Review: Somatization in the elderly.
ABSTRACT Somatization is a common medical problem encountered at all levels of medical care. It is strongly associated with use of services and may be difficult to treat. Somatization in the elderly has been traditionally seen as a masked presentation of depression. Population studies have shown no consistent increase in somatization among the elderly, and the elderly may down-play physical symptoms. Among the elderly depressed, somatization is common and may be commoner if physical illness is also present. Psychological distress is usually acknowledged, not masked, in the elderly depressed. Neuroticism, as well as psychiatric illness, may be an important aetiological factor for somatization in the elderly. Treatment strategies must attend to underlying psychiatric disorders, but there is a need for studies of treatment of the phenomenon in the elderly.
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ABSTRACT: IntroductionOlder adults commonly experience somatic symptoms, and those who do are more likely to have depressive disorders as well. Our goal in this study is to examine the influence of the number and severity of somatic symptoms on the severity of depressive symptoms, including suicidality, in elderly adults. Methods This study was conducted as part of the Ansan Geriatric (AGE) Study, a community-based cohort study in Ansan City, South Korea. A total of 3,210 elderly adults aged 60 years or over (1,388 males and 1,770 females) participated in this study. The Korean version of the Beck Depression Inventory (BDI) was used to measure depressive symptoms and suicidality. Somatic symptoms were assessed by the Patient Health Questionnaire-15 (PHQ-15). ResultsBoth mild and severe somatic symptoms significantly increased the risk for severe depression and high suicidality. Severe somatic symptoms doubled the risk for severe depression and suicidal intent. DiscussionSomatic symptoms not fully explained as medical illnesses are closely associated with late-life depression, even after adjustments for comorbid physical illnesses and other confounding factors. The presence of somatic symptoms concurrent with, but not fully explained by comorbid physical illness or disability, seems to be an independent marker for predicting the severity of late-life depression and suicidality.Asia-Pacific Psychiatry 06/2014; 6(3). DOI:10.1111/appy.12138 · 0.42 Impact Factor
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ABSTRACT: Odds of major depression have significantly increased among adults with chronic diseases. However, the diagnosis of depression is often unrecognized in China. To know the prevalence of depression in medical inpatients with different chronic diseases and to assess the level of unrecognized depression among hospitalized patients, we assessed depression in patients with cardiovascular disease, diabetes, and chronic pulmonary heart disease. In this study, it has been shown that 78.9% of patients with pulmonary heart disease, diabetes, hypertension, or coronary heart disease have different levels of depression. There were no significant differences in incidence of depression among different gender, age, education levels, marital status, or course of disease. There were no significant differences in total incidence rate of depression and in incidence rate of different levels of depression among the three groups of patients. It is very important to help patients with chronic diseases to reduce their depression by psychological nursing after evaluating their mental status.Archives of Psychiatric Nursing 03/2008; 22(1):39-49. DOI:10.1016/j.apnu.2007.04.007 · 1.03 Impact Factor
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ABSTRACT: RESUMEN Antecedentes: en el adulto mayor la depresión puede estar "enmascarada" por síntomas de tipo somático, con frecuencia de tipo doloroso, resultado de algún trastorno por somatización o ser parte de un trastorno afectivo. Esto se fundamenta en la frecuente existencia de depresión en trastornos de somatización. Ésta suele ser una expresión de los padecimientos médicos. Objetivo: describir la relación entre los síntomas somáticos dolorosos con ansiedad y la depresión en mujeres adultas mayores. Pacientes y método: se evaluaron transversalmente 17 mujeres mayores de 60 años de edad, las cuales reportaron síntomas de depresión y ansiedad acompañados de, al menos, algún síntoma doloroso durante más de seis meses. Las escalas utilizadas fueron: Inventario Neuropsiquiátrico (MINI), Inventario de Síntomas de Hopkins (SCL-90), Escala de Depresión Geriátrica (GDS-30) y Examen Breve del Estado Mental (MMSE-30). Resultados: la edad promedio de las mujeres evaluadas fue de 65.64 años (de 4.80). El diagnóstico más frecuente fue la comorbilidad entre el episodio depresivo mayor y el trastorno de ansiedad generalizada (35.2%). De acuerdo con los resultados de las subescalas del SCL-90, la depresión (1.86%; 0.85) y somatización (1.73%; 1.07) fueron las más frecuentes. El GDS-30 y el MMSE-30 se correlacionaron significativamente con la subescala de depresión del SCL-90 (r = 0.64, p < 0.05; r = 0.52, p < 0.05), respectivamente. Conclusiones: por lo general, en mujeres mayores de 60 años de edad los síntomas somáticos dolorosos coexisten con trastornos ansioso-depresivos. Palabras clave: ansiedad, depresión, somatización, trastornos. ABSTRACT Background: It has been stated that depression in the elderly may be "masked" with somatic symptoms, frequently painful symptoms, caused by somatization or affective disorders. This is based on the fact that depression generally exists in somatization disorders. Aditionally, somatization usually expresses itself in medical disorders. Objective: To describe the relationship between painful somatic symptoms with anxiety and depression in elderly women. Patients and methods: This cross-sectional trial included 17 women older than 60 years of age, who reported either anxiety, depression or both with at least one somatic painful symptom in the last 6 months. Assessment scales were: the MINI International Neuropsychiatric Inventory (MINI), Hopkins Symptom Checklist (SCL-90), Geriatric Depression Scale (GDS-30) and the Folstein Mini Mental State Examination (MMSE-30). Results: Average age of women included was 65.64 years (SD: 4.80). The most frequent psychiatric diagnosis was co-morbidity between major depressive disorder and generalized anxiety disorder (35.2%). Depression and somatization sub-scales were the most common diagnosis according to SCL-90 sub-scales (1.86%; SD: 0.85 and 1.73%; 1.07, respectively). Significant association existed between the generalized anxiety disorder and the Mini Mental State Examination scales with the depression sub-scale of the SCL-90 (r = 0.64, p < 0.05; r = 0.52, p < 0.05), respectively. Conclusions: Painful somatic symptoms often coexist with anxiety or depressive disorders in women older than 60 years of age.