The Frequency Distribution of Chief Complaints in Patients with Major Depressive Disorder Referring to Psychiatric Clinics in Kerman

Physical symptoms associated with depression and common psychiatric disorders sometimes lead to the misdiagnosis of depressive disorders. The aim of this study was to determine the frequency distribution of different chief complaints in patients with major depressive disorder referring to psychiatric clinics according to their demographic characteristics and source of referral.

The study was done on 246 depressed patients (191 females & 55 males) visited by three psychiatrists in Kerman. Patients’ chief complaints, duration of presenting symptoms, their demographic characteristics and source of referral were recorded and data were analyzed by chi-square.

Pain was more prevalent in women, while somatic complaints other than pain and psychiatric complaints were more prevalent in men. Higher educational level and age were significantly associated with higher rate of presenting psychiatric complaints (P<0.001, P<0.01 respectively). Marital status and duration of symptoms had no significant correlation with the type of somatic complaints. In patients with psychiatric complaints sources of referral were respectively patient’s own referring, general practitioners and specialists other than psychiatrists (P<0.001). In patients with pain complaint sources of referral were respectively patient’s own referring, specialists other than psychiatrists and general practitioners.

Somatic complaints are frequently present in depressed patients. Cultural differences in presenting complaints, stigma in referring to psychiatrists, general practitioners’ and specialists’ attitudes and knowledge toward psychiatric disorders affect appropriate and early diagnosis of major depressive disorder. Improving the knowledge of general practitioners about depressive disorders decreases mortality rate, social functioning disturbances, unnecessary expenses and the risk of unnecessary clinical procedures in these patients.