Characteristics of somatic symptoms among Chinese patients diagnosed with major depressive episode

Jian, Yaling; Jia, Shoumei; Shi, Zhongying; Zhao, Ying; Li, Ping; Chen, Li; Yang, Li

doi:10.1016/j.apnu.2020.11.001

Cited by 5 publications

(7 citation statements)

References 31 publications

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“…Patients regard these two symptoms as manifestations of heart disease, so they use more medical services (such as repeating visits to a cardiology department or conducting various cardiac examinations) and avoid daily activities, which will cause patients' health anxiety – that is, causing them to pay too much attention to physical symptoms and promoting the emergence of other symptoms ( 32 ). In clinical practice, more attention should be focused on palpitations and chest tightness in patients with depressive disorder, and efforts increased toward early identification and targeted model management to ensure improvement in the somatic symptoms and treatment outcomes ( 7 , 32 ).…”

Section: Discussionmentioning

confidence: 99%

“…According to a multicenter international study, ~66% of patients with depressive disorders were initially afflicted by somatic symptoms ( 6 ). In Western countries, the occurrence of somatic symptoms in patients with depression typically falls within the range of 66–93% ( 7 ). In China, patients with depressive disorder focus more on their somatic symptoms while ignoring shifts in emotion and frequently seek help outside of psychiatric contexts, which often leads to a higher prevalence of complaints regarding somatic symptoms, reported at 98.2% in general hospitals ( 7 ).…”

Section: Introductionmentioning

confidence: 99%

“…In Western countries, the occurrence of somatic symptoms in patients with depression typically falls within the range of 66–93% ( 7 ). In China, patients with depressive disorder focus more on their somatic symptoms while ignoring shifts in emotion and frequently seek help outside of psychiatric contexts, which often leads to a higher prevalence of complaints regarding somatic symptoms, reported at 98.2% in general hospitals ( 7 ). Previous research has shown that somatic symptoms in patients with depression might indicate increased severity, worsening prognosis, worsening treatment response, chronicity, and delayed remission ( 8 ).…”

Section: Introductionmentioning

confidence: 99%

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Network analysis of somatic symptoms in Chinese patients with depressive disorder

Jia

Cao

et al. 2023

Front. Public Health

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IntroductionNetwork theory conceptualizes somatic symptoms as a network of individual symptoms that are interconnected and influenced by each other. In this conceptualization, the network's central symptoms have the strongest effect on other symptoms. Clinical symptoms of patients with depressive disorders are largely determined by their sociocultural context. To our knowledge, no previous study has investigated the network structure of somatic symptoms among Chinese patients with depressive disorders. The aim of this study was to characterize the somatic symptoms network structure in patients with depressive disorders in Shanghai, China.MethodA total of 177 participants were recruited between October 2018 and June 2019. The Chinese version of the Patient Health Questionnaire-15 was used to assess somatic symptoms. In order to quantify the somatic symptom network structure, indicators of “closeness,” “strength,” and “betweenness” were employed as identifiers for network-central symptoms.ResultThe symptoms of “feeling your heart pound or race,” “shortness of breath,” and “back pain” had the highest centrality values, indicating that these symptoms were central to the somatic symptom networks. Feeling tired or mentally ill had the strongest positive correlation with insomnia or other sleep problems (r = 0.419), followed by chest pain and breathlessness (r = 0.334), back pain, and limb or joint pain (r = 0.318).DiscussionPsychological and neurobiological research that offers insights into somatic symptoms may focus on these central symptoms as targets for treatment and future research.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Network analysis of somatic symptoms in Chinese patients with depressive disorder

Jia

Cao

et al. 2023

Front. Public Health

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“…In Western countries, the prevalence of somatic symptoms in patients with depression reportedly ranges from 66% to 93% (Bekhuis et al, 2015;Caballero et al, 2008;Perugi et al, 2011;Vaccarino et al, 2008). According to a data analysis in China, 98.2% of depressed patients in general hospitals presented with somatic symptoms (Jian et al, 2021). It is common in patients with depressive disorder to display symptoms such as fatigue, lack of energy, and painful physical symptoms such as headaches and back pain (Kessler & Bromet, 2013).…”

Section: Introductionmentioning

confidence: 99%

“…Although improvement of somatic symptoms is correlated with that of depression (Jian et al, 2021), somatic symptoms are more difficult to treat than emotional symptoms and may worsen the treatment response (McIntyre et al, 2006). First, somatic symptoms may confound or mask the diagnosis of depression (Greden, 2003).…”

Section: Introductionmentioning

confidence: 99%

Experiences and coping strategies of somatic symptoms in patients with depressive disorder: A qualitative study

Chen

Jia

et al. 2022

Archives of Psychiatric Nursing

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Background: Depressive disorder is the most prevalent mental illness and is characterised by the presence of mental and somatic symptoms, with the latter affecting 65.0% to 98.2% of patients with their general function and quality of life. Purpose: The purpose of this study aimed to explore the experiences and coping strategies of somatic symptoms in Chinese patients with depressive disorder, and to gain new insight into the illness and the health care provided to patients. Methods: Semi-structured, in-depth interviews were conducted with 15 patients diagnosed with depressive disorder according to international classification of diseases 10th revision. The interviews were transcribed verbatim and the thematic analysis was adapted to the data. MAXQDA10 software was used to organise, encode, classify, induce, and extract themes. Results: Four major themes were extracted from the interviews: (1) descriptions of symptoms; (2) perceptions of the symptoms; (3) symptom disturbance; and (4) coping strategies of symptoms. Within the first theme, patients identified the following sub-themes: complex experiences of somatic symptoms, which were mainly in the neuromuscular system, circulatory respiratory system, gastrointestinal system and some symptoms without obvious systemic classification; difficulty in locating symptoms accurately; and being not consistent with examination results. The second theme included patient's inadequate understanding of somatic symptoms; and denial of the link between physical discomfort and depression. Disturbance of somatic symptoms embraced three sub-themes: (1) Uncertainty about somatic symptoms; (2) Struggling with daily life; (3) Impact on social activities; (4) feeling a decrease in family support. Lastly, coping strategies taken by patients in the face of various symptoms mainly included relying on drug treatment, avoiding stressors, diverting attention, and compromise or acceptance. Conclusions: Patients with depressive disorder experience a variety of somatic symptoms that have a negative impact on social function and reduce their quality of life. Patients did not have an adequate understanding of their physical discomfort and lacked effective coping strategies for these somatic symptoms. Professional staff should pay more attention to patients' somatic symptoms and focus on targeted symptom management to facilitate patient recovery.

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The state of mental health care in China

Gahr

Xiang

et al. 2022

Asian Journal of Psychiatry

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Characteristics of somatic symptoms among Chinese patients diagnosed with major depressive episode

Cited by 5 publications

References 31 publications

Network analysis of somatic symptoms in Chinese patients with depressive disorder

Network analysis of somatic symptoms in Chinese patients with depressive disorder

Experiences and coping strategies of somatic symptoms in patients with depressive disorder: A qualitative study

The state of mental health care in China

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