Differential associations of specific depressive and anxiety disorders with somatic symptoms

Ella Bekhuis, Lynn Boschloo, Judith G M Rosmalen, Robert A Schoevers

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

OBJECTIVE: Previous studies have shown that depressive and anxiety disorders are strongly related to somatic symptoms, but much is unclear about the specificity of this association. This study examines the associations of specific depressive and anxiety disorders with somatic symptoms, and whether these associations are independent of comorbid depressive and anxiety disorders.

METHODS: Cross-sectional data were derived from The Netherlands Study of Depression and Anxiety (NESDA). A total of 2008 persons (mean age: 41.6 years, 64.9% women) were included, consisting of 1367 patients with a past-month DSM-diagnosis (established with the Composite International Diagnostic Interview [CIDI]) of depressive disorder (major depressive disorder, dysthymic disorder) and/or anxiety disorder (generalized anxiety disorder, social phobia, panic disorder, agoraphobia), and 641 controls. Somatic symptoms were assessed with the somatization scale of the Four-Dimensional Symptom Questionnaire (4DSQ), and included cardiopulmonary, musculoskeletal, gastrointestinal, and general symptoms. Analyses were adjusted for covariates such as chronic somatic diseases, sociodemographics, and lifestyle factors.

RESULTS: All clusters of somatic symptoms were more prevalent in patients with depressive and/or anxiety disorders than in controls (all p<.001). Multivariable logistic regression analyses showed that all types of depressive and anxiety disorders were independently related to somatic symptoms, except for dysthymic disorder. Major depressive disorder showed the strongest associations. Associations remained similar after adjustment for covariates.

CONCLUSION: This study demonstrated that depressive and anxiety disorders show strong and partly differential associations with somatic symptoms. Future research should investigate whether an adequate consideration and treatment of somatic symptoms in depressed and/or anxious patients improve treatment outcomes.

Original languageEnglish
Pages (from-to)116-22
Number of pages7
JournalJournal of Psychosomatic Research
Volume78
Issue number2
DOIs
Publication statusPublished - Feb 2015

Fingerprint

Depressive Disorder
Anxiety Disorders
Dysthymic Disorder
Major Depressive Disorder
Agoraphobia
Medically Unexplained Symptoms
Panic Disorder
Netherlands
Life Style
Chronic Disease
Anxiety
Logistic Models
Regression Analysis
Interviews
Depression

Keywords

  • Adult
  • Aged
  • Anxiety Disorders/complications
  • Cardiovascular Diseases/epidemiology
  • Chronic Disease/epidemiology
  • Cluster Analysis
  • Comorbidity
  • Confounding Factors (Epidemiology)
  • Cross-Sectional Studies
  • Depressive Disorder/complications
  • Digestive System Diseases/epidemiology
  • Female
  • Humans
  • Life Style
  • Logistic Models
  • Male
  • Middle Aged
  • Musculoskeletal Diseases/epidemiology
  • Netherlands/epidemiology
  • Self Report
  • Surveys and Questionnaires

Cite this

Bekhuis, Ella ; Boschloo, Lynn ; Rosmalen, Judith G M ; Schoevers, Robert A. / Differential associations of specific depressive and anxiety disorders with somatic symptoms. In: Journal of Psychosomatic Research. 2015 ; Vol. 78, No. 2. pp. 116-22.
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abstract = "OBJECTIVE: Previous studies have shown that depressive and anxiety disorders are strongly related to somatic symptoms, but much is unclear about the specificity of this association. This study examines the associations of specific depressive and anxiety disorders with somatic symptoms, and whether these associations are independent of comorbid depressive and anxiety disorders.METHODS: Cross-sectional data were derived from The Netherlands Study of Depression and Anxiety (NESDA). A total of 2008 persons (mean age: 41.6 years, 64.9{\%} women) were included, consisting of 1367 patients with a past-month DSM-diagnosis (established with the Composite International Diagnostic Interview [CIDI]) of depressive disorder (major depressive disorder, dysthymic disorder) and/or anxiety disorder (generalized anxiety disorder, social phobia, panic disorder, agoraphobia), and 641 controls. Somatic symptoms were assessed with the somatization scale of the Four-Dimensional Symptom Questionnaire (4DSQ), and included cardiopulmonary, musculoskeletal, gastrointestinal, and general symptoms. Analyses were adjusted for covariates such as chronic somatic diseases, sociodemographics, and lifestyle factors.RESULTS: All clusters of somatic symptoms were more prevalent in patients with depressive and/or anxiety disorders than in controls (all p<.001). Multivariable logistic regression analyses showed that all types of depressive and anxiety disorders were independently related to somatic symptoms, except for dysthymic disorder. Major depressive disorder showed the strongest associations. Associations remained similar after adjustment for covariates.CONCLUSION: This study demonstrated that depressive and anxiety disorders show strong and partly differential associations with somatic symptoms. Future research should investigate whether an adequate consideration and treatment of somatic symptoms in depressed and/or anxious patients improve treatment outcomes.",
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Differential associations of specific depressive and anxiety disorders with somatic symptoms. / Bekhuis, Ella; Boschloo, Lynn; Rosmalen, Judith G M; Schoevers, Robert A.

In: Journal of Psychosomatic Research, Vol. 78, No. 2, 02.2015, p. 116-22.

Research output: Contribution to JournalArticleAcademicpeer-review

TY - JOUR

T1 - Differential associations of specific depressive and anxiety disorders with somatic symptoms

AU - Bekhuis, Ella

AU - Boschloo, Lynn

AU - Rosmalen, Judith G M

AU - Schoevers, Robert A

N1 - Copyright © 2014 Elsevier Inc. All rights reserved.

PY - 2015/2

Y1 - 2015/2

N2 - OBJECTIVE: Previous studies have shown that depressive and anxiety disorders are strongly related to somatic symptoms, but much is unclear about the specificity of this association. This study examines the associations of specific depressive and anxiety disorders with somatic symptoms, and whether these associations are independent of comorbid depressive and anxiety disorders.METHODS: Cross-sectional data were derived from The Netherlands Study of Depression and Anxiety (NESDA). A total of 2008 persons (mean age: 41.6 years, 64.9% women) were included, consisting of 1367 patients with a past-month DSM-diagnosis (established with the Composite International Diagnostic Interview [CIDI]) of depressive disorder (major depressive disorder, dysthymic disorder) and/or anxiety disorder (generalized anxiety disorder, social phobia, panic disorder, agoraphobia), and 641 controls. Somatic symptoms were assessed with the somatization scale of the Four-Dimensional Symptom Questionnaire (4DSQ), and included cardiopulmonary, musculoskeletal, gastrointestinal, and general symptoms. Analyses were adjusted for covariates such as chronic somatic diseases, sociodemographics, and lifestyle factors.RESULTS: All clusters of somatic symptoms were more prevalent in patients with depressive and/or anxiety disorders than in controls (all p<.001). Multivariable logistic regression analyses showed that all types of depressive and anxiety disorders were independently related to somatic symptoms, except for dysthymic disorder. Major depressive disorder showed the strongest associations. Associations remained similar after adjustment for covariates.CONCLUSION: This study demonstrated that depressive and anxiety disorders show strong and partly differential associations with somatic symptoms. Future research should investigate whether an adequate consideration and treatment of somatic symptoms in depressed and/or anxious patients improve treatment outcomes.

AB - OBJECTIVE: Previous studies have shown that depressive and anxiety disorders are strongly related to somatic symptoms, but much is unclear about the specificity of this association. This study examines the associations of specific depressive and anxiety disorders with somatic symptoms, and whether these associations are independent of comorbid depressive and anxiety disorders.METHODS: Cross-sectional data were derived from The Netherlands Study of Depression and Anxiety (NESDA). A total of 2008 persons (mean age: 41.6 years, 64.9% women) were included, consisting of 1367 patients with a past-month DSM-diagnosis (established with the Composite International Diagnostic Interview [CIDI]) of depressive disorder (major depressive disorder, dysthymic disorder) and/or anxiety disorder (generalized anxiety disorder, social phobia, panic disorder, agoraphobia), and 641 controls. Somatic symptoms were assessed with the somatization scale of the Four-Dimensional Symptom Questionnaire (4DSQ), and included cardiopulmonary, musculoskeletal, gastrointestinal, and general symptoms. Analyses were adjusted for covariates such as chronic somatic diseases, sociodemographics, and lifestyle factors.RESULTS: All clusters of somatic symptoms were more prevalent in patients with depressive and/or anxiety disorders than in controls (all p<.001). Multivariable logistic regression analyses showed that all types of depressive and anxiety disorders were independently related to somatic symptoms, except for dysthymic disorder. Major depressive disorder showed the strongest associations. Associations remained similar after adjustment for covariates.CONCLUSION: This study demonstrated that depressive and anxiety disorders show strong and partly differential associations with somatic symptoms. Future research should investigate whether an adequate consideration and treatment of somatic symptoms in depressed and/or anxious patients improve treatment outcomes.

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KW - Aged

KW - Anxiety Disorders/complications

KW - Cardiovascular Diseases/epidemiology

KW - Chronic Disease/epidemiology

KW - Cluster Analysis

KW - Comorbidity

KW - Confounding Factors (Epidemiology)

KW - Cross-Sectional Studies

KW - Depressive Disorder/complications

KW - Digestive System Diseases/epidemiology

KW - Female

KW - Humans

KW - Life Style

KW - Logistic Models

KW - Male

KW - Middle Aged

KW - Musculoskeletal Diseases/epidemiology

KW - Netherlands/epidemiology

KW - Self Report

KW - Surveys and Questionnaires

U2 - 10.1016/j.jpsychores.2014.11.007

DO - 10.1016/j.jpsychores.2014.11.007

M3 - Article

VL - 78

SP - 116

EP - 122

JO - Journal of Psychosomatic Research

JF - Journal of Psychosomatic Research

SN - 0022-3999

IS - 2

ER -