Can we determine depressive conditions on the basis of somatic symptoms? A cross-sectional study of depressive conditions among Japanese patients at a university hospital general medicine clinic.
OBJECTIVE
We evaluated the relationship between somatic symptoms and depressive conditions among patients visiting the general medicine clinic of a university hospital.


METHODS
We distributed interview forms to 332 consecutive patients who visited our clinic for the first time between March and July 2011. Somatic symptoms were rated using a symptom checklist, and depressive conditions were evaluated using the Zung Self-Rating Depression Scale (SDS). We categorized and compared 2 groups of patients: patients with an SDS score of more than 48 (depressive group) and patients with an SDS score of less than 48 (non-depressive group).


RESULTS
A total of 284 (85.5%) patients returned the forms. The SDS scores were obtained from the forms of 182 patients (64.1%). The average age of these 182 patients was 46.5±18.04 years. The mean number of checked symptoms was 4.3±3.03, and the most common symptom was general fatigue (n=106; 58.2%). The number of checked symptoms in the survey was higher in the depressive group patients than in the non-depressive group patients. Multiple logistic regression analysis indicated that general fatigue, headache, and sleeping problems were significant dependent variables which were related to depressive conditions. We defined these 3 symptoms as depression-related somatic symptoms (DRSS). On a receiver-operating characteristic curve, the optimal cutoff scores were 2 of 3 DRSS and 4 of 20 somatic symptoms.


CONCLUSIONS
General physicians should consider possible depressive conditions when patients have 2 or more DRSS or 4 or more somatic symptoms.
Department of General Medicine, Tokyo Medical University Hachioji Medical Center, Japan. aaoki@tokyo-med.ac.jp
Akiko
A
Aoki
Motoyoshi
M
Nagate
Kenta
K
Utsumi
Asashi
A
Tanaka
Yuichi
Y
Inoue
Junji
J
Otaki
Takuro
T
Shimbo
Tatsuto
T
Ashizawa
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis*; D003866:Depressive Disorder / Q000175:diagnosis*; D059026:Diagnostic Self Evaluation; D005260:Female; D058006:General Practice; D006785:Hospitals, University; D006801:Humans; D007564:Japan; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital; D055815:Young Adult