The relationship of presenting physical complaints to depressive symptoms in primary care patients

J Gen Intern Med. 1992 Mar-Apr;7(2):170-3. doi: 10.1007/BF02598007.


Objective: To assess the relationship of specific patient chief physical complaints to underlying depressive symptoms in primary care practice.

Design: A cross-sectional study that was part of a larger prevalence study of depression in primary care.

Setting: A general medical primary care practice in a teaching medical center in rural New England.

Patients: 1,042 consecutive outpatients screened for depression with the Hopkins Symptom Checklist 49-item depression scale and for whom physicians filled out a form recording both specific chief complaints and two aspects of complaint presentation style, clarity and amplification.

Interventions: None.

Results: Complaints that discriminated between depressed and non-depressed patients (at the p = 0.05 level) were sleep disturbance (PPV 61%), fatigue (PPV 60%), multiple (3+) complaints (PPV 56%), nonspecific musculoskeletal complaints (PPV 43%), back pain (PPV 39%), shortness of breath (PPV 39%), amplified complaints (PPV 39%), and vaguely stated complaints (PPV 37%).

Conclusions: Depressed patients are common in primary care practice and important to recognize. Certain specific complaints and complaint presentation styles are associated with underlying depressive symptoms.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Cross-Sectional Studies
  • Depression / complications*
  • Depression / etiology
  • Family Practice
  • Female
  • Humans
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Prevalence