Somatic symptoms in treatment-naïve Hispanic and non-Hispanic patients with major depression.
African Americans
Latino
Spanish
acculturation
anxiety
ethnicity
Journal
Depression and anxiety
ISSN: 1520-6394
Titre abrégé: Depress Anxiety
Pays: United States
ID NLM: 9708816
Informations de publication
Date de publication:
02 2020
02 2020
Historique:
received:
02
08
2019
revised:
29
10
2019
accepted:
28
11
2019
pubmed:
13
12
2019
medline:
30
5
2020
entrez:
13
12
2019
Statut:
ppublish
Résumé
Somatic complaints are a major driver of health care costs among patients with major depressive disorder (MDD). Some epidemiologic and clinical data suggest that Hispanic and non-Hispanic Black patients with MDD endorse higher levels of somatic symptoms than non-Hispanic White patients. Somatic symptoms in 102 Hispanic, 61 non-Hispanic Black, and 156 non-Hispanic White patients with treatment-naïve MDD were evaluated using the somatic symptom subscale of the Hamilton anxiety rating scale (HAM-A). The other seven items of the HAM-A comprise the psychic anxiety subscale, which was also evaluated across ethnicities. Hispanic patients reported significantly greater levels of somatic symptoms than non-Hispanic patients, but levels of psychic anxiety symptoms did not differ by ethnicity. Levels of somatic symptoms did not significantly differ between Black and White non-Hispanic patients. Within the Hispanic sample, somatic symptom levels were higher only among those who were evaluated in Spanish; Hispanics who spoke English showed no significant differences versus non-Hispanics. In this medically healthy sample of patients with MDD, monolingual Spanish-speaking Hispanic patients endorsed high levels of somatic symptoms. Clinicians should be mindful that the depressive experience may manifest somatically and be judicious in determining when additional medical work-up is warranted for somatic complaints.
Sections du résumé
BACKGROUND
Somatic complaints are a major driver of health care costs among patients with major depressive disorder (MDD). Some epidemiologic and clinical data suggest that Hispanic and non-Hispanic Black patients with MDD endorse higher levels of somatic symptoms than non-Hispanic White patients.
METHODS
Somatic symptoms in 102 Hispanic, 61 non-Hispanic Black, and 156 non-Hispanic White patients with treatment-naïve MDD were evaluated using the somatic symptom subscale of the Hamilton anxiety rating scale (HAM-A). The other seven items of the HAM-A comprise the psychic anxiety subscale, which was also evaluated across ethnicities.
RESULTS
Hispanic patients reported significantly greater levels of somatic symptoms than non-Hispanic patients, but levels of psychic anxiety symptoms did not differ by ethnicity. Levels of somatic symptoms did not significantly differ between Black and White non-Hispanic patients. Within the Hispanic sample, somatic symptom levels were higher only among those who were evaluated in Spanish; Hispanics who spoke English showed no significant differences versus non-Hispanics.
CONCLUSIONS
In this medically healthy sample of patients with MDD, monolingual Spanish-speaking Hispanic patients endorsed high levels of somatic symptoms. Clinicians should be mindful that the depressive experience may manifest somatically and be judicious in determining when additional medical work-up is warranted for somatic complaints.
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
156-165Subventions
Organisme : NIH HHS
ID : UL1 RR025008
Pays : United States
Organisme : NIMH NIH HHS
ID : P50 MH077083
Pays : United States
Organisme : NIMH NIH HHS
ID : R01MH080880
Pays : United States
Informations de copyright
© 2019 Wiley Periodicals, Inc.
Références
American Psychiatric Association, DSM-5 Task Force. (2013). Diagnostic and statistical manual of mental disorders: DSM-5 (5th ed.). Arlington, VA: American Psychiatric Publishing, Inc.
Aponte Rivera, V., Dunlop, B. W., Ramirez, C., Kelley, M. E., Schneider, R., Blastos, B., & Craighead, W. E. (2014). Enhancing Hispanic participation in mental health clinical research: Development of a Spanish-speaking depression research site. Depression and Anxiety, 31, 258-267.
Bagayogo, E. P., Interian, A., & Escobar, J. I. (2013). Transcultural aspects of somatic symptoms in the context of depressive disorders. Advances in Psychosomatic Medicine, 33, 64-74.
Bakhshaie, J., Hanna, A. E., Viana, A. G., Garza, M., Valdivieso, J., Ochoa-Perez, M., & Zvolensky, M. J. (2018). Acculturative stress and mental health among economically disadvantaged Spanish-speaking Latinos in primary care: The role of anxiety sensitivity. Psychiatry Research, 261, 421-427.
Ballenger, J. C., Davidson, J. R., Lecrubier, Y., Nutt, D. J., Kirmayer, L. J., Lépine, J. P., … Ono, Y. (2001). Consensus statement on transcultural issues in depression and anxiety from the International Consensus Group on Depression and Anxiety. Journal of Clinical Psychiatry, 62(Suppl 13), 47-55.
Barsky, A. J., Orav, E. J., & Bates, D. W. (2005). Somatization increases medical utilization and costs independent of psychiatric and medical comorbidity. Archives of General Psychiatry, 62, 903-910.
Bauer, A. M., Chen, C. N., & Alegría, M. (2012). Prevalence of physical symptoms and their association with race/ethnicity and acculturation in the United States. General Hospital Psychiatry, 34, 323-331.
Beck, A. T., Ward, C. H., Mendelson, M., Mock, J., & Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 561-571.
Bernstein, D. P., Ahluvalia, T., Pogge, D., & Handelsman, L. (1997). Validity of the childhood trauma questionnaire in an adolescent psychiatric population. Journal of the American Academy of Child & Adolescent Psychiatry, 36, 340-348.
Brown, C., Schulberg, H. C., & Madonia, M. J. (1996). Clinical presentations of major depression by African Americans and Whites in primary medical care practice. Journal of Affective Disorders, 41, 181-191.
Canino, G., Lewis-Fernandez, R., & Bravo, M. (1997). Methodological challenges in cross-cultural mental health research. Transcultural Psychiatry, 34, 163-184.
Canino, G. J., Bird, H. R., Shrout, P. E., Rubio-Stipec, M., Bravo, M., Martinez, R., … Guevara, L. M. (1987). The prevalence of specific psychiatric disorders in Puerto Rico. Archives of General Psychiatry, 44, 727-735.
Canino, I. A., Rubio-Stipek, M., Canino, G., & Escobar, J. I. (1992). Functional somatic symptoms: A cross-ethnic comparison. American Journal of Orthopsychiatry, 62, 605-612.
Cleary, P., & Guy, W. (1977). Factor analysis of the Hamilton depression scale. Drugs Under Experimental and Clinical Research, 1, 115-120.
Cuellar, I., Harris, L., & Jasso, R. (1980). An acculturation scale for Mexican American normal and clinical populations. Hispanic Journal of Behavioral Sciences, 2, 199-217.
Dawson, E., Crano, W., & Burgoon, M. (1996). Refining the meaning and measurement of acculturation: Revisiting a novel methodological approach. Intercultural Relations, 20, 97-114.
Delisle, V. C., Beck, A. T., Dobson, K. S., Dozois, D. J., & Thombs, B. D. (2012). Revisiting gender differences in somatic symptoms of depression: Much ado about nothing? PLoS One, 7(2), e32490.
Demyttenaere, K., Reed, C., Quail, D., Bauer, M., Dantchev, N., Montejo, A. L., … Grassi, L. (2010). Presence and predictors of pain in depression: Results from the FINDER study. Journal of Affective Disorders, 125, 53-60.
Dunlop, B. W., Binder, E. B., Cubells, J. F., Goodman, M. G., Kelley, M. E., Kinkead, B., … Mayberg, H. S. (2012). Predictors of remission in depression to individual and combined treatments (PReDICT): Study protocol for a randomized controlled trial. Trials, 13, 106.
Dunlop, B. W., Kelley, M. E., Aponte-Rivera, V., Kinkead, B., Mletzko-Crowe, T., Ritchie, J. C., … Mayberg, H. S. (2017). Effects of patient preferences on outcomes in the predictors of remission in depression to individual and combined treatments (PReDICT) study. American Journal of Psychiatry, 174, 546-556.
Durant, R. W., Davis, R. B., St, George, D. M., Williams, I. C., Blumenthal, C., & Corbie-Smith, G. M. (2007). Participation in research studies: Factors associated with failing to meet minority recruitment goals. Annals of Epidemiology, 17, 634-642.
Escobar, J. I., & Canino, G. (1989). Unexplained physical complaints. Psychopathology and epidemiological correlates. British Journal of Psychiatry. Supplement, 4, 24-27.
Fabrega, H., Jr, Mezzich, J., & Ulrich, R. F. (1988). Black-White differences in psychopathology in an urban psychiatric population. Comprehensive Psychiatry, 29, 285-297.
Ferrari, A. J., Somerville, A. J., Baxter, A. J., Norman, R., Patten, S. B., … Whiteford, H. A. (2013). Global variation in the prevalence and incidence of major depressive disorder: A systematic review of the epidemiological literatur. Psychological Medicine, 43, 471-481.
First, M. B., Spitzer, R. L., Gibbon, M., & Williams, J. B. (1995). Structured Clinical Interview for DSM-IV Axis I Disorders-Patient Edition (SCID-I/P, Version 2.0). New York: Biometrics Research Department, New York State Psychiatric Institute.
Fried, E. I., & Nesse, R. M. (2015). Depression is not a consistent syndrome: An investigation of unique symptom patterns in the STAR*D study. Journal of Affective Disorders, 172, 96-102.
García-Campayo, J., Ayuso-Mateos, J. L., Caballero, L., Romera, I., Aragonés, E., Rodríguez-Artalejo, F., … Gilaberte, I. (2008). Relationship of somatic symptoms with depression severity, quality of life, and health resources utilization in patients with major depressive disorder seeking primary health care in Spain. Primary Care Companion Journal of Clinical Psychiatry, 10, 355-362.
Hamilton, M. (1959). The assessment of anxiety states by rating. British Journal of Medical Psychology, 32, 50-55.
Hamilton, M. (1967). Development of a rating scale for primary depressive illness. British Journal of Social and Clinical Psychology, 6, 278-296.
Hankerson, S. H., Fenton, M. C., Geier, T. J., Keyes, K. M., Weissman, M. M., & Hasin, D. S. (2011). Racial differences in symptoms, comorbidity, and treatment for major depressive disorder among Black and White adults. Journal of the National Medical Association, 103, 576-584.
Hegeman, J. M., de Waal, M. W., Comijs, H. C., Kok, R. M., & van der Mast, R. C. (2015). Depression in later life: A more somatic presentation? Journal of Affective Disorders, 170, 196-202.
Hinton, D. E., Lewis-Fernández, R., & Pollack, M. H. (2009). A model of the generation of ataque de nervios: The role of fear of negative affect and fear of arousal symptoms. CNS Neuroscience and Therapeutics, 15, 264-275.
Hockenberry, J. M., Joski, P., Yarbrough, C., & Druss, B. G. (2019). Trends in treatment and spending for patients receiving outpatient treatment of depression in the United States, 1998-2015. JAMA Psychiatry, 76, 810. Epub ahead of print.
Husain, M. M., Rush, A. J., Trivedi, M. H., McClintock, S. M., Wisniewski, S. R., Davis, L., … Fava, M. (2007). Pain in depression: STAR*D study findings. Journal of Psychosomatic Resarch, 63, 113-122.
Kapfhammer, H. P. (2006). Somatic symptoms in depression. Dialogues in Clinical Psychiatry, 8, 227-239.
Kealy, D., Rice, S. M., Ogrodniczuk, J. S., & Spidel, A. (2018). Childhood trauma and somatic symptoms among psychiatric outpatients: Investigating the role of shame and guilt. Psychiatry Research, 268, 169-174.
Kessler, R. C., & Bromet, E. J. (2013). The epidemiology of depression across cultures. Annual Review of Public Health, 34, 119-138.
Kirmayer, L., & Sartorius, N. (2007). Cultural models and somatic syndromes. Psychosomatic Medicine, 69, 832-840.
Kirmayer, L. J. (2001). Cultural variations in the clinical presentation of depression and anxiety: Implications for diagnosis and treatment. Journal of Clinical Psychiatry, 62(Suppl 13), 22-28.
Kolody, B., Vega, W., Meinhardt, K., & Bensussen, G. (1986). The correspondence of health complaints and depressive symptoms among Anglos and Mexican-Americans. Journal of Nervous and Mental Disease, 174, 221-228.
Koneru, V. K., Weisman, A., Flynn, P. M., & Betancourt, H. (2007). Acculturation and mental health: Current findings and recommendations for future research. Applied and Preventive Psychology, 12, 76-96.
Koss, J. D. (1990). Somatization and somatic complaint syndromes among Hispanics: Overview and ethnopsychological perspectives. Transcultural Psychiatric Research Review, 27, 5-29.
Lau, A. S., Chang, D. F., & Okazaki, S. (2010). Methodological challenges in treatment outcome research with ethnic minorities. Cultural Diversity and Ethnic Minority Psychology, 16, 573-580.
Lessenger, L. (1997). Use of an acculturation rating scale for Mexican Americans-II with substance abuse patients. Hispanic Journal of Behavioral Sciences, 19, 387-398.
Maier, W., Buller, R., Philipp, M., & Heuser, I. (1988). The Hamilton anxiety scale: Reliability, validity, and sensitivity to change in anxiety and depressive disorders. Journal of Affective Disorders, 14, 61-68.
Mak, W. W., Law, R. W., Alvidrez, J., & Pérez-Stable, E. J. (2007). Gender and ethnic diversity in NIMH-funded clinical trials: Review of a decade of published research. Administration and Policy in Mental Health and Mental Health Services Research, 34, 497-503.
Mezzich, J. E., & Raab, E. S. (1980). Depressive symptomatology across the Americas. Archives of General Psychiatry, 37, 818-823.
Novick, D., Montgomery, W., Aguado, J., Kadziola, Z., Peng, X., Brugnoli, R., & Haro, J. M. (2013). Which somatic symptoms are associated with an unfavorable course in Asian patients with major depressive disorder? Journal of Affective Disorders, 149, 182-188.
Park, S., Hong, J. P., Bae, J. N., Cho, S. J., Lee, D. W., Lee, J. Y., … Cho, M. J. (2014). Impact of childhood exposure to psychological trauma on the risk of psychiatric disorders and somatic discomfort: Single versus multiple types of psychological trauma. Psychiatry Research, 219, 443-449.
Pina, A. A., & Silverman, W. K. (2004). Clinical phenomenology, somatic symptoms, and distress in Hispanic/Latino and European American youths with anxiety disorders. Journal of Clincal Child & Adolescent Psychology, 33, 227-236.
Ramos, B. M. (2005). Acculturation and depression among Puerto Ricans in the mainland. Social Work Research, 29, 95-105.
Rao, U., Poland, R. E., & Lin, K. M. (2012). Comparison of symptoms in African-American, Asian-American, Mexican-American, and Non-Hispanic White patients with major depressive disorder. Asian Journal of Psychiatry, 5, 28-33.
Ryder, A. G., Yang, J., Zhu, X., Yao, S., Yi, J., Heine, S. J., & Bagby, R. M. (2008). The cultural shaping of depression: Somatic symptoms in China, psychological symptoms in North America? Journal of Abnormal Psychology, 117, 300-313.
Schaakxs, R., Comijs, H. C., Lamers, F., Beekman, A. T., & Penninx, B. W. (2017). Age-related variability in the presentation of symptoms of major depressive disorder. Psychological Medicine, 47, 543-552.
Silverstein, B. (2002). Gender differences in the prevalence of somatic versus pure depression: A replication. American Journal of Psychiatry, 159, 1051-1052.
Simon, G. E., VonKorff, M., Piccinelli, M., Fullerton, C., & Ormel, J. (1999). An international study of the relation between somatic symptoms and depression. New England Journal of Medicine, 341, 1329-1335.
Spertus, I. L., Yehuda, R., Wong, C. M., Halligan, S., & Seremetis, S. V. (2003). Childhood emotional abuse and neglect as predictors of psychological and physical symptoms in women presenting to a primary care practice. Child Abuse & Neglect, 27, 1247-1258.
Suarez-Morales, L., Matthews, J., Martino, S., Ball, S. A., Rosa, C., Farentinos, C., … Carroll, K. M. (2007). Issues in designing and implementing a Spanish-language multi-site clinical trial. American Journal on Addictions, 16, 206-215.
Sumathipala, A., & Murray, J. (2000). New approach to translating instruments for cross-cultural research: A combined qualitative and quantitative approach for translation and consensus generation. International Journal of Methods in Psychiatric Research, 9, 87-95.
Tamayo, J. M., Román, K., Fumero, J. J., & Rivas, M. (2005). The level of recognition of physical symptoms in patients with a major depression episode in the outpatient psychiatric practice in Puerto Rico: An observational study. BMC Psychiatry, 5, 28.
Tylee, A., & Gandhi, P. (2005). The importance of somatic symptoms in depression in primary care. Journal of Clinical Psychiatry, 7, 167-176.
U.S. Census Bureau (2003). Language Use and English-Speaking Ability: 2000. Available at https://www.census.gov/library/publications/2003/dec/c2kbr-29.html
U.S. Census Bureau (2011). The Hispanic population 2010: 2010 census briefs. Available at http://www.census.gov/prod/cen2010/briefs/c2010br-04.pdf
Wallace, P. M., Pomery, E. A., Latimer, A. E., Martinez, J. L., & Salovey, P. (2010). A review of acculturation measures and their utility in studies promoting Latino health. Hispanic Journal of Behavioral Sciences, 32, 37-54.
Williams, J. B. (1989). A structured interview guide for the Hamilton depression rating scale. Archives of General Psychiatry, 45, 742-747. Spanish translation, Jan 2009, obtained from author.
Zijlema, W. L., Stolk, R. P., Löwe, B., Rief, W., BioSHaRE, White, P. D., & Rosmalen, J. G. (2013). How to assess common somatic symptoms in large-scale studies: A systematic review of questionnaires. Journal of Psychosomatic Research, 74, 459-468.