Masked Depression: Profile and Severity of Symptoms and Impulsivity in Patients with Generalized Anxiety Disorder
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Major depressive disorder may remain underdiagnosed as it can be hidden behind somatic complaints or behavioral problems such as impulsivity, making other symptoms difficult to be recognized. The aim of the study was to determine the presence of depression in a sample of patients first-time diagnosed with generalized anxiety disorder that do not refer symptoms related to depression and to compare anxiety symptoms profile and impulsivity features between depressed and non-depressed patients. A total of 86 patients with DSM-IV diagnosis of GAD were recruited from the outpatient psychiatric services of the General Hospital of Comalcalco, Tabasco. Anxiety symptom severity and impulsivity were assessed with previously validated instruments. Depression was rated with the Hamilton Depression Rating Scale and the sample was categorized in depressed and non-depressed patients. More than half of the patients (54.7%) were identified as clinically depressed. These patients reported more severe anxiety symptomatology and more impulsivity than non-depressed patients; depressed patients also reported more somatic symptoms (e.g., gastrointestinal and hypochondriasis) which patients might identify as anxiety symptoms. In Latin-America, it is very common to use somatic symptoms as idioms of expression of emotional distress. Therefore, in patients with GAD with high levels of somatic complaints and impulsivity, depression should be evaluated.
KeywordsComorbidity Somatic symptoms Generalized anxiety disorder Major depression Hamilton Depression Rating Scale
The authors wish to thank for all the participants for their contribution, and the “Universidad Juárez Autónoma de Tabasco” and the “Hospital General de Comalcalco” personnel for their invaluable work for the logistics of the project.
Compliance with Ethical Standards
All procedures of the present study were in accordance with ethical standards of the Helsinki Declaration (World Medical Association 2013). The Ethics Review Board of the General Hospital of Comalcalco where patients were recruited and the University of Tabasco (UJAT-DAMC), Mexico approved the study. After receiving a comprehensive explanation of the nature and aims of the study, all patients enrolled gave their written informed consent to take part voluntarily in the study.
Conflict of Interest
The authors declare that they have no conflict of interest.
All procedure followed were in accordance with the ethical standards of the responsible committee on human experimentation and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients for being included in the study.
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