Prevalence and Association of Somatic Symptoms with Depression Severity in Major Depressive Disorder Patients at Suanprung Psychiatric Hospital
Article Sidebar
Main Article Content
Abstract
Objective: To determine the prevalence of somatic symptoms among patients with major depressive disorders and the association between somatic symptoms and the severity of major depressive disorder among outpatients receiving care at Suanprung Psychiatric Hospital, Chiangmai province.
Materials and methods: This analytical cross-sectional study was conducted among newly diagnosed outpatients with major depressive disorder aged ≥20 years, diagnosed according to ICD-10 criteria between January and May 2025. Somatic symptoms were assessed using the Thai version of PHQ-15. Data were analyzed using the chi-square test and multivariate logistic regression.
Results: A total of 230 participants were included. The prevalence of somatic symptoms was 96.96%. The most common symptoms were sleep problems (92.17%), fatigue or low energy (81.74%), and headache (76.96%) respectively. Most participants had a medium level of somatic symptom severity (38.26%). Regarding depression severity, most patients were classified as having a severe depressive episode without psychotic symptoms (68.26%). Factors predicting severe depression included age ≤40 years (OR 1.85, p=0.05), duration of illness <4 months (OR 2.35, p=0.01), and medium-to-high somatic symptom severity (OR 1.92, p=0.04).
Conclusion: Patients with major depressive disorder receiving care have a high prevalence of somatic symptoms, which are significantly associated with depression severity.
A systematic assessment of somatic symptoms using the PHQ-15 alongside clinical evaluation may facilitate earlier identification and screening of patients at risk for severe depression.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
บทความหลังผ่านการปรับแก้จากกองบรรณาธิการแล้ว เป็นลิขสิทธ์ของวารสารจิตเวชวิทยาสาร โรงพยาบาลสวนปรุง กรมสุขภาพจิต กระทรวงสาธารณสุข ห้ามเผยแพร่เพื่อประโยชน์ทางการค้าโดยไม่ได้รับอนุญาต แต่อนุญาตให้เผยแพร่บทความดังกล่าวเพื่อประโยชน์ทางการศึกษาแก่ประชาชนทั่วไป ทั้งนี้กองบรรณาธิการไม่จำเป็นต้องเห็นด้วยกับบทความหรือข้อคิดเห็นใดๆ ที่ปรากฏในวารสารสวนปรุง
References
Boland RJ, Verduin ML, Ruiz P. Kaplan & Sadock’s synopsis of psychiatry. 12th ed. Philadelphia: Wolters Kluwer; 2022.
World Health Organization. Depressive disorder (depression) [Internet]. Geneva: WHO; 2023 Mar 31 [cited 2023 Jun 11]. Available from: https://www.who.int/news-room/fact-sheets/detail/depression
World Health Organization. Creating awareness on prevention and control of depression [Internet]. Bangkok: WHO Thailand; [cited 2023 Jun 11]. Available from: https://www.who.int/thailand/activities/creating-awareness-on-prevention-and-control-of-depression
Kapfhammer HP. Somatic symptoms in depression. Dialogues Clin Neurosci. 2006;8(2):227-39.
Henningsen P. Management of somatic symptom disorder. Dialogues Clin Neurosci. 2018;20(1):23-31.
Bekhuis E, Boschloo L, Rosmalen JG, Schoevers RA. Differential associations of specific depressive and anxiety disorders with somatic symptoms. J Psychosom Res. 2015;78(2):116-22.
Caballero L, Aragones E, Garcia-Campayo J, Rodriguez-Artalejo F, Ayuso-Mateos JL, Polavieja P, et al. Prevalence, characteristics, and attribution of somatic symptoms in Spanish patients with major depressive disorder seeking primary health care. Psychosomatics. 2008;49(6):520-9.
Perugi G, Akiskal HS, Rossi L, Paiano A, Ambrogi C, Dell'Osso L, et al. Unexplained somatic symptoms in major depressive disorder: prevalence and clinical impact. Psychopathology. 2011;44(2):116-24.
Vaccarino AL, Sills TL, Evans KR, Kalali AH. Prevalence and association of somatic symptoms in patients with major depressive disorder. J Affect Disord. 2008;110(3):270-6.
Lee P, Zhang M, Hong JP, Chua HC, Chen KP, Tang SW, et al. Frequency of painful physical symptoms with major depressive disorder in Asia: relationship with disease severity and quality of life. J Clin Psychiatry. 2009;70(1):83-91.
Li Y, Jia S, Cao B, Chen L, Shi Z, Zhang H. Network analysis of somatic symptoms in Chinese patients with depressive disorder. Front Public Health. 2023;11:1079873. doi: 10.3389/fpubh.2023.1079873.
Jian Y, Jia S, Shi Z, Zhao Y, Li P, Chen L, et al. Characteristics of somatic symptoms among Chinese patients diagnosed with major depressive episode. Arch Psychiatr Nurs. 2021;35(1):27-33.
Chinvararak C, Lueboonthavatchai P. Somatic symptoms and its association to depressive severity in patients with major depressive disorder in King Chulalongkorn Memorial Hospital. J Psychiatr Assoc Thailand. 2016;61(4):293-306.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Text rev. Washington (DC): American Psychiatric Association; 2022.
Ministry of Public Health (TH). Standard coding guidelines. 2017 ed. Bangkok: Sangchan Printing; 2017. [Thai]
Bekhuis E, Boschloo L, Rosmalen JGM, de Boer MK, Schoevers RA. The impact of somatic symptoms on the course of major depressive disorder. J Psychosom Res. 2016;85:55-61. doi: 10.1016/j.jpsychores.2016.03.135.
Garcia-Campayo J, Ayuso-Mateos JL, Caballero L, Romera I, Aragones E, Rodriguez-Artalejo F, et al. 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. Prim Care Companion J Clin Psychiatry. 2008;10(5):355-62.
Reed C, Monz BU, Perahia DG, et al. Quality of life outcomes among patients with depression after 6 months of starting treatment: results from FINDER. J Affect Disord. 2009;113(3):296-302.
Karp JF, Scott J, Houck P, Reynolds CF 3rd, Kupfer DJ, Frank E. Pain predicts longer time to remission during treatment of recurrent depression. J Clin Psychiatry. 2005;66(5):591-7.
Greden JF. Physical symptoms of depression: unmet needs. J Clin Psychiatry. 2003;64(Suppl 7):5-11.
Husain MM, Rush AJ, Trivedi MH, et al. Pain in depression: STAR*D study findings. J Psychosom Res. 2007;63(2):113-22.
Ho PNY, Pham CM, Bui MX, Tran NA, Tran NT, Huynh QHN, et al. Somatic symptoms in major depressive disorder: a cross-sectional study in a mental health setting, Vietnam. MedPharmRes. 2023;7(3):42-8. doi: 10.32895/UMP.MPR.7.3.6.
Kroenke K, Spitzer RL, Williams JB. The PHQ-15: validity of a new measure for evaluating the severity of somatic symptoms. Psychosom Med. 2002;64(2):258-66.
Fink P, Rosendal M, Toft T. Assessment and treatment of functional disorders in general practice: the extended reattribution and management model. Psychosomatics. 2002;43(2):93-131.
Terluin B, Barends H, van der Horst HE, Dekker J, van der Wouden JC. Head-to-head comparison of somatic symptom scales: PHQ-15 and 4DSQ-S. J Psychosom Res. 2022;162:111031. doi: 10.1016/j.jpsychores.2022.111031.
Tylee A, Gandhi P. The importance of somatic symptoms in depression in primary care. J Clin Psychiatry. 2005;66(7):167-76.
Lotrakul M, Saipanit R, Theeramoke W. Symptoms of depression in Thai patients. Asian J Psychiatr. 1996;4(1):24-32.
Fornaro M, Maremmani I, Canonico PL, Carbonato P, Mencacci C, Muscettola G, et al. Prevalence and diagnostic distribution of medically unexplained painful somatic symptoms across major depressed outpatients. Neuropsychiatr Dis Treat. 2011;7:217-21.
Simon GE, Von Korff M, Piccinelli M, Fullerton C, Ormel J. An international study of the relation between somatic symptoms and depression. N Engl J Med. 1999;341(18):1329-35.
Zhao D, Zhao M, Shi Z, Chen L, Jian Y, Shi J, et al. Somatic symptoms vary in major depressive disorder in China. Compr Psychiatry. 2018;87:32-7.
Henningsen P, Zipfel S, Herzog W. Management of functional somatic syndromes. Lancet. 2007;369(9565):946-55.
