Somatic manifestations of depressive patients in different psychiatric settings

The diagnostic and prognostic significance of somatic manifestations in various depressive conditions is discussed with special reference to the somatic complaints in masked depression. The experience presented is based on 788 depressive patients studied in three different psychiatric services of a Greek rural district--an inpatient, an outpatient and a mobile unit service. Headache was found to be on top of the symptom checklist in both outpatient and mobile unit population. Musculoskeletal complaints and dizziness had also a high incidence and to a lesser degree gastrointestinal, cardiovascular and genitourinary symptoms. Though the incidence of all other somatic complaints increased with age and was higher in inpatients, headache was a prominent symptom in younger patients, too, and in outpatients, proving to be also an early diagnostic phenomenon for an underlying depression. The mental health mobile unit saw the greatest percentage of neurotic depressives, who also presented the highest incidence of headache (62.63%). The efficacy of that service for tracing such cases and the need for cooperation with the primary health care for better preventive measures are stressed.