Hostname: page-component-cd9895bd7-gvvz8 Total loading time: 0 Render date: 2024-12-24T13:23:01.109Z Has data issue: false hasContentIssue false
  • English
  • Français

Identificación de los síntomas somáticos y de ansiedad que contribuyen a la detección de la depresión en la atención primaria

Published online by Cambridge University Press:  12 May 2020

Katrin Barkowa ,
T. Reinhard Heuna ,
T. Bedirhan Üstÿnb ,
Mathias Berger ,
Isaac Bermejo ,
Wolfgang Gaebeld ,
Martin Hárter ,
Frank Schneider ,
Rolf-Dieter Stieglitz  and
Wolfgang Maier
Katrin Barkowa
Affiliation:
Departamento de Psiquiatría, Universidad de Bonn, Sigmund-Freud-Strasse 25, 53105Bonn, Alemania
T. Reinhard Heuna
Affiliation:
Departamento de Psiquiatría, Universidad de Bonn, Sigmund-Freud-Strasse 25, 53105Bonn, Alemania
T. Bedirhan Üstÿnb
Affiliation:
Organización Mundial de la Salud, Ginebra, Suiza
Mathias Berger
Affiliation:
Departamento de Psiquiatría, Universidad de Friburgo, Alemania
Isaac Bermejo
Affiliation:
Departamento de Psiquiatría, Universidad de Friburgo, Alemania
Wolfgang Gaebeld
Affiliation:
Departamento de Psiquiatría, Universidad de Düsseldorf, Alemania
Martin Hárter
Affiliation:
Departamento de Psiquiatría, Universidad de Friburgo, Alemania
Frank Schneider
Affiliation:
Departamento de Psiquiatría, Universidad de Düsseldorf, Alemania Departamento de Psiquiatría y Psicoterapia, Hospital Universitario, Aquisgrán, Alemania
Rolf-Dieter Stieglitz
Affiliation:
Departamento Ambulatorio Psiquiátrico Universitario, Universidad de Basilea, Suiza
Wolfgang Maier
Affiliation:
Departamento de Psiquiatría, Universidad de Bonn, Sigmund-Freud-Strasse 25, 53105Bonn, Alemania
Get access

Resumen

A menudo, se hace caso omiso de los smtomas somáticos y los síntomas de ansiedad en la detección de la depresión en atencion primaria. La presente investigacion examinó en qué medida los síntomas somáticos y de ansiedad registrados en la Entrevista Diagnostica Internacional Compuesta-Version de Atención Primaria (CIDI-PHC) pueden mejorar la detección de la depresión comparado con el Cuestionario de Salud General, versión de 12 elementos, solo. Se utilizaron datos del estudio de la Organización Mundial de la Salud sobre Problemas Psicológicos en Atención Sanitaria General. La muestra de estudio constaba de las personas que acudieron a los servicios de atención primaria de 15 centros de todo el mundo y se sometieron a un examen psiquiátrico con la CIDI-PHC. Los smtomas somáticos sin explicación médica (dolor de espalda, sensaciones de pesadez/ligereza en partes del cuerpo, períodos de debilidad corporal, crisis/convulsiones, cansancio permanente, agotamiento después de un esfuerzo mínimo) y -en menor medidasíntomas de ansiedad diversos (p. ej., sentimientos de ansiedad/nerviosismo, sentimientos de tensión, dificultades para relajarse) contribuyeron significativamente a la detección de la depresión en un análisis de regresión logística. Los resultados confirman la observación de que, en la atención primaria, los síntomas somáticos desempefian un papel importante en la manifestacion de los trastornos depresivos. Los elementos investigados aquí podrían resultar beneficiosos para que futuros instrumentos de deteccion selectiva de la depresivos en la atención primaria.

Keywords

DepresiónAtención primariaDetecciónInstrumentos de detección selectivaSomatizaciónAnsiedad
Type
Artículo original
Information
European Psychiatry (Ed. Española) , Volume 11 , Issue 8 , November 2004 , pp. 514 - 521
Copyright
Copyright © European Psychiatric Association 2000

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bibliografía

Andrews, G, Peters, L.The psychometrie properties of the Composite International Diagnostic Interview. Soc Psychiatry Psychiatr Epidemiology 1998;33:80–88.CrossRefGoogle Scholar
Aneshensel, CS, Frerichs, RR, Haba, GJ.Depression and physical illness: a multiwave, nonrecursive causal model. J Health Soc Behav 1984;25:350–371.CrossRefGoogle ScholarPubMed
Angst, J.Major depression in 1998: are we providing optimal therapy? J Clin Psychiatry 1999;60(Suppl 6):5–9.Google ScholarPubMed
American Psychiatric Association (APA). Diagnostic and statistical manual of mental disorders. 4th ed. (DSM-IV). Washington (DC): APA; 1994.Google Scholar
Barsky, AJ, Borus, JB.Somatization and rnedicalization in the era of managed care. JAMA 1995;274:1931–1934.CrossRefGoogle Scholar
Burnam, MA, Wells, KB, Leake, B, Landsverk, J.Development of a brief screening instrument for detecting depressive disorders. Med Care 1988;26:775–789.CrossRefGoogle ScholarPubMed
Cadoret, RJ, Widmer, RB, North, C.Depression in family practice: Long term prognosis and somatic complaints. J Fam Pract 1980;10:625–629.Google ScholarPubMed
Cadoret, RJ, Widmer, RB, Troughton, EP.Somatic complaints— harbinger of depression in primary care. J Affect Disord 1980;2:61–70.CrossRefGoogle ScholarPubMed
Cheung, FM, Lau, BW, Waldmann, E.Somatization among Chínese depressives in general practice. Int J Psychiatry Med 1980-81;10:361–74.CrossRefGoogle Scholar
Coyne, JC, Fechner-Bates, S, Schwenk, TL.Prevalence, nature, and comorbidity of depressive symptoms in primary care. Gen Hosp Psychiatry 1994;16:267–276.CrossRefGoogle ScholarPubMed
Diamond, EL, Gage, L, Epting, R.Symptoms associated with the diagnosis and treatment of depression in family practice. Fam Pract Res J 1987;6:206–214.Google ScholarPubMed
División of Mental Health. CIDI-Core. Composite International Diagnostic Interview, Core Versión 1.0—November 1990. Geneva: WHO; 1990.Google Scholar
Fishbain, DA, Cutler, R, Rosomoff, HL, Rosomoff, RS.Chronic pain-associated depression: antecedent or consequence of chronic pain? A review. Clin J Pain 1997;13:116–137.CrossRefGoogle ScholarPubMed
Geerlings, SW, Beekman, ATF, Deeg, DJH, van Tilburg, W.Physical health and the onset and persistence of depression in older adults: an eight-wave prospective community-based study. Psychol Med 2000;30:369–380.CrossRefGoogle Scholar
Gerber, PD, Barrett, JE, Barrett, JA, Oxman, TE, Manheimer, E, Smith, R, et al.The relationship of presenting physical complaints to depressive symptoms in primary care patients. J Gen Intern Med 1992;7:170–173.CrossRefGoogle ScholarPubMed
Goldberg, D.Epidemiology of mental disorders in primary care settings. Epidemiol Rev 1995;7:182–190.CrossRefGoogle Scholar
Goldberg, DP, Williams, P.A users guide to the General Health Questionnaire: GHQ. Windsor: NFER-NELSON; 1988.Google Scholar
Goldman, LS, Nielsen, NH, Champion, HC.Awareness, diagnosis, and treatment of depression. J Gen Intern Med 1999;14:569–580.CrossRefGoogle ScholarPubMed
Henkel, V, Mergl, R, Kohnen, R, Maier, W, Moller, H-J, Hegerl, U.Identifying depression in primary care: a comparison of different methods in a prospective cohort study. BMJ 2003;326:200–201.CrossRefGoogle ScholarPubMed
Herrman, H, Patrick, DL, Diehr, P, Martin, ML, Fleck, M, Simón, GE, et al.Longitudinal investigation of depression outcomes in primary care in six countries: the LIDO Study. Functional status, health Service use and treatment of people with depressive symptoms. Psychol Med 2002;32:889–902.CrossRefGoogle ScholarPubMed
Hickie, I, Hadzi-Pavlovic, D, Scott, E, Davenport, T, Koschera, A, Naismith, S.SPHERE: a national depression project. Australas Psychiatry 1998;6:248–250.CrossRefGoogle Scholar
Hirschfeld, RM, Keller, MB, Pánico, S, Arons, BS, Barlow, D, Davi-doff, F, et al.The National Depressive and Manic-Depressive Association consensus statement on the undertreatment of depression. JAMA 1997;277:333–340.CrossRefGoogle ScholarPubMed
Hurwitz, EL, Morgenstern, H.Cross-sectional association of asthma, hay fever, and other allergies with major depression and low-back pain among adults aged 20-39 years in the United States. Am J Epidemiol 1999;150:1107–16.CrossRefGoogle ScholarPubMed
Janea, A, Robins, LN, Cottler, LB, Early, TS.Clinical observation of assessment using the Composite International Diagnostic Interview (CIDI): an analysis of the CIDI field triáis–wave II at the St Louis site. Br J Psychiatry 1992;160:815–818.Google Scholar
Katon, W.The epidemiology of depression in medical care. Int J Psychiatry Med 1987;17:93–112.CrossRefGoogle ScholarPubMed
Katon, W, Russo, J.Somatic symptoms and depression. J Fam Pract 1989;29:65–69.Google ScholarPubMed
Katon, W, Schulberg, H.Epidemiology of depression in primary care. Gen Hosp Psychiatry 1992;14:237–247.CrossRefGoogle ScholarPubMed
Kroenke, K, Jackson, JL, Chamberlin, J.Depressive and anxiety disorders in patients presenting with physical complaints: clinical predictors and outcome. Am J Med 1997;103:339–347.CrossRefGoogle ScholarPubMed
Kroenke, K, Spitzer, RL, Williams, J, Linzer, M, Hahn, SR, de, Gruy FV III, et al.Physical symptoms in primary care. Predictors of psychiatric disorders and functional impairment. Arch Fam Med 1994;3:774–779.CrossRefGoogle ScholarPubMed
Luber, MP, Hollenberg, JP, Williams-Russo, P, DiDomenico, TN, Meyers, BS, Alexopoulos, GS, et al.Diagnosis, treatment, comorbidity, and resource utilization of depressed patients in a general medical practice. Int J Psychiatry Med 2000;30:1–13.CrossRefGoogle Scholar
Mulrow, CD, Williams, JW Jr, Gerety, MB, Ramírez, G, Montiel, OM, Kerber, C.Case-fmding instruments for depression in primary care settings. Ann Intern Med 1995;123:913–921.CrossRefGoogle Scholar
Nisenson, LG, Pepper, CM, Schwenk, TL, Coyne, JC.The nature and prevalence of anxiety in primary care. Gen Hosp Psychiatry 1998;20:21–28.CrossRefGoogle ScholarPubMed
Ormel, J, Von Korff, M, Ustun, TB, Pini, S, Korten, A, Oldehinkel, T.Common mental disorders and disability across cultures. Results from the WHO collaborative study on psychological problems in general health care. JAMA 1994;272:1741–1748.CrossRefGoogle Scholar
Patemiti, S, Verdier-Taillefer, M-H, Geneste, C, Bisserbe, J-C, Alpérovitch, A.Low blood pressure and risk of depression in the elderly. A prospective community-based study. Br J Psychiatry 2000;176:464–467.CrossRefGoogle Scholar
Pini, S, Perkonnig, A, Tansella, M, Wittchen, H-U. Prevalence and 12-month outcome of threshold and subthreshold mental disorders in primary care. J Affect Disord 1999;56:37–48.CrossRefGoogle ScholarPubMed
Rogers, WH, Wilson, IB, Bungay, KM, Cynn, DJ, Adler, DA.Assessing the performance of a new depression screener for primary care (PCSAD). J Clin Epidemiol 2002;55:16475.CrossRefGoogle Scholar
Salokangas, RKR, Poutanen, O, Stengard, E.Screening for depression in primary care. Development and validation of the Depression Scale, a screening instrument for depression. Acta Psychiatr Stand 1995;92:10–16.CrossRefGoogle ScholarPubMed
Sartorius, N, Üstün, TB, Costa e Silva, J-A, Goldberg, D, Lecrubier, Y, Ormel, J, et al.An international study of psychological problems in primary care. Preliminary report from the World Health Organizaron collaborative project on ‘Psychologicai Problems in General Health Care’. Arch Gen Psychiatry 1993;50:819–824.CrossRefGoogle Scholar
Sherbourne, CD, Jackson, CA, Meredith, LS, Camp, P, Wells, KB.Prevalence of comorbid anxiety disorders in primary cure outpatients. Arch Fam Med 1996;5:27–34.CrossRefGoogle Scholar
Simón, GE, Von Korff, M, Barlow, W.Health care costs of primary cure patients with recognized depression. Arch Gen Psychiatry 1995;52:850–856.CrossRefGoogle Scholar
Simón, GE, Von Korff, M, Piccinelli, M, Fullerton, C, Ormel, J.An international study of the relation between somatic symptoms and depression. N Engl J Med 1999;341:1329–35.CrossRefGoogle Scholar
Spitzer, RL, Williams, JB, Kroenke, K, Linzer, M, de Gruy, FV III, Hahn, SR, et al.Utility of a new procedure for diagnosing mental disorders in primary care. The PRIME-MD 1000 study. JAMA 1994;272:1749–56.CrossRefGoogle ScholarPubMed
Stewart, R, Prince, M, Richards, M, Brayne, C, Mann, A.Stroke, vascular risk factors and depression. Cross-sectional study in a UK Caribbean born population. Br J Psychiatry 2001;178:23–28.CrossRefGoogle Scholar
Susman, JL, Crabtree, BF, Essink, G.Depression in rural family practice. Easy to recognize, difficult to diagnose. Arch Fam Med 1995;4:427–431.CrossRefGoogle ScholarPubMed
Turk, DC, Okifuji, A, Scharff, L.Chronic pain and depression: role of perceived impact and perceived control in different age cohorts. Pain 1995;61:93–101.CrossRefGoogle ScholarPubMed
Tylee, A.Depression in the community: physician and patient perspective. J Clin Psychiatry 1999;60(Suppl 7): 12–60.Google ScholarPubMed
Üstün, TB, Sartorins, N, editors. Mental illness in general health cure An international study. Chichester: Wiley; 1995.Google Scholar
Üstün, TB, Von Korff, M.Primary mental health services: access and provisión of care. In: Ustan, TB, Sartorius, N, editors. Mental illness in general health care An international study. Chichester: Wiley; 1995. p. 347–60.Google Scholar
Von Korff, M, Simón, G.The relationship between pain and depression. Br J Psychiatry 1996;168(Suppl 30): 101–168.CrossRefGoogle Scholar
Von Korff, M, Üstün, TB.Methods of the WHO collaborative study on 'Psychological Problems in General Health Care'. In: Üstün, TB, Sartorius, N, editors. Mental illness in general health care An international study. Chichester: Wiley; 1995. p. 19–38.Google Scholar
Walker, EA, Katon, WJ, Jemelka, RP, Roy-Byrne, PP.Comorbidity of gastrointestinal complaints, depression, and anxiety in the Epidemiologic Catchment Area (ECA) Study. Am J Med 1992;92(1A): 26S–30S.CrossRefGoogle ScholarPubMed
Widmer, RB, Cadoret, RJ.Depression in primary care: changes in pattern of patient visits and complaints during a developing depression. J Fam Pract 1978;7:293–302.Google ScholarPubMed
Williams, JW Jr, Pignone, M, Ramírez, G, Perez Stellato, C.Identifying depression in primary care: a literature synthesis of case-finding instruments. Gen Hosp Psychiatry 2002;24:225–237.CrossRefGoogle ScholarPubMed
Williamson, HA. JrClinical and demographic factors associated with high levels of depression symptoms. Fam Med 1989;21:428–432.Google ScholarPubMed
Williamson, GM, Schulz, R.Pain, activity restriction, and symptoms of depression among community-residing elderly adults. J Gerontol 1992;47:P367–72.CrossRefGoogle ScholarPubMed
Wilson, DR, Widmer, RB, Cadoret, RJ, Judiesch, K.Somatic Symptoms. A major feature of depression in a family practice. J Affect Disord 1983;5:199–207.CrossRefGoogle Scholar
Wittchen, H-U.Generalized anxiety disorder: prevalence, barden, and cost to society. Depress Anxiety 2002;16:162–171.CrossRefGoogle Scholar
Wittchen, H-U, Hoyer, J.Generalized anxiety disorder: nature and course. J Clin Psychiatry 2001;62(Suppl 11): 15–62.Google ScholarPubMed
World Health Organization (WHO). The ICD-10 Classification of mental and behavioural disorders. Clinical descriptions and diagnostic guidelines. Geneva: WHO; 1992.Google Scholar