Somatic symptoms in treatment-naïve Hispanic and non-Hispanic patients with major depression

Depress Anxiety. 2020 Feb;37(2):156-165. doi: 10.1002/da.22984. Epub 2019 Dec 12.

Abstract

Background: Somatic complaints are a major driver of health care costs among patients with major depressive disorder (MDD). Some epidemiologic and clinical data suggest that Hispanic and non-Hispanic Black patients with MDD endorse higher levels of somatic symptoms than non-Hispanic White patients.

Methods: Somatic symptoms in 102 Hispanic, 61 non-Hispanic Black, and 156 non-Hispanic White patients with treatment-naïve MDD were evaluated using the somatic symptom subscale of the Hamilton anxiety rating scale (HAM-A). The other seven items of the HAM-A comprise the psychic anxiety subscale, which was also evaluated across ethnicities.

Results: Hispanic patients reported significantly greater levels of somatic symptoms than non-Hispanic patients, but levels of psychic anxiety symptoms did not differ by ethnicity. Levels of somatic symptoms did not significantly differ between Black and White non-Hispanic patients. Within the Hispanic sample, somatic symptom levels were higher only among those who were evaluated in Spanish; Hispanics who spoke English showed no significant differences versus non-Hispanics.

Conclusions: In this medically healthy sample of patients with MDD, monolingual Spanish-speaking Hispanic patients endorsed high levels of somatic symptoms. Clinicians should be mindful that the depressive experience may manifest somatically and be judicious in determining when additional medical work-up is warranted for somatic complaints.

Keywords: African Americans; Latino; Spanish; acculturation; anxiety; ethnicity.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anxiety / epidemiology
  • Anxiety / psychology
  • Anxiety Disorders / epidemiology
  • Anxiety Disorders / psychology
  • Black or African American / psychology*
  • Black or African American / statistics & numerical data*
  • Depressive Disorder, Major / epidemiology
  • Depressive Disorder, Major / psychology*
  • Female
  • Hispanic or Latino / psychology*
  • Hispanic or Latino / statistics & numerical data*
  • Humans
  • Male
  • Medically Unexplained Symptoms*
  • Middle Aged
  • White People / psychology*
  • White People / statistics & numerical data*
  • Young Adult