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.
"These somatic symptoms are ubiquitous across studies, although there are some geographical differences in the specific characteristics and proportions (Gureje et al., 1997). These symptoms are considered to be associated with comorbid physical illnesses and disability, and are usually concomitant with aging (Sheehan and Banerjee, 1999). Depressive symptoms are closely related to functional somatic symptoms. "
[Show abstract][Hide abstract] 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.
"For example , the geriatri - cian may fail to recognize depression among patients with osteoarticular diseases who complain about bone and joint pain , although the pain associated with this common degenerative disorder may be increased by depression . Moreover , physi - cians are probably not sufficiently aware of the fact that older patients with depression often present somatic complaints ( Sheehan & Banerjee , 1999 ) in that they think somatic symptoms may be the result of the physical illness itself . Furthermore , depres - sive symptoms may be present covertly , in particular with psychosomatic symptoms or with hypochon - dria , which may lead to confusion with the coexisting illness . "
[Show abstract][Hide abstract] 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.
"First, it would be most beneficial to replicate the current study for different age groups (young adult, adult, middle age, young-old, old, and old-old) with the newly revised DSI-R and determine if the relationship between level of differentiation and symptomatology is consistent across the complete life span. One of the problems with studies across the whole range is that researchers often include relatively few older people, with the consequence that prevalence estimates may be subject to substantial measurement error (Sheehan & Banerjee, 1999). Also, because of the complexity in the concept of differentiation of self, it is important that future research assess the individual's family history to strengthen the conclusions of this theory. "
[Show abstract][Hide abstract] ABSTRACT: This study examines the relationship between Bowen's concept of differentiation of self and psychological symptom status in individuals age 62 years and older. Specifically, this study examines through regression methods whether the self-reported differentiation dimensions of Emotional Reactivity, “I” Position, Emotional Cutoff, and Fusion with Others (FO) accurately predicted the level of psychological symptom status as measured by a brief symptom check-list. The major hypotheses of this study were found to be supportive of Bowen's theory of differentiation, even across the stages of later life (with the exception of the FO dimension). These findings have meaningful implications for the assessment and treatment of older individuals.
The Family Journal 07/2007; 15(3):224-233. DOI:10.1177/1066480707301291
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