Seifsafari Shekoofeh, Firoozabadi Ali, Ghanizadeh Ahmad, Salehi Alireza
Research Center for Psychiatry and Behavioral Sciences, Department of Psychiatry, Hafez Hospital, Shiraz University of Medical Sciences, Shiraz, Iran;
Iran J Med Sci. 2013 Mar;38(1):22-9.
In some cultures, including ours, direct explanation of inner psychic world is inhibited and stigmatized, therefore finding alternative modes of expression. The aim of this cross-sectional study was to assess the frequency of somatization in the depressed patients.
The present study comprised 500 patients referred to the outpatient clinic of Shiraz University of Medical Sciences, and diagnosed with major depressive disorders based on DSM-IV-TR. The presenting complaints of these patients were assessed through psychiatric interview. The presenting symptoms were divided into three main categories including mental symptoms, pain, and physical symptoms without pain. Statistical analysis (chi-square and logistic regression) were performed to determine the relationship between presenting symptoms and some demographic variables such as age, gender, marital status, educational level and cultural background (urban or rural).
Physical symptoms other than pain, mental symptoms, and pain were found in 193 (38.6%), 186 (37.2%), and in 121 (24.2%) patients respectively. Pain and physical complaints were more common in patients with rural cultural background, lower education, women and the married individuals. Headache (15.2%), irritability (10.6%) and pain in different parts of the body (10.4%) were the most frequent chief complaints of the patients. Hypochondriasis, suicidal idea, crying, irritability and insomnia were significant symptoms associated with the complaint of somatization.
Somatic symptoms, especially pain, have a significant weight in the chief complaints of depressed patients. Physicians need to pay particular attention to this important issue in order to better understand these patients.
在包括我们自己的一些文化中,对内心心理世界的直接解释受到抑制和污名化,因此需要寻找替代的表达方式。这项横断面研究的目的是评估抑郁症患者中躯体化的频率。
本研究纳入了500名转诊至设拉子医科大学门诊并根据《精神疾病诊断与统计手册》第四版修订版(DSM-IV-TR)被诊断为重度抑郁症的患者。通过精神科访谈评估这些患者的主诉。将呈现的症状分为三大类,包括精神症状、疼痛和无疼痛的躯体症状。进行统计分析(卡方检验和逻辑回归)以确定呈现的症状与一些人口统计学变量之间的关系,如年龄、性别、婚姻状况、教育水平和文化背景(城市或农村)。
分别在193名(38.6%)、186名(37.2%)和121名(24.2%)患者中发现了无疼痛的躯体症状、精神症状和疼痛。疼痛和躯体主诉在具有农村文化背景、低教育水平、女性和已婚个体的患者中更为常见。头痛(15.2%)、易怒(10.6%)和身体不同部位疼痛(10.4%)是患者最常见的主要主诉。疑病症、自杀观念、哭泣、易怒和失眠是与躯体化主诉相关的显著症状。
躯体症状,尤其是疼痛,在抑郁症患者的主要主诉中占有重要比重。医生需要特别关注这个重要问题,以便更好地理解这些患者。