 2004 to July 2004.
  
  
  RESULTS
  Disability associated with somatic symptoms and number of somatic symptoms were strongly associated with increased depression severity (2.45 and 0.29 increase in SDS score, respectively) and health resources utilization (odds ratios of 1.42 and 1.04, respectively). Associated disability, frequency, and persistence during leisure time of somatic symptoms were strongly associated with poorer QOL. In contrast, we found a weaker relationship between duration and intensity of somatic symptoms and depression severity, QOL, and health resources utilization.
  
  
  CONCLUSIONS
  Of the studied somatic symptom characteristics, somatic symptom-associated disability and number of somatic symptoms are strongly associated with increased depression severity and health resources utilization, as well as with decreased QOL. Our results may help physicians identify relevant characteristics of somatic symptoms to more effectively diagnose and treat depression in primary care patients.
authors.affiliation: Department of Psychiatry, Hospital Miguel Servet, Zaragoza, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: García-Campayo
authors.forename: José Luis
authors.initials: JL
authors.lastname: Ayuso-Mateos
authors.forename: Luis
authors.initials: L
authors.lastname: Caballero
authors.forename: Irene
authors.initials: I
authors.lastname: Romera
authors.forename: Enric
authors.initials: E
authors.lastname: Aragonés
authors.forename: Fernando
authors.initials: F
authors.lastname: Rodríguez-Artalejo
authors.forename: Deborah
authors.initials: D
authors.lastname: Quail
authors.forename: Inmaculada
authors.initials: I
authors.lastname: Gilaberte