Somatic symptoms in depression: Evaluation of their diagnostic weight in an African setting

Background: Somatic symptoms are extremely common features of depression and other mental disorders in African countries such as Nigeria, but their weight in the diagnosis ofdepression is not certain. Aim: To determine what weight should be assigned to these symptoms in comparison with other well-known symptoms in the diagnosis of depression. Method: A sample of 829 persons completed the Patient Health Questionnaire which was earlier modified by the inclusion of the somatic symptoms being studied. Using principal component analysis and a logistic regression model, the contributions ofthese symptoms in comparison with others were determined. Results: Core depressive symptoms accounted for most of the total variance for depression. The somatic symptoms studied loaded separately from the core depressive symptoms and were not as good predictors of depression. A cognitive factor emerged as well as some somatic factors. Conclusions: Although somatic symptoms may be florid among patients with depression, they have considerably less weight than core depressive symptoms in the diagnosis of depression. The emerging cognitive factor could be similar tothat described by previous authors.