Women and somatization: unrecognized depression

Depression is the mental health disorder most commonly seen in the primary health care setting. Estimates of the prevalence of people who are depressed but are seeking treatment for physical disorders in the primary care setting range from 12% to 55% of total patients. We conducted a study to determine the number of women with high depressive symptoms who were seeking treatment for physical disorders and compared this group with women with no depressive symptoms who were also seeking physical health care. The women with high depressive symptoms (n = 122) and the women with no depressive symptoms (n = 115) were similar in age, economic status, occupation status, and lifestyle. The depressed women reported significantly more physical complaints, increased disability, increased functional limitations, and increased use of health care services than did the nondepressed women. They disclosed a variety of physical complaints in all organ systems, had had more life events, and had a diminished belief in their ability to control their environments. The results of this study support the view that large numbers of women with depression that is unrecognized present themselves to the health care system for physical complaints. Health care providers need to extend their view of women as whole beings, instead of as a somatic complaint.