TY - JOUR
KW - Activities of Daily Living/psychology
KW - Adolescent
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Anxiety Disorders/diagnosis/epidemiology/psychology
KW - Comorbidity
KW - Cross-Sectional Studies
KW - Depressive Disorder, Major/diagnosis/epidemiology/psychology
KW - Depressive Disorder/diagnosis/epidemiology/psychology
KW - Diagnosis, Differential
KW - Disability Evaluation
KW - Female
KW - Humans
KW - Interview, Psychological
KW - Male
KW - Middle Aged
KW - Personality Inventory
KW - Primary Health Care
KW - Somatoform Disorders/diagnosis/epidemiology/psychology
AU - B. Lowe
AU - R. L. Spitzer
AU - J. B. Williams
AU - M. Mussell
AU - D. Schellberg
AU - K. Kroenke
A1 - 
AB - OBJECTIVE: To determine diagnostic overlap of depression, anxiety and somatization as well as their unique and overlapping contribution to functional impairment. METHOD: Two thousand ninety-one consecutive primary care clinic patients participated in a multicenter cross-sectional survey in 15 primary care clinics in the United States (participation rate, 92%). Depression, anxiety, somatization and functional impairment were assessed using validated scales from the Patient Health Questionnaire (PHQ) (PHQ-8, eight-item depression module; GAD-7, seven-item Generalized Anxiety Disorder Scale; and PHQ-15, 15-item somatic symptom scale) and the Short-Form General Health Survey (SF-20). Multiple linear regression analyses were used to investigate unique and overlapping associations of depression, anxiety and somatization with functional impairment. RESULTS: In over 50% of cases, comorbidities existed between depression, anxiety and somatization. The contribution of the commonalities of depression, anxiety and somatization to functional impairment substantially exceeded the contribution of their independent parts. Nevertheless, depression, anxiety and somatization did have important and individual effects (i.e., separate from their overlap effect) on certain areas of functional impairment. CONCLUSIONS: Given the large syndrome overlap, a potential consideration for future diagnostic classification would be to describe basic diagnostic criteria for a single overarching disorder and to optionally code additional diagnostic features that allow a more detailed classification into specific depressive, anxiety and somatoform subtypes.
BT - General hospital psychiatry
C5 - Medically Unexplained Symptoms
CP - 3
CY - United States
DO - 10.1016/j.genhosppsych.2008.01.001
IS - 3
JF - General hospital psychiatry
N2 - OBJECTIVE: To determine diagnostic overlap of depression, anxiety and somatization as well as their unique and overlapping contribution to functional impairment. METHOD: Two thousand ninety-one consecutive primary care clinic patients participated in a multicenter cross-sectional survey in 15 primary care clinics in the United States (participation rate, 92%). Depression, anxiety, somatization and functional impairment were assessed using validated scales from the Patient Health Questionnaire (PHQ) (PHQ-8, eight-item depression module; GAD-7, seven-item Generalized Anxiety Disorder Scale; and PHQ-15, 15-item somatic symptom scale) and the Short-Form General Health Survey (SF-20). Multiple linear regression analyses were used to investigate unique and overlapping associations of depression, anxiety and somatization with functional impairment. RESULTS: In over 50% of cases, comorbidities existed between depression, anxiety and somatization. The contribution of the commonalities of depression, anxiety and somatization to functional impairment substantially exceeded the contribution of their independent parts. Nevertheless, depression, anxiety and somatization did have important and individual effects (i.e., separate from their overlap effect) on certain areas of functional impairment. CONCLUSIONS: Given the large syndrome overlap, a potential consideration for future diagnostic classification would be to describe basic diagnostic criteria for a single overarching disorder and to optionally code additional diagnostic features that allow a more detailed classification into specific depressive, anxiety and somatoform subtypes.
PP - United States
PY - 2008
SN - 0163-8343; 0163-8343
SP - 191
EP - 199
EP - 
T1 - Depression, anxiety and somatization in primary care: syndrome overlap and functional impairment
T2 - General hospital psychiatry
TI - Depression, anxiety and somatization in primary care: syndrome overlap and functional impairment
U1 - Medically Unexplained Symptoms
U2 - 18433651
U3 - 10.1016/j.genhosppsych.2008.01.001
VL - 30
VO - 0163-8343; 0163-8343
Y1 - 2008
ER -