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Unexplained somatic symptoms--diagnostic window for mental disorders.
1DTM&H, Liverpool.
Journal of the Indian Medical Association
|October 25, 2006
Summary
Many patients with unexplained somatic symptoms (USSs) have underlying anxiety and depression. Early diagnosis and treatment of these mental health conditions, often presenting as physical complaints, improve patient outcomes.
Area of Science:
- Medical Science
- Psychiatry
- Gastroenterology
Background:
- Prevalence of anxiety disorders and depression is high in primary and specialist care settings.
- Patients often present with unexplained somatic symptoms (USSs) that lack organic basis, masking underlying mental health conditions.
- Poor diagnosis rates for mental health issues are linked to patients not reporting psychological complaints and clinicians overlooking USSs.
Purpose of the Study:
- To develop an algorithm for the early and accurate diagnosis of mental health disorders in specialist clinic settings.
- To investigate the correlation between common USSs and underlying anxiety and depression.
- To evaluate the effectiveness of antidepressant treatment for patients with USSs.
Main Methods:
- A three-year study involving 1297 patients across four cohorts, including a group treated with antidepressants.
- Detailed history taking, physical examinations, and investigations were used to identify systemic diseases and symptom-correlates of USSs.
- Patients were screened for neurotic diseases (ICD-10) and their responses to antidepressant treatment were recorded.
Main Results:
- Common USSs like "gas", "acidity", and "dysentery" were found to be correlates of anxiety and depression in 73-85% of patients screened.
- Psychiatric comorbidity was identified in various percentages across different cohorts when USSs were properly evaluated.
- Antidepressant treatment showed satisfactory to good results in 84.4% to 90% of patients with USSs, indicating their effectiveness.
Conclusions:
- Unexplained somatic symptoms frequently represent underlying anxiety disorders and depression.
- Clinicians should consider USSs as potential indicators of comorbid mental health conditions.
- Implementing an algorithm for diagnosing and managing USSs can improve patient outcomes and quality of life.
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