The Efficacy of Somatic Symptoms in Assessing Depression in Older Primary Care Patients
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This investigation tested the hypothesis that somatic symptoms such as reduced energy, loss of interest, and sleep disturbance are accurate indices of depression in older medical patients. The Beck Depression Inventory-II (BDI-II) and the Medical Outcomes Study Short-Form General Health Survey (SF-20) were administered to 90 primary care older patients of a large HMO. Exploratory factor analysis of the BDI-II identified three factors (Cognitive/Distress, Depressed Mood, and Somatic). A second-order factor analysis confirmed that all somatic items contributed to the second-order factor of depression. Item analyses also supported the consistency, severity discrimination, and classification efficiency of somatic items. These findings suggest that somatic symptoms, including fatigue, anhedonia, loss of interest, sleep disturbance, and concentration problems should be included when assessing older primary care patients for depression. Although these symptoms may be signs of physical decline, presentation of these symptoms warrants a more complete evaluation of depression in elderly medical patients. 2004 by The Haworth Press, Inc. All rights reserved.