The impact of somatic symptoms on the course of major depressive disorder

Ella Bekhuis, Lynn Boschloo, Judith G M Rosmalen, Marrit K de Boer, Robert A Schoevers

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

OBJECTIVE: Somatic symptoms have been suggested to negatively affect the course of major depressive disorder (MDD). Mechanisms behind this association, however, remain elusive. This study examines the impact of somatic symptoms on MDD prognosis and aims to determine whether this effect can be explained by psychiatric characteristics, somatic diseases, lifestyle factors, and disability.

METHODS: In 463 MDD patients (mean age=44.9 years, 69.8% female) from the Netherlands Study of Depression and Anxiety (NESDA), we examined whether the type and number of somatic symptom clusters predicted the two-year persistence of MDD. Diagnoses of MDD were established with the Composite International Diagnostic Interview (CIDI) and somatic symptom clusters were assessed with the Four-Dimensional Symptom Questionnaire (4DSQ) somatization scale. Psychiatric characteristics, somatic diseases, lifestyle factors, and disability were taken into account as factors potentially underlying the association.

RESULTS: The cardiopulmonary, gastrointestinal, and general cluster significantly predicted the two-year persistence of MDD, but only when two or more of these clusters were present (OR=2.32, 95% CI=1.51-3.57, p=<0.001). Although the association was partly explained by MDD severity, the presence of multiple somatic symptom clusters remained a significant predictor after considering all potentially underlying factors (OR=1.69, 95%CI=1.07-2.68, p=0.03).

CONCLUSIONS: Somatic symptoms are predictors of a worse prognosis of MDD independent of psychiatric characteristics, somatic diseases, lifestyle factors, and disability. These results stress the importance of considering somatic symptoms in the diagnostic and treatment trajectory of patients with MDD. Future research should focus on identifying treatment modalities targeting depressive as well as somatic symptoms.

Original languageEnglish
Pages (from-to)112-118
Number of pages7
JournalJournal of Affective Disorders
Volume205
DOIs
Publication statusPublished - 15 Nov 2016

Fingerprint

Major Depressive Disorder
Psychiatry
Life Style
Depression
Medically Unexplained Symptoms
Netherlands
Anxiety
Interviews
Therapeutics

Keywords

  • Adult
  • Aged
  • Cardiovascular Diseases/psychology
  • Cluster Analysis
  • Depressive Disorder, Major/psychology
  • Female
  • Gastrointestinal Diseases/psychology
  • Humans
  • Life Style
  • Logistic Models
  • Male
  • Medically Unexplained Symptoms
  • Middle Aged
  • Musculoskeletal Diseases/psychology
  • Netherlands
  • Prognosis
  • Somatoform Disorders/psychology
  • Surveys and Questionnaires
  • Young Adult

Cite this

Bekhuis, Ella ; Boschloo, Lynn ; Rosmalen, Judith G M ; de Boer, Marrit K ; Schoevers, Robert A. / The impact of somatic symptoms on the course of major depressive disorder. In: Journal of Affective Disorders. 2016 ; Vol. 205. pp. 112-118.
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title = "The impact of somatic symptoms on the course of major depressive disorder",
abstract = "OBJECTIVE: Somatic symptoms have been suggested to negatively affect the course of major depressive disorder (MDD). Mechanisms behind this association, however, remain elusive. This study examines the impact of somatic symptoms on MDD prognosis and aims to determine whether this effect can be explained by psychiatric characteristics, somatic diseases, lifestyle factors, and disability.METHODS: In 463 MDD patients (mean age=44.9 years, 69.8{\%} female) from the Netherlands Study of Depression and Anxiety (NESDA), we examined whether the type and number of somatic symptom clusters predicted the two-year persistence of MDD. Diagnoses of MDD were established with the Composite International Diagnostic Interview (CIDI) and somatic symptom clusters were assessed with the Four-Dimensional Symptom Questionnaire (4DSQ) somatization scale. Psychiatric characteristics, somatic diseases, lifestyle factors, and disability were taken into account as factors potentially underlying the association.RESULTS: The cardiopulmonary, gastrointestinal, and general cluster significantly predicted the two-year persistence of MDD, but only when two or more of these clusters were present (OR=2.32, 95{\%} CI=1.51-3.57, p=<0.001). Although the association was partly explained by MDD severity, the presence of multiple somatic symptom clusters remained a significant predictor after considering all potentially underlying factors (OR=1.69, 95{\%}CI=1.07-2.68, p=0.03).CONCLUSIONS: Somatic symptoms are predictors of a worse prognosis of MDD independent of psychiatric characteristics, somatic diseases, lifestyle factors, and disability. These results stress the importance of considering somatic symptoms in the diagnostic and treatment trajectory of patients with MDD. Future research should focus on identifying treatment modalities targeting depressive as well as somatic symptoms.",
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The impact of somatic symptoms on the course of major depressive disorder. / Bekhuis, Ella; Boschloo, Lynn; Rosmalen, Judith G M; de Boer, Marrit K; Schoevers, Robert A.

In: Journal of Affective Disorders, Vol. 205, 15.11.2016, p. 112-118.

Research output: Contribution to JournalArticleAcademicpeer-review

TY - JOUR

T1 - The impact of somatic symptoms on the course of major depressive disorder

AU - Bekhuis, Ella

AU - Boschloo, Lynn

AU - Rosmalen, Judith G M

AU - de Boer, Marrit K

AU - Schoevers, Robert A

N1 - Copyright © 2016 Elsevier B.V. All rights reserved.

PY - 2016/11/15

Y1 - 2016/11/15

N2 - OBJECTIVE: Somatic symptoms have been suggested to negatively affect the course of major depressive disorder (MDD). Mechanisms behind this association, however, remain elusive. This study examines the impact of somatic symptoms on MDD prognosis and aims to determine whether this effect can be explained by psychiatric characteristics, somatic diseases, lifestyle factors, and disability.METHODS: In 463 MDD patients (mean age=44.9 years, 69.8% female) from the Netherlands Study of Depression and Anxiety (NESDA), we examined whether the type and number of somatic symptom clusters predicted the two-year persistence of MDD. Diagnoses of MDD were established with the Composite International Diagnostic Interview (CIDI) and somatic symptom clusters were assessed with the Four-Dimensional Symptom Questionnaire (4DSQ) somatization scale. Psychiatric characteristics, somatic diseases, lifestyle factors, and disability were taken into account as factors potentially underlying the association.RESULTS: The cardiopulmonary, gastrointestinal, and general cluster significantly predicted the two-year persistence of MDD, but only when two or more of these clusters were present (OR=2.32, 95% CI=1.51-3.57, p=<0.001). Although the association was partly explained by MDD severity, the presence of multiple somatic symptom clusters remained a significant predictor after considering all potentially underlying factors (OR=1.69, 95%CI=1.07-2.68, p=0.03).CONCLUSIONS: Somatic symptoms are predictors of a worse prognosis of MDD independent of psychiatric characteristics, somatic diseases, lifestyle factors, and disability. These results stress the importance of considering somatic symptoms in the diagnostic and treatment trajectory of patients with MDD. Future research should focus on identifying treatment modalities targeting depressive as well as somatic symptoms.

AB - OBJECTIVE: Somatic symptoms have been suggested to negatively affect the course of major depressive disorder (MDD). Mechanisms behind this association, however, remain elusive. This study examines the impact of somatic symptoms on MDD prognosis and aims to determine whether this effect can be explained by psychiatric characteristics, somatic diseases, lifestyle factors, and disability.METHODS: In 463 MDD patients (mean age=44.9 years, 69.8% female) from the Netherlands Study of Depression and Anxiety (NESDA), we examined whether the type and number of somatic symptom clusters predicted the two-year persistence of MDD. Diagnoses of MDD were established with the Composite International Diagnostic Interview (CIDI) and somatic symptom clusters were assessed with the Four-Dimensional Symptom Questionnaire (4DSQ) somatization scale. Psychiatric characteristics, somatic diseases, lifestyle factors, and disability were taken into account as factors potentially underlying the association.RESULTS: The cardiopulmonary, gastrointestinal, and general cluster significantly predicted the two-year persistence of MDD, but only when two or more of these clusters were present (OR=2.32, 95% CI=1.51-3.57, p=<0.001). Although the association was partly explained by MDD severity, the presence of multiple somatic symptom clusters remained a significant predictor after considering all potentially underlying factors (OR=1.69, 95%CI=1.07-2.68, p=0.03).CONCLUSIONS: Somatic symptoms are predictors of a worse prognosis of MDD independent of psychiatric characteristics, somatic diseases, lifestyle factors, and disability. These results stress the importance of considering somatic symptoms in the diagnostic and treatment trajectory of patients with MDD. Future research should focus on identifying treatment modalities targeting depressive as well as somatic symptoms.

KW - Adult

KW - Aged

KW - Cardiovascular Diseases/psychology

KW - Cluster Analysis

KW - Depressive Disorder, Major/psychology

KW - Female

KW - Gastrointestinal Diseases/psychology

KW - Humans

KW - Life Style

KW - Logistic Models

KW - Male

KW - Medically Unexplained Symptoms

KW - Middle Aged

KW - Musculoskeletal Diseases/psychology

KW - Netherlands

KW - Prognosis

KW - Somatoform Disorders/psychology

KW - Surveys and Questionnaires

KW - Young Adult

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DO - 10.1016/j.jad.2016.06.030

M3 - Article

VL - 205

SP - 112

EP - 118

JO - Journal of Affective Disorders

JF - Journal of Affective Disorders

SN - 0165-0327

ER -