A team from Duke University Medical Center, North Carolina, asked 1,822 adult patients to complete a 17-item questionnaire measuring health status and quality of life, and a depression-scale survey, quizzing them about mood disorders and whether they had trouble sleeping.

The team found that poor health, high levels of pain, disability and female gender increased the risk of depression and anxiety.

The authors emphasized the importance of identifying mood disorders because they can exacerbate physical illness and quality of life.

However, they point out that it may be difficult to spot the symptoms of depression, such as crying and fatigue, because they are not always reported to doctors or, even, the patient’s immediate family.

“Also, some symptoms such as fatigue can be a symptom of depression or heart disease, so it can be difficult to isolate symptoms or reach a definitive diagnosis,” said lead author Dr Lawrence Wu.

The study found no connection between “headache, osteoarthritis and abdominal pain” and anxiety and depression, however.

“Everyone is aware of the emotional symptoms of depression…what is less appreciated is that depression and anxiety can just as frequently present with painful and debilitating physical symptoms,” said co-author of the study Dr P Murali Doraiswamy. “Failure to treat such symptoms can reduce the chances of a full recovery.”

The authors also point out that it is difficult to diagnose whether depression and anxiety is caused by physical illness, or was present in the first place.

Source: Journal of the American Board of Family Practice, May/June edition, 2002

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