The level of recognition of physical symptoms in patients with a major depression episode in the outpatient psychiatric practice in Puerto Rico: An observational study

doi:10.1186/1471-244X-5-28

BMC Psychiatry
Volume 5

Viewing options:

Abstract
Full text
PDF (468KB)

Associated material:

Related literature:

Articles citing this article
on BioMed Central
on Google Scholar
on PubMed Central
Other articles by authors
on Google Scholar

Tamayo JM
Román K
Fumero JJ
Rivas M

on PubMed

Tamayo JM
Román K
Fumero JJ
Rivas M
Related articles/pages
on Google

on Google Scholar

on PubMed

Tools:

Post to:

Research article

The level of recognition of physical symptoms in patients with a major depression episode in the outpatient psychiatric practice in Puerto Rico: An observational study

Jorge M Tamayo¹^,2 , Karis Román¹^,3 , Juan J Fumero⁴ and María Rivas¹^,5

¹Lilly Research Laboratories, Eli Lilly and Company, San Juan, Puerto Rico

²Department of Psychiatry, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico

³Department of Biostatistics & Epidemiology, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico

⁴Department of Psychiatry, San Juan Bautista University, Caguas, Puerto Rico

⁵Department of Internal Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan Puerto Rico

author email corresponding author email

BMC Psychiatry 2005, 5:28doi:10.1186/1471-244X-5-28


Published:	20 June 2005

Abstract

Background

This study was designed to evaluate the psychiatrists' level of recognition of somatic symptoms associated to a major depressive episode (MDE) (DSM-IV-TR criteria) and the impact of those somatic symptoms on the treatment effectiveness.

Methods

This non-interventional study was conducted in 25 medical offices in Puerto Rico from February to December 2003. It had 2 visits separated by 8 weeks. The level of recognition was determined by: the correlation between the physician clinical evaluation and their patients' self-evaluations through different validated instruments using kappa statistics. Chi-square test was used to evaluate the impact of somatic symptoms on treatment antidepressants' effectiveness.

Results

All the 145 recruited patients reported the presence of at least one somatic symptom associated with their current MDE. In the two visits covered by the study, a fair agreement between the psychiatrists' and the patients' reports was noted for headache, abdominal pain and upper limb pains (0.4003 ≤ κ ≥ 0.6594). For other painful symptoms and painless somatic symptoms, the Kappa values obtained were non-significant. Slight but significant reductions in depression and painful symptoms severity were observed after 8 weeks of treatment. A proportional relationship between the pain and depression severity was observed (p < 0.0001).

Conclusion

The study results show that somatic symptoms: are very common in depressed Puerto Rican patients; are significant under-reported by psychiatrists; and have a significant impact on the antidepressant effectiveness.