SAMJ: South African Medical Journal
On-line version ISSN 2078-5135
Print version ISSN 0256-9574
MULLER, Jacqueline E; WENTZEL, Ignatius; NEL, Daniel G and STEIN, Dan J. Depression and anxiety in multisomatoform disorder: Prevalence and clinical predictors in primary care. SAMJ, S. Afr. med. j. [online]. 2008, vol.98, n.6, pp.473-476. ISSN 2078-5135.
OBJECTIVE: Multisomatoform disorder (MSD) is characterised by >3 medically inexplicable, troublesome physical symptoms, together with a >2-year history of somatisation. The aim of this study was to evaluate the prevalence of depressive and anxiety disorders in a South African sample MSD, and to compare demographic and clinical outcomes in those patients with and without co-morbidity. METHODS: Fifty-one adult outpatients with MSD were recruited from primary care clinics in the Cape Town metropole. Participants were assessed for the presence of co-morbid depressive and anxiety disorders using the Mini Neuropsychiatric Interview-Plus (MINI-Plus). Outcomes included somatic symptom severity, disability, reported sick days and health care visits, pain experience, patient satisfaction with health services, and clinician-experienced difficulty. RESULTS: A current co-morbid depressive disorder was present in 29.4% (N=15) of patients, and a current co-morbid anxiety disorder in 52.9% (N=27). MSD patients with a co-morbid depressive disorder (current or lifetime) had significantly higher physical symptom counts, greater functional impairment, higher unemployment rates, more clinician-reported difficulties, and more dissatisfaction with health care services than those without the disorder. A larger number of co-morbid disorders was associated with greater overall disability. CONCLUSION: High rates of co-morbid depressive and anxiety disorders were present in a South African sample of primary care patients with MSD. Not all patients had co-morbidity, which is consistent with the view that MSD should be viewed as an independent disorder. However, co-morbid depressive disorders were associated with increased symptom severity and functional impairment, consistent with previous reports from developing countries, emphasising the importance of co-morbidity in MSD.