Depression, somatic complaints and medical help-seeking in a Romanian sample

Abstract

Introduction

Depression as a disorder, with all its intensities and clinical forms, requires to be projected on the backdrop of human suffering. In evaluating a depressive episode of a somatically ill person, it is important to assess personality and social context as a whole.

Objectives

To establish the degree of somatic comorbidity/somatization in depressive patients and the correlation with their social support network.

Aims

To recommend cost-effective psycho-social interventions to offer relief and support.

Method

We evaluated 60 patients with depression of various etiologies (Recurrent depressive disorder, Paranoid-depressive disorder, Anxious-depressive disorder). Self-report and observer rating scales were used (SCL-90, Beck, Hamilton) along with a suplimentary consult (where required) by different specialists. Direct observations were made regarding the social support network, in terms of evaluating their scale and efficiency.

Results

The majority of patients included showed an obvious inconsistency in terms of objective and subjective symptoms, correlated with the lack of an adequate social support network. This resulted in more medical help-seeking, a polymorphic array of somatic symptoms, oscillations of somatic complaints, some showing lack of adherence and only mild improvement with psychotropic therapy. Most of the somatized complaints were gastro-intestinal, respiratory, pain-related and pseudo-neurological, with an increased overall evidence-based cardio-vascular comorbidity.

Conclusions

We suggest that in order to help support patients and ensure fluidization of medical services, mental health care could also be delivered effectively in primary care settings, through community-based programmes and task shifting approaches that engage and support skilled non-specialist health professionals, lay workers, affected individuals, and caregivers (Kakuma, 2011).

Disclosure of interest

The authors have not supplied their declaration of competing interest.