Somatic symptoms of depression in elderly patients with medical comorbidities

Drayer, Rebecca A.; Mulsant, Benoit H.; Lenze, Eric J.; Rollman, Bruce L.; Dew, Mary Amanda; Kelleher, Kelly J.; Karp, Jordan F.; Begley, Amy; Schulberg, Herbert C.; Reynolds, Charles F.

doi:10.1002/gps.1389

Cited by 132 publications

(99 citation statements)

References 52 publications

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“…The common complaint of physical symptoms, rather than psychiatric symptoms-or somatization-also precludes the diagnosis in the elderly. In a study of psychiatric patients aged ≥60 years, psychological symptoms of depression were independent predictors of somatization, but not medical comorbidities (Drayer et al, 2005). As a result of psychological distress, patients can magnify the perception of somatic symptoms-or "somatosensory amplification"-further increasing patients' focus on somatic complaints (Ellison, et al, 2008).…”

Section: Characteristics and Diagnosismentioning

confidence: 99%

Nutritional predictors of depression in a cohort of community-dwelling elderly Canadians: NuAge cohort

GougeonLaura¹

2014

Appl. Physiol. Nutr. Metab.

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Depression is associated with decreased quality of life and high mortality risk at all ages and, despite having lower prevalence in community-dwelling seniors compared to other stages of the life span or institutionalized elderly, it negatively affects seniors' health outcomes. Most evidence linking late-life depression, defined as first onset after 65 years of age, with dietary factors comes from cross-sectional studies, which cannot provide information on whether declines in diet were a consequence of depression-the reverse causality hypothesis. The Quebec Longitudinal Study on Nutrition and Aging (NuAge) provides an ideal setting to explore such a relationship among a healthy, community-dwelling elderly population. Diet is hypothesized to be a factor associated with depression. Some longitudinal evidence from studies with middle-aged adults suggests that dietary patterns such as the Mediterranean or patterns deemed "healthy" are protective against depression, while "western" and "unhealthy" patterns are risk factors for the disease. B-vitamins are important cofactors in neurotransmitter synthesis and in the enzymes of the one-carbon metabolism, which has been hypothesized to have an aetiological role in depression through its neurotoxic derivates, such as homocysteine. Nonetheless, it is still largely unknown how depression affects nutrient intake in the elderly population, raising the question of the directionality of the association. Therefore, ii the three objectives of this thesis were to explore the longitudinal associations of i) dietary patterns and macronutrient intake and of ii) B6, B12 and folate intakes with the incidence of depression in late life; and iii) to investigate whether depression significantly affects short-term nutrient intakes (reverse causality effect) in comparison to intakes among non-depressed seniors.Data for this study have been obtained from the NuAge cohort, a 4-y longitudinal study of 1,793 community-dwelling men and women aged 68 to 82 years at baseline. The main outcome is incidence of depression as defined by scores in the 30-item Geriatric Depression Scale ≥11 and or antidepressant medication use over the three years of follow-up. Participants were free of depression at the study's baseline through the exclusion of those with GDS scores ≥11 or antidepressant use at the time of the recruitment. Individuals with invalid or missing dietary information were also excluded. Dietary patterns were created through principal component analysis on amount (grams) of food items consumed in each of the 32 predefined food categories. Sex-specific tertiles of intake were created from the mean of three non-consecutive 24h-recalls. Multiple logistic regression models were adjusted for several demographic, health, and social confounders. For the study of the reverse causality hypothesis, we conducted a case-control nested within the NuAge cohort. Participants free of iii depression at baseline who developed depression at some point of follow-up were matched by age group and sex with...

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Section: Characteristics and Diagnosismentioning

confidence: 99%

Nutritional predictors of depression in a cohort of community-dwelling elderly Canadians: NuAge cohort

GougeonLaura¹

2014

Appl. Physiol. Nutr. Metab.

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“…[1][2][3] Although depression represents the third most common reason for consultation, the diagnosis is frequently missed in primary care settings, [4][5][6][7] largely because patients often present with somatic symptoms [8][9][10] and do not consider themselves to have a mental illness. 11 In an attempt to address this, the routine screening of patients with diabetes and coronary heart disease for concurrent depression has been widely advocated 12,13 and has now been introduced into the UK general practice contract.…”

Section: Introductionmentioning

confidence: 99%

Screening older people with musculoskeletal pain for depressive symptoms in primary care

Mallen

Peat²

2008

Br J Gen Pract

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“…Large heterogeneity has been reported in a previous review [41], between 3.1% and 26.9%. Among factors the variability or possible underestimation of prevalence rates of depression may be associated with the fact that depressive symptoms in older adults may often manifest through somatic symptoms and may be confused with these symptoms [50]. Furthermore, the consequences of symptoms may not affect the daily life of elderly people as much as they affect younger age groups [51].…”

Section: Discussionmentioning

confidence: 99%