ABSTRACT Objective: Treatment of psychiatric patients with psychosomatic or somatic symptoms needs special attention. Methods: We examined correlates, change and recovery from depression among psychiatric patients (n = 150) during the assessment of their work ability. Patients were referred to an open psychiatric ward during 8/2004-9/2005. Psychiatric diseases were diagnosed with the ICD-10 by the psychiatrist, but also the Structured Clinical Interview for DSM-IV (SCID I and II) was conducted. The patients replied to questionnaires after admission and before discharge including questions on life changes, somatic health, psychosocial and health-related factors as well as psychometric scales for depression (BDI), life satisfaction (LS) and general psychopathology (SCL). RESULTS. At baseline, 75% of the patients reported clinically significant depression (BDI > 15) and a quarter of them experienced their depression as severe (BDI ≥ 30). Whereas, according to ICD-10 guidelines, 91% of the patients suffered from depressive disorder and 66% of them from major depression. The average duration of inpatient evaluation was 24 (SD 9, 4) days. Baseline poor general health, life dissatisfaction, psychosomatic symptoms, bodily pains as well as poor financial situation and adverse life events predicted prevailing depression at discharge. Clinical symptoms improved significantly, especially among younger patients, recovery could not be reached by the time of discharge. Conclusions: Psychiatric patients with somatic complaints tended to under-rate their depression. To enhance their recovery, long-term and individually planned out-patient treatment and surveillance are needed.
Cite this paper
Kokkonen, M. , Salke, K. , Saharinen, T. , Haatainen, K. and Koivumaa-Honkanen, H. (2012) The need for long-term surveillance of recovery of psychiatric patients with somatic complaints. Open Journal of Psychiatry, 2, 157-163. doi: 10.4236/ojpsych.2012.22021.
 Balon, R. (2006) Mood, anxiety and physical illness: Body and mind, or mind and body? Depression and Anxiety, 23, 377-387. doi:10.1002/da.20217
 Halaris, A. (2009) Comorbidity between depression and cardiovascular disease. International Angiology, 28, 92-99.
 Frasure-Smith, N. and Lespérance, F. (2006) Recent evidence linking coronary heart disease and depression. The Canadian Journal of Psychiatry, 51, 730-737.
 Engum, A. (2007) The role of depression and anxiety in onset of diabetes in a large population-based study. Journal of Psychosomatic Research, 62, 31-38.
 Wilson, D. and Warise, L. (2008) Cytokines and their role in depression. Perspectives in Psychiatric Care, 44, 285-289. doi:10.1111/j.1744-6163.2008.00188.x
 Zhang, J., Ye, M., Huang, H., Li, L. and Yang, A. (2008) Depression of chronic medical inpatients in China. Archives of Psychiatric Nursing, 22, 39-49.
 Viinamaki, H., Heiskanen, T., Lehto, S., Niskanen, L., Koivumaa-Honkanen, H., Tolmunen, T., Honkalampi, K., Saharinen, T., Haatainen, K. and Hintikka, J. (2009) Association of depressive symptoms and metabolic syndrome in men. Acta Psychiatrica Scandinavica, 120, 23-29. doi:10.1111/j.1600-0447.2008.01333.x
 Alvarenga, M.E., Caniato, R.N., Mauritz, A., Braun, A., Aljeesh, Y. and Braune, B. (2008) Health service utilization in patients with major depression and co-morbid pain. Psychiatry and Clinical Neurosciences, 63, 101-106.
 Lewandowski, W. (2004) Psychological Factors in chronic pain: A worthwhile undertaking for nursing. Archives of Psychiatric Nursing, 18, 97-105.
 Pincus, T., Burton, A.K., Vogel, S. and Field, A. (2002) Systematic review of psychological factors as predictors of chronicity/disability in prospective cohorts of low back pain. Spine, 27, E109-E120.
 Mok, L.C. and Lee, I.F.-K. (2008) Anxiety, depression and pain intensity in patients with low back pain who are admitted to acute care hospitals. Journal of Clinical Nursing, 17, 1471-1480.
 Bair, M.J., Robinson, R.L., Katon, W. and Kroenke, K. (2003) Depression and pain comorbidity. Archives of Internal Medicine, 163, 2433-2445.
 Moussavi, S., Chatterji, S., Verdes, E., Tandon, A., Patel, V. and Ustun, B. (2007) Depression, chronic diseases, and decrements in health: results from the World Health Surveys. The Lancet, 370, 851-858.
 Sinikallio, S., Aalto, T., Airaksinen, O., Herno, A., Kroger, H, Savolainen, S., Turunen, V. and Viinamaki, H. (2006) Depression and associated factors in patients with lumbar spinal stenosis. Disability & Rehabilitation, 28, 415-422. doi:10.1080/09638280500192462
 Sinikallio, S., Aalto, T., Airaksinen, O., Herno, A., Kroger, H. and Viinamaki, H. (2009) Depressive burden in the preoperative and early recovery phase predicts poorer surgery outcome among lumbar spinal stenosis patients: A one-year prospective follow-up study. Spine, 34, 2573-2578. doi:10.1097/BRS.0b013e3181b317bd
 Romanov, K., Varjonen, J., Kaprio, J. and Koskenvuo, M. (2003) Life events and depressiveness—The effect of adjustment for psychosocial factors, somatic health and genetic liability. Acta Psychiatrica Scandinavica, 107, 25-33. doi:10.1034/j.1600-0447.2003.01419.x
 Aro, R., Nyberg, N., Absetz, P., Henriksson, M. and Lonnqvist, J. (2001) Depressive symptoms in middle-aged women are more strongly associated with physical health and social support than socioeconomic factors. Nordic Journal of Psychiatry, 55, 191-198.
 Chong, J., Reinschmidt, K.M. and Moreno, F.A. (2010) Symptoms of depression in a Hispanic primary care population with and without chronic medical illnesses. The Primary Care Companion to the Journal of Clinical Psychiatry, 12, e1-e9.
 Escobar, J.I., Interian, A., Diaz-Martinez, A. and Gara, M. (2006) Idiopathic physical symptoms: A common manifestation of psychiatric disorders in primary care. The International Journal of Neuropsychiatric Medicine, 11, 201-210.
 Antikainen, R. and Hintikka, J. (1996) Somatic comorbidity in personality disorder inpatients. Effect on treatment outcome in a 3-year follow-up study. Nordic Journal of Psychiatry, 50, 469-476.
 Viinamaki, H., Hintikka, J., Haatainen, K., Antikainen, R., Honkalampi, K., Haatainen, K., Koivumaa-Honkanen, H., Saarinen, P. and Lehtonen, J. (2000) Effect of somatic comorbidity on alleviation of depressive symptoms. The Australian and New Zealand Journal of Psychiatry, 34, 755-761.
 Beck, A., Ward, C., Mendelson, M., Mock, J. and Erbaugh, J. (1961) An inventory for measuring depression. Archives of General Psychiatry, 4, 561-571.
 Viinamaki, H., Tanskanen, A., Honkalampi, K., Koivumaa-Honkanen, H., Haatainen, K., Kaustio, O. and Hintikka, J. (2004) Is the beck depression inventory suitable for screening major depression in different phases of the disease? Nordic Journal of Psychiatry, 58, 49-53.
 Allardt, E. (1973) About dimensions of welfare: Explanatory analysis of the comparative Scandinavian survey. Research Group of Comparative Sociology. Research Reports, University of Helsinki, Helsinki.
 Koivumaa-Honkanen, H., Honkanen, R., Viinamaki, H., Heikkila, K., Kaprio, J. and Koskenvuo, M. (2000) Selfreported life satisfaction and 20-year mortality in healthy Finnish adults. American Journal of Epidemiology, 152, 983-991. doi:10.1093/aje/152.10.983
 Koivumaa-Honkanen, H. (1998) Life satisfaction as a health predictor. Kuopio University Printing Office, Kuopio.
 Koivumaa-Honkanen, H., Kaprio, J., Honkanen, R., Viinamaki, H. and Koskenvuo, M. (2004) Life satisfaction and depression in a 15-year follow-up. Social Psychiatry and Psychiatric Epidemiology, 39, 994-999.
 Koivumaa-Honkanen, H., Huovinen, T.K., Honkalampi, K., Antikainen, R., Hintikka, J., Haatainen, K. and Viinamaki, H. (2008) Mental health and well-being in a 6-year follow-up of patients with depression: assessments of patients and clinicians. Social Psychiatry and Psychiatric Epidemiology, 43, 688-696.
 Derogatis, L.R. and Cleary, P.A. (1977) Confirmation of the dimensional structure of the SCL-90: Study in construct validation. Journal of Clinical Psychology, 33, 981-989.
 World Health Organization (1992) International statistical classification of diseases and related health problems (ICD-10). World Health Organization, Geneva.
 First, M.B., Spitzer, R.L., Gibbon, M. and Williams, J.B.W. (1997) User’s guide for the structured clinical interview for DSM-IV Axis I disorders (SCID-I)—Clinician Version. American Psychiatric Press, Washington DC.
 First, M.B., Gibbon, M., Spitzer, R.L. and Williams, J.B.W. (1997) Structured clinical interview for DSM-IV Axis II personality disorders (SCID-II). American Psychiatric Press, Washington DC.
 Viinamaki, V., Hintikka, J., Tanskanen, A., Honkalampi, K., Antikainen, R., Koivumaa-Honkanen, H., Haatainen, K., Saarinen, P. and Lehtonen, J. (2002) Partial remission in major depression: A two-phase, 12-month prospective study. Nordic Journal of Psychiatry, 56, 33-37.
 Givens, J.L., Katz, I.R., Bellamy, S. and Holmes, W.C. (2007) Stigma and the acceptability of depression treatments among african americans and whites. Journal of General Internal Medicine, 22, 1292-1297.
 Viinamaki, H., Haatainen, K., Honkalampi, K., Tanskanen, A., Koivumaa-Honkanen, H., Antikainen, R., Valkonen-Korhonen, M. and Hintikka, J. (2006) Which factors are important predictors of non-recovery from major depression? A 2-year prospective observational study. Nordic Journal of Psychiatry, 60, 410-416.
 Honkalampi, K., Hintikka, J., Haatainen, K., Koivumaa-Honkanen, H., Tanskanen, A. and Viinamaki, H. (2005) Adverse childhood experiences, stressful life events or demographic factors: Which are important in women’s depression? A 2-year follow-up population study. Australian and New Zealand Journal of Psychiatry, 39, 627-632. doi:10.1080/j.1440-1614.2005.01636.x