Physical symptoms of depression may be misdiagnosed

July 16, 2004

A study published in the Journal of General Internal Medicine revealed that physicians sometimes misattribute ill-defined physical symptoms to causes other than what may actually be depression. Patients complaining of physical ailments related to depression may not receive appropriate treatment from their doctors, as compared to patients who present with psychological symptoms.

Palpitations, hot flashes, chest pains, or problems with appetite, can be overlooked as signs of depression, according to a study of 200 adults. The study focused on a secondary analysis of patients beginning a new treatment episode for depression, and evaluated the effects of treatment as a result of physical versus psychological symptoms presented.

"While we are aware that current depression treatment is most often ineffective," offers author Dr. Robert D. Keeley, "we attempted to define the patient group that does not receive appropriate treatment, or does not respond to adequate treatment, by returning to the basic medical tenet of listening to the patient." The findings pointed out that physicians sometimes misattribute ill-defined physical symptoms to causes other than depression.

The most effective treatments, regardless of symptoms, were successful because they matched patient preference. Patients who had physical symptoms of depression were less likely to agree with a medical diagnosis of depression and thus tended to be nonaccepting of antidepressants, while 72% of patients with psychological symptoms who were presented with antidepressants as a treatment showed improved outcomes.

The study concludes that physicians need to search for new or modified interventions for depression when treating a patient with physical symptoms to improve the outcome.

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About the Author

Dr. Robert D. Keeley received his M.D. from Stanford University School of Medicine in 1994. He resides in Longmont, Colorado and has received multiple awards in the areas of Neuroscience, Primary Care Research and Family Practice. Dr. Keeley is available for questions and interviews and can be reached at or 303-775-0812.

About the Journal of General Internal Medicine

The Journal of General Internal Medicine (JGIM) is the official scientific publication of the Society of General Internal Medicine, whose mission is to promote improved patient care, research, and education in primary care and general internal medicine. JGIM articles focus on topics such as clinical research, curriculum development, epidemiology, prevention, and health care delivery in general internal medicine.

About Blackwell Publishing

Blackwell Publishing is the world's leading, independent society publisher with offices in the US, UK, Japan, Denmark, Australia, and Germany. Blackwell publishes over 700 journals in partnership with more than 550 academic and professional societies.

Blackwell Publishing Ltd.

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