Introduction. Mood disorders represent a crucial problem in the primary care setting, so that the general practitioner (Gp) must play an increasing role in their management. However, at present the management of depression does not seem appropriate in general practice, because of the many difficulties in recognizing this condition. Objective. A descriptive study on depression and somatic symptoms has been planned in order to value the incidence of depressive disorders in subjects suffering from somatic symptoms, without organic aetiology. Method. Every Gp taking part in the study recruited one day of the week, from 1st November 1999 to 30th June 2000, all patients attending his practice and meeting the criteria for inclusion. Depressed patients with non-organic somatic symptoms were detected using the G.H.Q.-12 questionnaire and in those with final score >5 the WHO Checklist of depressive symptoms; depression was diagnosed following ICD-10 criteria. Chi-square test, Mann-Whitney or Kruskal-Wallis tests were used for statistical analysis. Results. 49 Gps took part in the study. Over 1576 days 521 subjects were recruited (1.61% of the patients seeking care); 309 (M/F 74/235) had a G.H.Q. >5; 268 of them had depression (87% - C.I. 95% 83-91): 10.1% mild, 49.2% moderate and 40.7% severe. Asthenia (p=0.001), gastrointestinal symptoms (p=0.03) (dyspepsia, constipation, diarrhoea) were more frequent in depressed patients than in non-depressed ones. The G.H.Q. score was higher in severely depressed patients. There was an increasing proportion of patients with headache, dyspnoea, constipation/diarrhoea, muscle-skeletal pain in classes of increasing severity of depression. Conclusion. The expression of depression in a somatic form is perhaps the commonest reason of under-recognition of depression in primary care. In our study 89.9% of patients with depression had a moderate or severe form. The study demonstrates the feasibility and utility of using the Italian version of the G.H.Q.-12 questionnaire as a screening instrument in a general practice setting.
|Translated title of the contribution||Somatic symptoms and depression in general practice: A strict relation|
|Number of pages||15|
|Journal||Ricerca e Pratica|
|Publication status||Published - 2001|
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