うつ病の身体症状と精神症状の関連について

Relationship between Somatic Symptoms and Depression

抄録

　うつ病患者の多くは，さまざまな身体的自覚症状を有するために精神科以外の科を受診することが多いといわれている。しかし，うつ病患者の身体的自覚症状についての研究報告は少ない。本調査の目的は，CMIを用いてうつ病患者に認められる身体的自覚症状と精神的自覚症状の関連を明らかにすることである。20～64歳のうつ病患者2,605名に，初診時にCMIを施行し，そのスコアを性差，年齢群で統計学的に比較検討を行った。その結果，女性が男性より有意にCMIのスコアが高く，成人期群が初老期群より有意に身体症状の訴えが多い傾向にあることが明らかとなった。これらの結果は，プライマリケア医や内科医に対するうつ病の啓発に役立つものと考えられた。

　Several lines of evidence have shown that depressive patients usually visit physicians before psychiatrists;however, there has been little systematic research on physical complaints among patients with depression. This study investigated the characteristics of somatic symptoms in patients with depression. The subjects were 2,605 patients (1,246men and 1,359women) aged 20 to 64 years with depression. They were administered the CMI (Cornell Medical Index). Differences in age and gender on CMI scores were analyzed. In order to examine age differences in CMI scores, we divided the subjects into two groups:young adults (aged 20 to 39 years) and older adults (aged 40 to 64 years). We found a positive correlation between "depressive mood" and twelve types of subjective physical symptoms. The young-adult group scored significantly higher on most items while the older adult group had significantly higher CMI scores on only the categories of "urogenital system", "musculoskeletal system", and "previous illness", all of which are conditions associated with physical aging. Women had significantly higher scores for most items except "respiratory system" and "lifestyle habit". We found that the participants' somatic complaints varied with age and gender. Our results could help physicians and primarycare doctors realize that depression may underlie somatic complaints.