Depression Symptoms in patients with and without Chronic Disease

Authors: Jenny Chong, PhD, Kerstin M. Reinschmidt, PhD, MPH, and Francisco Moreno, MD

Background:
Symptoms of depression may be missed by healthcare providers if the patients are also suffering from one or more chronic diseases. This problem may be compounded if Hispanic patients express their depression differently from the majority culture. This presentation will describe a survey of 104 Hispanic patients of a Mobile Health Program (MHP) in southern Arizona to identify symptoms that are associated with individuals with and without chronic diseases, and with and without depression using the PHQ-9 and the Symptom Checklist 90 R (SCL 90R).

Method:
Patients from the University of Arizona’s MHP were invited to participate in a self administered survey that asked about the patient’s health status (different types of chronic disease), demographic information, as well as symptoms of depression from the PHQ-9, the SCL-90R and other symptoms identified as symptoms of depression by the MHP patients.

Results:
Half of the survey respondents reported having at least one chronic illness. Significant differences in symptom types were found between depressed and not depressed patients, and between patients with and without chronic diseases. Patients with depression were more likely to report many different symptoms indicative of psychological distress as measured by the SCL-90R compared to patients with chronic illnesses. These include symptoms indicative of anxiety, hostility, paranoid ideation, and psychoticism.

Conclusions:
People who are depressed tend to have many physical and mental symptoms. Patients with chronic diseases were significantly more likely to be depressed than patients without chronic diseases. Results suggest that while Hispanic patients with chronic illnesses have some symptoms that mimic depression, patients with depression have symptoms that are broad-based, both somatically as well as psychologically.