A PROSPECTIVE STUDY OF MEDICALLY UNEXPLAINED PHYSICAL SYMPTOMS IN DEPRESSIVE DISORDERS

CORRESPONDING AUTHOR:
Dr. A. John Dinesh,
Assistant Professor,
Department of Psychiatry,
SVMCH & RC,
Ariyur, Pondicherry.
Email: dr.johndinesh@gmail.com
              

ABSTRACT: Physical symptoms in depression are highly prevalent and associated with substantial functional impairment. The prevalence of physical illness in psychiatric patients is higher than that in the general population. Both in developed & developing countries, very little attention is paid to the physical illness of psychiatric patients, which leads to a poorer outcome. Hence we decided to conduct this study and find out the effect of antidepressant treatment on somatic symptoms in depressive disorders. The study was conducted at Sri Venkateshwaraa medical college hospital & research center, Puducherry. Our study sample consisted of 72 consecutive new patients who fulfilled inclusion criteria and had consented to participate in the study. All new patients in the age group 18 to 60 years, who fulfill ICD-10-DCR (Diagnostic criteria for Research) criteria for the Depressive episode (F 32), recurrent depressive disorder (F33), Dysthymia (F 34.1), bipolar affective disorder, current episode depression (F 31.3) were included in our study. MATERIALS AND METHODS: A semi-structured proforma was used to collect socio demographic and clinical data from all the subjects included in the study. Enrolment of cases was done over a period of 6 months. All the subjects were rated on the Hamilton Depression Rating Scale (HDRS-17) to quantify the baseline severity of the depressive symptoms. Screenings for physical symptoms were done for all patients using the Patient Health Questionnaire (PHQ-15). The patients were classified into 4 groups based on physical complaints & co-morbid medical/ surgical diagnosis. HDRS-17 rating was recorded at baseline, 1 month & 6 months for the entire study sample. PHQ-15 scores were recorded at baseline, 1 month & 6 months after initiation of antidepressant treatment for all patients enrolled in the study. RESULTS: The study revealed the prevalence of medically unexplained physical symptoms in depressive disorders in patients attending our psychiatry OPD. The Results depicts the prevalence of physical pain symptoms in patients with depressive disorders. The reduction in HDRS-17 and PHQ-15 scores in 1month and 6 months shows the effect of antidepressant treatment in reducing both depressive symptoms and physical symptoms CONCLUSION: This study had been undertaken with intent to study the prevalence of unexplained physical symptoms and physical illnesses among patients with depressive disorders and to analyze the effect of antidepressant treatment on these unexplained physical symptoms.

KEYWORDS: Depression, physical symptoms, unexplained somatic symptoms.