title: Differential associations of specific depressive and anxiety disorders with somatic symptoms.
abstract: OBJECTIVE
  Previous studies have shown that depressive and anxiety disorders are strongly related to somatic symptoms, but much is unclear about the specificity of this association. This study examines the associations of specific depressive and anxiety disorders with somatic symptoms, and whether these associations are independent of comorbid depressive and anxiety disorders.
  
  
  METHODS
  Cross-sectional data were derived from The Netherlands Study of Depression and Anxiety (NESDA). A total of 2008 persons (mean age: 41.6 years, 64.9% women) were included, consisting of 1367 patients with a past-month DSM-diagnosis (established with the Composite International Diagnostic Interview [CIDI]) of depressive disorder (major depressive disorder, dysthymic disorder) and/or anxiety disorder (generalized anxiety disorder, social phobia, panic disorder, agoraphobia), and 641 controls. Somatic symptoms were assessed with the somatization scale of the Four-Dimensional Symptom Questionnaire (4DSQ), and included cardiopulmonary, musculoskeletal, gastrointestinal, and general symptoms. Analyses were adjusted for covariates such as chronic somatic diseases, sociodemographics, and lifestyle factors.
  
  
  RESULTS
  All clusters of somatic symptoms were more prevalent in patients with depressive and/or anxiety disorders than in controls (all p<.001). Multivariable logistic regression analyses showed that all types of depressive and anxiety disorders were independently related to somatic symptoms, except for dysthymic disorder. Major depressive disorder showed the strongest associations. Associations remained similar after adjustment for covariates.
  
  
  CONCLUSIONS
  This study demonstrated that depressive and anxiety disorders show strong and partly differential associations with somatic symptoms. Future research should investigate whether an adequate consideration and treatment of somatic symptoms in depressed and/or anxious patients improve treatment outcomes.
authors.affiliation: University of Groningen, University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), Groningen, The Netherlands. Electronic address: e.bekhuis@umcg.nl.
authors.forename: Ella
authors.initials: E
authors.lastname: Bekhuis
authors.affiliation: University of Groningen, University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), Groningen, The Netherlands. Electronic address: l.boschloo@umcg.nl.
authors.forename: Lynn
authors.initials: L
authors.lastname: Boschloo
authors.affiliation: University of Groningen, University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), Groningen, The Netherlands. Electronic address: j.g.m.rosmalen@umcg.nl.
authors.forename: Judith G M
authors.initials: JG
authors.lastname: Rosmalen
authors.affiliation: University of Groningen, University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), Groningen, The Netherlands. Electronic address: r.a.schoevers@umcg.nl.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Schoevers
mesh_terms: D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000150:complications / Q000453:epidemiology*; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000523:psychology; D002908:Chronic Disease / Q000453:epidemiology* / Q000523:psychology*; D016000:Cluster Analysis; D015897:Comorbidity; D015986:Confounding Factors, Epidemiologic; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000150:complications / Q000453:epidemiology*; D004066:Digestive System Diseases / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006801:Humans; D008019:Life Style; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000453:epidemiology / Q000523:psychology; D009426:Netherlands / Q000453:epidemiology; D057566:Self Report; D011795:Surveys and Questionnaires
keywords: Anxiety disorders; Comorbidity; Depressive disorders; Functional somatic symptoms; Somatic symptoms