Year 2023,
Volume: 13 Issue: 2, 243 - 249, 15.06.2023
Erdoğdu Akça
,
Zeynep Nur Demirok Akça
,
Mesut Yıldız
References
- American Psychiatric Association. American Psychiatric Association-Diagnostic and Statistical Manual of Mental Disorders (DSM-5®).5th edition. Arlington: American Psyhiatric Publishing; 2013.
- Goodwin FK, Jamison KR. Manic-Depressive Illness : Bipolar Disorders and Recurrent Depression. 2nd edition. New York: Oxford University Press; 2007.
- Ghaemi SN, Sachs GS, Chiou AM, Pandurangi AK, Goodwin K. Is bipolar disorder still underdiagnosed? Are antidepressants overutilized? J Affect Disord. 1999;52(1-3):135-144.
- Ghaemi SN, Boiman EE, Goodwin FK. Diagnosing bipolar disorder and the effect of antidepressants: A naturalistic study. J Clin Psychiatry 2000;61(10):804-808.
- Shippee ND, Shah ND, Williams MD, Moriarty JP, Frye MA, Ziegenfuss JY. Differences in demographic composition and in work, social, and functional limitations among the populations with unipolar depression and bipolar disorder: results from a nationally representative sample. Health Qual Life Outcomes 2011;9:90.
- Kirmayer LJ, Robbins JM, Dworkind M, Yaffe MJ. Somatization and the recognition of depression and anxiety in primary care. Am J Psychiatry 1993;150(5):734-741.
- Simon GE, VonKorff 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):1329-1335.
- Terre L, Poston WSC, Foreyt J, St Jeor ST. Do somatic complaints predict subsequent symptoms of depression? Psychother Psychosom. 2003;72(5):261-267.
- Hotopf M, Mayou R, Wadsworth M, Wessely S. Temporal relationships between physical symptoms and psychiatric disorder. Results from a national birth cohort. Br J Psychiatry 1998;173(3):255-261.
- Bair MJ, Robinson RL, Katon W, Kroenke K. Depression and pain comorbidity. Arch Intern Med. 2003;163(20):2433.
- Kennedy N, Paykel E. Residual symptoms at remission from depression: Impact on long-term outcome. J Affect Disord. 2004;80(2-3):135-144.
- Edgcomb JB, Tseng C-H, Kerner B. Medically unexplained somatic symptoms and bipolar spectrum disorders: A systematic review and meta-analysis. J Affect Disord. 2016;204:205-213.
- Perugi G, Canonico PL, Carbonato P, Mencacci C, Muscettola G, Pani L, Torta R, Vampini C, Fornaro M, Parazzini F, Dumitriu A. Unexplained somatic symptoms during major depression: Prevalence and clinical impact in a national sample of Italian psychiatric outpatients. Psychopathology 2011;44(2):116-124.
- Perlis RH, Brown E, Baker RW, Nierenberg AA. Clinical features of bipolar depression versus major depressive disorder in large multicenter trials. Am J Psychiatry 2006;163(2):225-231.
- Brockington IF, Altman E, Hillier V, Meltzer HY, Nand S. The clinical picture of bipolar affective disorder in its depressed phase. A report from London and Chicago. Br J Psychiatry 1982;141(6):558-562.
- Donnelly EF, Murphy DL, Waldman IN. Denial and somatization as characteristics of bipolar depressed groups. J Clin Psychol. 1980;86(1):159-162.
- Montgomery SA, Asberg M. A new depression scale designed to be sensitive to change. Br J Psychiatry 1979;134(4):382-389.
- Kara Özer S, Demiṙ B, Tuğal Ö, Kabakçı E. Montgomery– Åsberg Depresyon Değerlendirme Ölçeği: Değerlendiriciler arası güvenilirlik ve geçerlik çalışması. Türk Psikiyatri Dergisi 2001;12(3):185-194. (Turkish)
- Mumford DB, Bavington JT, Bhatnagar KS, Hussain Y, Mirza S, Naraghi MM. The Bradford Somatic Inventory. A multiethnic inventory of somatic symptoms reported by anxious and depressed patients in Britain and the Indo-Pakistan subcontinent. Br J Psychiatry 1991;158(3):379-386.
- Köse S, Tekintaş NS, Durmuş FB, Akın E, Sayar K. Reliability, validity, and factorial structure of the Turkish version of the Bradford Somatic Inventory (Turkish BSI-44) in a university student sample. Psychiatry Clin Psychopharmacol. 2017;27(1):62-69.
- Forty L, Smith D, Jones L, Jones I, Caesar S, Cooper C, Fraser C, Gordon-Smith G, Hyde S, Farmer A, McGuffin P, Craddock N. Clinical differences between bipolar and unipolar depression. Br J Psychiatry 2008;192(5):388-389.
- Benazzi F. Clinical differences between bipolar II depression and unipolar major depressive disorder: Lack of an effect of age. J Affect Disord. 2003;75(2):191-195.
- Winokur G, Coryell W, Keller M, Endicott J, Akiskal H. A Prospective follow-up of patients with bipolar and
primary unipolar affective disorder. Arch Gen Psychiatry 1993;50(6):457-465.
- Hantouche EG, Akiskal HS. Bipolar II vs. unipolar depression: Psychopathologic differentiation by dimensional measures. J Affect Disord. 2005;84(2-3):127-132.
- Haug TT, Mykletun A, Dahl AA. The association between anxiety, depression, and somatic symptoms in a large population: The HUNT-II Study. Psychosom Med. 2004;66(6):845-851.
- Munoz RA, McBride ME, Brnabic AJM, Lopez CJ, Hetem LAB. Major depressive disorder in Latin America: The relationship between depression severity, painful somatic symptoms, and
quality of life. J Affect Disord. 2005;86(1):93-98.
- Barsky AJ, Orav EJ, Bates DW. Somatization increases medical utilization and costs independent of psychiatric and medical comorbidity. Arch Gen Psychiatry 2005;62(8):903-910.
- Tsang A, Von Korff M, Lee S, Alonso J, Karam E, Angermeyer MC, Borges GLG, Bromet EJ, de Girolamo G, de Graaf R, Gureje O, Lepine JP, Haro JM, Levinson D, Browne MAO, Posada-Villa J, Seedat S, Watanabe M. Common chronic pain conditions in developed and developing countries: Gender and age differences and comorbidity with depression-anxiety disorders. J Pain 2008;9(10):883-891.
- Small DM, Simons AD, Yovanoff P, Silva SG, Lewis CC, Murakami JL, March J. Depressed adolescents and comorbid psychiatric disorders: Are there differences in the presentation of depression? J Abnorm Child Psychol. 2008;36(7):1015-1028.
- Sayar K, Kirmayer LJ, Taillefer SS. Predictors of somatic symptoms in depressive disorder. Gen Hosp Psychiatry. 2003;25(2):108-114.
- Piccinelli M, Simon G. Gender and cross-cultural differences in somatic symptoms associated with emotional distress. An international study in primary care. Psychol Med. 1997;27(2):433-444.
The Relationship Between Somatization and Depression Types: Comparison of Unipolar Depression and Bipolar Depression
Year 2023,
Volume: 13 Issue: 2, 243 - 249, 15.06.2023
Erdoğdu Akça
,
Zeynep Nur Demirok Akça
,
Mesut Yıldız
Abstract
Objective: Somatic symptoms are more likely to be present in depression and anxiety, which causes to waste medical resources due to excessive hospital addmissions. It has been observed that the unclarity of qualitative and quantitative characteristics of somatization depending on the type of depression influences clinical practice less than expected. In the present study, it was aimed to determine the hallmarks of somatic symptoms in depression groups and to investigate the factors that might have an effect on somatic symptoms.
Method: One hundred consecutive patients (50 with Bipolar Depression (BD), 50 with Unipolar Depression (UD)) who met the criteria participated in the study. Patients were assessed for depressive symptoms with Montgomery Asberg Depression Scale and for somatic symptoms with Bradford Somatic Symptom Inventory. Clinical features were obtained by the clinician via Sociodemographic Data Form.
Results: It was found that no significant difference in somatization characteristics between the depression groups. (p> .05). Somatic symptom severity was higher in the UD group in the presence of psychiatric comorbidity (p= .013), but not in BD. Another prominent finding was that the severity of depression was noted the only predictor of severe somatization.
Conclusion: The results show that increased somatic symptoms are associated with the severity of depression, suggesting treatment of depression with somatization rather than differential diagnosis should be primary concern.
References
- American Psychiatric Association. American Psychiatric Association-Diagnostic and Statistical Manual of Mental Disorders (DSM-5®).5th edition. Arlington: American Psyhiatric Publishing; 2013.
- Goodwin FK, Jamison KR. Manic-Depressive Illness : Bipolar Disorders and Recurrent Depression. 2nd edition. New York: Oxford University Press; 2007.
- Ghaemi SN, Sachs GS, Chiou AM, Pandurangi AK, Goodwin K. Is bipolar disorder still underdiagnosed? Are antidepressants overutilized? J Affect Disord. 1999;52(1-3):135-144.
- Ghaemi SN, Boiman EE, Goodwin FK. Diagnosing bipolar disorder and the effect of antidepressants: A naturalistic study. J Clin Psychiatry 2000;61(10):804-808.
- Shippee ND, Shah ND, Williams MD, Moriarty JP, Frye MA, Ziegenfuss JY. Differences in demographic composition and in work, social, and functional limitations among the populations with unipolar depression and bipolar disorder: results from a nationally representative sample. Health Qual Life Outcomes 2011;9:90.
- Kirmayer LJ, Robbins JM, Dworkind M, Yaffe MJ. Somatization and the recognition of depression and anxiety in primary care. Am J Psychiatry 1993;150(5):734-741.
- Simon GE, VonKorff 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):1329-1335.
- Terre L, Poston WSC, Foreyt J, St Jeor ST. Do somatic complaints predict subsequent symptoms of depression? Psychother Psychosom. 2003;72(5):261-267.
- Hotopf M, Mayou R, Wadsworth M, Wessely S. Temporal relationships between physical symptoms and psychiatric disorder. Results from a national birth cohort. Br J Psychiatry 1998;173(3):255-261.
- Bair MJ, Robinson RL, Katon W, Kroenke K. Depression and pain comorbidity. Arch Intern Med. 2003;163(20):2433.
- Kennedy N, Paykel E. Residual symptoms at remission from depression: Impact on long-term outcome. J Affect Disord. 2004;80(2-3):135-144.
- Edgcomb JB, Tseng C-H, Kerner B. Medically unexplained somatic symptoms and bipolar spectrum disorders: A systematic review and meta-analysis. J Affect Disord. 2016;204:205-213.
- Perugi G, Canonico PL, Carbonato P, Mencacci C, Muscettola G, Pani L, Torta R, Vampini C, Fornaro M, Parazzini F, Dumitriu A. Unexplained somatic symptoms during major depression: Prevalence and clinical impact in a national sample of Italian psychiatric outpatients. Psychopathology 2011;44(2):116-124.
- Perlis RH, Brown E, Baker RW, Nierenberg AA. Clinical features of bipolar depression versus major depressive disorder in large multicenter trials. Am J Psychiatry 2006;163(2):225-231.
- Brockington IF, Altman E, Hillier V, Meltzer HY, Nand S. The clinical picture of bipolar affective disorder in its depressed phase. A report from London and Chicago. Br J Psychiatry 1982;141(6):558-562.
- Donnelly EF, Murphy DL, Waldman IN. Denial and somatization as characteristics of bipolar depressed groups. J Clin Psychol. 1980;86(1):159-162.
- Montgomery SA, Asberg M. A new depression scale designed to be sensitive to change. Br J Psychiatry 1979;134(4):382-389.
- Kara Özer S, Demiṙ B, Tuğal Ö, Kabakçı E. Montgomery– Åsberg Depresyon Değerlendirme Ölçeği: Değerlendiriciler arası güvenilirlik ve geçerlik çalışması. Türk Psikiyatri Dergisi 2001;12(3):185-194. (Turkish)
- Mumford DB, Bavington JT, Bhatnagar KS, Hussain Y, Mirza S, Naraghi MM. The Bradford Somatic Inventory. A multiethnic inventory of somatic symptoms reported by anxious and depressed patients in Britain and the Indo-Pakistan subcontinent. Br J Psychiatry 1991;158(3):379-386.
- Köse S, Tekintaş NS, Durmuş FB, Akın E, Sayar K. Reliability, validity, and factorial structure of the Turkish version of the Bradford Somatic Inventory (Turkish BSI-44) in a university student sample. Psychiatry Clin Psychopharmacol. 2017;27(1):62-69.
- Forty L, Smith D, Jones L, Jones I, Caesar S, Cooper C, Fraser C, Gordon-Smith G, Hyde S, Farmer A, McGuffin P, Craddock N. Clinical differences between bipolar and unipolar depression. Br J Psychiatry 2008;192(5):388-389.
- Benazzi F. Clinical differences between bipolar II depression and unipolar major depressive disorder: Lack of an effect of age. J Affect Disord. 2003;75(2):191-195.
- Winokur G, Coryell W, Keller M, Endicott J, Akiskal H. A Prospective follow-up of patients with bipolar and
primary unipolar affective disorder. Arch Gen Psychiatry 1993;50(6):457-465.
- Hantouche EG, Akiskal HS. Bipolar II vs. unipolar depression: Psychopathologic differentiation by dimensional measures. J Affect Disord. 2005;84(2-3):127-132.
- Haug TT, Mykletun A, Dahl AA. The association between anxiety, depression, and somatic symptoms in a large population: The HUNT-II Study. Psychosom Med. 2004;66(6):845-851.
- Munoz RA, McBride ME, Brnabic AJM, Lopez CJ, Hetem LAB. Major depressive disorder in Latin America: The relationship between depression severity, painful somatic symptoms, and
quality of life. J Affect Disord. 2005;86(1):93-98.
- Barsky AJ, Orav EJ, Bates DW. Somatization increases medical utilization and costs independent of psychiatric and medical comorbidity. Arch Gen Psychiatry 2005;62(8):903-910.
- Tsang A, Von Korff M, Lee S, Alonso J, Karam E, Angermeyer MC, Borges GLG, Bromet EJ, de Girolamo G, de Graaf R, Gureje O, Lepine JP, Haro JM, Levinson D, Browne MAO, Posada-Villa J, Seedat S, Watanabe M. Common chronic pain conditions in developed and developing countries: Gender and age differences and comorbidity with depression-anxiety disorders. J Pain 2008;9(10):883-891.
- Small DM, Simons AD, Yovanoff P, Silva SG, Lewis CC, Murakami JL, March J. Depressed adolescents and comorbid psychiatric disorders: Are there differences in the presentation of depression? J Abnorm Child Psychol. 2008;36(7):1015-1028.
- Sayar K, Kirmayer LJ, Taillefer SS. Predictors of somatic symptoms in depressive disorder. Gen Hosp Psychiatry. 2003;25(2):108-114.
- Piccinelli M, Simon G. Gender and cross-cultural differences in somatic symptoms associated with emotional distress. An international study in primary care. Psychol Med. 1997;27(2):433-444.