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Depression, anxiety and somatization in primary care: syndrome overlap and functional impairment.
Gen Hosp Psychiatry. 2008 May-Jun; 30(3):191-9.GH

Abstract

OBJECTIVE

To determine diagnostic overlap of depression, anxiety and somatization as well as their unique and overlapping contribution to functional impairment.

METHOD

Two thousand ninety-one consecutive primary care clinic patients participated in a multicenter cross-sectional survey in 15 primary care clinics in the United States (participation rate, 92%). Depression, anxiety, somatization and functional impairment were assessed using validated scales from the Patient Health Questionnaire (PHQ) (PHQ-8, eight-item depression module; GAD-7, seven-item Generalized Anxiety Disorder Scale; and PHQ-15, 15-item somatic symptom scale) and the Short-Form General Health Survey (SF-20). Multiple linear regression analyses were used to investigate unique and overlapping associations of depression, anxiety and somatization with functional impairment.

RESULTS

In over 50% of cases, comorbidities existed between depression, anxiety and somatization. The contribution of the commonalities of depression, anxiety and somatization to functional impairment substantially exceeded the contribution of their independent parts. Nevertheless, depression, anxiety and somatization did have important and individual effects (i.e., separate from their overlap effect) on certain areas of functional impairment.

CONCLUSIONS

Given the large syndrome overlap, a potential consideration for future diagnostic classification would be to describe basic diagnostic criteria for a single overarching disorder and to optionally code additional diagnostic features that allow a more detailed classification into specific depressive, anxiety and somatoform subtypes.

Authors+Show Affiliations

Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf and Hamburg-Eilbek (Schön Clinics), Germany. b.loewe@uke.uni-hamburg.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18433651

Citation

Löwe, Bernd, et al. "Depression, Anxiety and Somatization in Primary Care: Syndrome Overlap and Functional Impairment." General Hospital Psychiatry, vol. 30, no. 3, 2008, pp. 191-9.
Löwe B, Spitzer RL, Williams JB, et al. Depression, anxiety and somatization in primary care: syndrome overlap and functional impairment. Gen Hosp Psychiatry. 2008;30(3):191-9.
Löwe, B., Spitzer, R. L., Williams, J. B., Mussell, M., Schellberg, D., & Kroenke, K. (2008). Depression, anxiety and somatization in primary care: syndrome overlap and functional impairment. General Hospital Psychiatry, 30(3), 191-9. https://doi.org/10.1016/j.genhosppsych.2008.01.001
Löwe B, et al. Depression, Anxiety and Somatization in Primary Care: Syndrome Overlap and Functional Impairment. Gen Hosp Psychiatry. 2008 May-Jun;30(3):191-9. PubMed PMID: 18433651.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Depression, anxiety and somatization in primary care: syndrome overlap and functional impairment. AU - Löwe,Bernd, AU - Spitzer,Robert L, AU - Williams,Janet B W, AU - Mussell,Monika, AU - Schellberg,Dieter, AU - Kroenke,Kurt, PY - 2007/06/15/received PY - 2008/01/07/revised PY - 2008/01/09/accepted PY - 2008/4/25/pubmed PY - 2008/8/12/medline PY - 2008/4/25/entrez SP - 191 EP - 9 JF - General hospital psychiatry JO - Gen Hosp Psychiatry VL - 30 IS - 3 N2 - OBJECTIVE: To determine diagnostic overlap of depression, anxiety and somatization as well as their unique and overlapping contribution to functional impairment. METHOD: Two thousand ninety-one consecutive primary care clinic patients participated in a multicenter cross-sectional survey in 15 primary care clinics in the United States (participation rate, 92%). Depression, anxiety, somatization and functional impairment were assessed using validated scales from the Patient Health Questionnaire (PHQ) (PHQ-8, eight-item depression module; GAD-7, seven-item Generalized Anxiety Disorder Scale; and PHQ-15, 15-item somatic symptom scale) and the Short-Form General Health Survey (SF-20). Multiple linear regression analyses were used to investigate unique and overlapping associations of depression, anxiety and somatization with functional impairment. RESULTS: In over 50% of cases, comorbidities existed between depression, anxiety and somatization. The contribution of the commonalities of depression, anxiety and somatization to functional impairment substantially exceeded the contribution of their independent parts. Nevertheless, depression, anxiety and somatization did have important and individual effects (i.e., separate from their overlap effect) on certain areas of functional impairment. CONCLUSIONS: Given the large syndrome overlap, a potential consideration for future diagnostic classification would be to describe basic diagnostic criteria for a single overarching disorder and to optionally code additional diagnostic features that allow a more detailed classification into specific depressive, anxiety and somatoform subtypes. SN - 0163-8343 UR - https://www.unboundmedicine.com/medline/citation/18433651/Depression_anxiety_and_somatization_in_primary_care:_syndrome_overlap_and_functional_impairment_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0163-8343(08)00002-9 DB - PRIME DP - Unbound Medicine ER -