Somatic Enzalutamide nmr symptoms of depressive disorders in inpatient care and primary care In a clinical study, Hamilton reported that

somatic symptoms prevailed in a great majority of depressed patients.12 Somatic symptoms, particularly somatic anxiety and fatigue, were documented in up to 80% of a sample of 260 women and 239 men suffering from major depression. These somatic symptoms very frequently had an underlying psychopathologically relevant hypochondriasis, both in women and men. This study confirmed earlier studies showing that depressive disorders with predominantly somatic presentation were likely Inhibitors,research,lifescience,medical to be the most common form of depression, both in inpatient and outpatient care.13,14 Hagnell and Rorsman stressed the Indicative significance of somatic symptoms in depressed primary care patients regarding their risk of suicide.15 Epidemiological studies designed to establish prevalence figures for depressive disorders Inhibitors,research,lifescience,medical In primary care during recent years have uniformly demonstrated

that depressive disorders are highly prevalent at this level of medical care.16-19 For the great majority of depressed patients seeking professional help in the official health care system, general practitioners and internists are the decisive interface for diagnosis and treatment of depression.20 Primary-care patients with depression very Inhibitors,research,lifescience,medical Inhibitors,research,lifescience,medical often present with somatic complaints. This seems to be more the rule than the exception

worldwide.21,22 Two of the three most common symptoms reported during a current depressive episode were somatic (tlred/no energy/listless: 73%, broken sleep/decreased sleep: 63%) as shown by the European Study Society study (DEPRES II).23 This study, however, also underlined that 65% of the depressed primary Inhibitors,research,lifescience,medical care patients suffered from a concomitant medical condition pointing to some likely difficulties In differential diagnosis. The multlcenter International study (n =1146) conducted by the World Health Organization (WHO) confirmed that two thirds of the patients presented their depressive mood with somatic symptoms exclusively, and more than half complained of multiple medically unexplained somatic symptoms.24 In another primary care study, Kirmayer et al arrived at a similar finding of patients presenting their depressive or anxiety Parvulin disorders exclusively with somatic symptoms in an overwhelming majority (73%). The identified somatic symptoms were the main reason for the initial visit to the primary care physician.25 In a US study in 573 patients with the diagnosis of major depression, two thirds (69%) complained of general aches and pains, hinting at a close relationship between pain symptoms and depression.26 The diagnostic situation In primary care frequently manifests Itself, however, as somewhat more complicated.