Prevalence, Characteristics, and Attribution of Somatic Symptoms in Spanish Patients With Major Depressive Disorder Seeking Primary Health Care

Background: Somatic symptoms (SS) tend to dominate clinical symptomatology in patients with depression in primary care. Objective: The authors performed a cross-sectional nationwide epidemiological study on 1,150 primary-care patients with major depression and evaluated the prevalence of SS and physicians' attribution of their origin. Method: Patients were administered the Structured Polyvalent Psychiatric Interview. Results: Ninety-three percent of patients had at least one SS fully or partially attributed to depression, and 45% of patients had four to nine. Painful symptoms, despite being the most frequent, were the least often attributed to depression (fewer than 25% of patients with pain) and significantly more often attributed to a combined origin. Conclusion: Results suggest that primary-care physicians tend to associate pain with depression to a significantly lesser extent than any other somatic symptom (e. g., cardiopulmonary or gastrointestinal). Therefore, special attention should be given to painful symptoms in order to ensure efficient management of depression in primary care. (Psychosomatics 2008; 49: 520-529)