Somatic Symptoms in Major Depressive Disorder: A Cross-sectional Study in a Mental Health Setting, Vietnam

Introduction: Major depressive disorder (MDD) presents a diverse clinical picture, especially with somatic symptoms, which can lead to negative impacts on the course and prognosis of the illness. This study aimed to (1) assess the prevalence of various somatic symptoms in MDD patients and (2) assess their association with demographic factors.

Methods: A total of 345 outpatients diagnosed with MDD according to DSM-5 criteria were enrolled in this cross-sectional study over 6 months. Participants completed a questionnaire that included clinical and demographic information as well as the PHQ-9.

Results: There were 99.7% of patients who had at least one somatic symptom. The common somatic symptoms were fatigue (89.9%), insomnia (87.8%), palpitations (77.7%), headache (69.6%) and dizziness (61.4%). Total PHQ-9 scores and total number of somatic symptoms were found to have a regression relationship with a regression coefficient of 0.14 (t = 6.001, p < 0.001). In multiple logistic regression analysis, female gender was found to be associated with dizziness (odd ratios [OR] = 2.54, 95% confidence interval [CI] 1.53-4.21, p < 0.01), headaches (OR = 1.94, 95% CI 1.16-3.32, p < 0.05), and bowel problems (OR = 0.59, 95% CI 0.37-0.96, p < 0.05); while headaches (OR = 1.73, 95% CI 1.05-2.85, p < 0.05), and stomach problems (OR = 0.56, 95% CI 0.36-0.88, p < 0.05) were associated with age 40 and below.

Conclusions: The study findings provide a resource for clinicians in mental health settings as well as primary care clinics in detecting inexplicable somatic symptoms associated with MDD.