Academic journal article Social Behavior and Personality: an international journal

Can Somatic Symptoms Predict Depression?

Academic journal article Social Behavior and Personality: an international journal

Can Somatic Symptoms Predict Depression?

Article excerpt

In this study Kuwaiti undergraduate students (N = 215) completed the 60 individual items of the Somatic Symptoms Inventory (Abdel-Khalek, 2003) and 3 scales of depression - the Symptom Checklist-90, Depression Subscale (SCL-90; D: Derogatis, 1994) the Center for Epidemiologic Studies-Depression Scale (CESD: Radloff, 1977) and the Hopkins Symptoms Check List-Depression Scale (HCS-D: Derogatis, Lipman, Rickels, Uhlenhuth, & Covi, 1974) to determine the correlation between the 60 individual items of the SSI and the 3 scales of depression. It was concluded that the following somatic symptoms can predict depression in a nonclinical sample: tension, heart pains, sleep disorder, anorexia, weight gain, migraine, and sexual disorders, respectively.

The somatoform disorder in the Diagnostic and Statistical Manual of mental disorders (DSM-IV), is defined as "the presence of physical symptoms that suggest a general medical condition ... and are not fully explained by a general medical condition, by the direct effects of a substance or by another mental disorder... Somatoform disorders differ from psychological factors affecting medical conditions in that there is no diagnosable general medical condition to fully account for the physical symptoms" (American Psychiatric Association, 1994, p. 445).

Referring to the previous literature, the somatic element in emotional disorders (mainly anxiety and depression) came under different names, that is, organic, physical symptoms that suggest physical illness, physiological, autonomic, psychosomatic, somatic preoccupation, somatization, physical symptoms with no apparent physical etiology, and medically unexplained symptoms. In the same vein, Barsky and Borus (1999) introduced the term functional somatic syndromes to include: multiple chemical sensitivity, the sick building syndrome, repetitive stress injury, the side-effects of silicone breast implants, the Gulf War syndrome, chronic whiplash, the chronic fatigue syndrome, the irritable bowel syndrome, and fibromyalgia. In the present study, there was a tendency for "somatic symptoms" to refer to most of these different terms. The emphasis was centered around the mere presence of the somatic symptom(s) in general, according to the subject's self-report, and regardless of the cause, whether it was an actual medical condition, substance effect, or mental disorder.

Numerous studies have shown that depressed and anxious individuals are at higher risk of physical illness. Sometimes the differentiation between the somatic and psychic becomes a dilemma, for example, pain, insomnia, headache, dizziness and fatigue. In this respect, Von Korff and Simon (1996) pointed out that "when chronic pain and depression co-occur, physical and psychological illnesses become enmeshed in ways that challenge conventional notions of the boundaries between physical disease and psychological disorder" (p. 101).

Stevens, Merikangas and Merikangas (1995) have noted that "a strong association between depression and numerous physical diseases has been consistently reported in clinical studies of patients with specific medical disorders... Conversely [a portion] of depressed patients manifest a medical disorder as the underlying precipitant or cause of depression" (p. 147).

Silverstein (1999) found that female subjects exhibited a higher prevalence than did male subjects of somatic depression (fatigue, appetite and sleep disturbance), but not a higher prevalence of pure depression. Somatic depression was associated with a high prevalence of anxiety disorder, and, among female subjects, with body aches and onset of depression during early adolescence.

The objectives of the present study of nonclinical subjects were fourfold: (a) to examine the correlation between self-ratings of somatic symptoms and depression, (b) to define the top ten individual somatic symptoms with higher correlations with depression, (c) to examine the factor structure of the total scores of depression and somatic symptoms, and (d) to test the feasibility of predicting depression with the help of somatic symptom(s). …

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