Analysis of the Somatic Component of Depression in the Development of a Physical Therapy Program

Abstract

Depressive disorders occupy a leading position among mental disorders in Ukrainians. The work of a physical therapist with patients with recurrent depressive disorder has its characteristics, which arise in connection with the somatic component in the clinical picture.
 The study aimed to analyze the polymorphism of complaints of patients with recurrent depressive disorder and to determine the correlation between them and the degree of the depressive disorder according to the results of the Patient Health Questionnaire - 9 (PHQ-9). The age of the patients was 45.37±12.01 years (min – 23 years; max – 69 years). The results showed that the most common complaints were: low mood (85.1%), headache (47.8%), apathy and insomnia (38.8%), changes in body weight (37.3%), loss of appetite and increased irritability (34.3%). The wide variety of complaints in the group of patients with recurrent depressive disorder is a confirmation of the work of scientists who claim that the most important diagnostic sign of a mental disorder is the phenomenon of "multiple somatic symptoms". This set of complaints required a more detailed study of their relationship. In fact, the determination of the correlation relationship by calculating Spearman's rank correlation coefficient revealed positive and negative relationships of different strengths. According to our study, a strong positive relationship was identified between impaired sexual function and loss of appetite (r = 0.72), a significant direct correlation was found between complaints such as decreased mood and loss of appetite (r = 0.52); between impaired sexual function, low mood (r = 0.53), fear of the evening (r = 0.5) and dizziness (r = 0.61).
 A strong negative correlation was observed between dizziness and loss of appetite (r= - 0.86). A significant inverse correlation was found between changes in body weight and low mood (r = - 0.53); between sensations of pain in the stomach and headache (r = - 0.64); between disorders of sexual function and changes in body weight (r = - 0.65), sensations of pain in the stomach (r = - 0.62); between tearfulness and apathy (r = - 0.5). Actually, a relationship with weak strength was noted between other complaints.
 While determining the degree of depressive disorder based on the results of the PHQ-9 survey, we found that a third of the respondents (34.4%) had a mild depressive disorder, a quarter (23.9%) had moderate depressive symptoms, and 14.9% of respondents had severe depressive disorders. When Although some correlation was found, no direct relationship was identified between the severity of depression and complaints during the calculation of the relationship between the degree of depressive disorder and existing complaints.
 According to the results of the PHQ-9, mild depressive disorder has a negative relationship with the change in body weight. Moderate depressive disorder is strongly correlated with loss of appetite. Severe depression disorder has a strong negative relationship with increased irritability and a significant negative relationship with headache. Therefore, further studies with larger cohorts of patients are needed to better understand this aspect of depression.
 To conclude, the data obtained would be important for physical therapists and other members of the multidisciplinary rehabilitation team, as the results indicated that patients with depression had multiple somatic symptoms that were not always associated with the health condition and the degree of depressive disorder.