This is a fairly good overview of research on illnesses and depression and anxiety:Medically unexplained physical symptoms, anxiety, and depression: ameta-analytic review.Journal: Psychosom Med. 2003 Jul-Aug;65(4):528-33.Authors: Henningsen P, Zimmermann T, Sattel H.Affiliation: Department of Psychosomatic Medicine, University ofHeidelberg, Heidelberg, Germany.Address reprint requests to: Peter Henningsen, MD, Department ofPsychosomatic Medicine, University Hospital, Thibautstrasse 2, 69115Heidelberg, Germany. Email: mailto
eter_henningsen###med.uni-heidelberg.deReceived for publication June 6, 2002; revision received October 15,2002.NLM Citation: PMID: 12883101OBJECTIVE: Our objective was to review and compare, with meta-analyticmethods, observational studies on the association of medicallyunexplained physical symptoms, anxiety, and depression with specialemphasis on healthy and organically ill control groups and on differenttypes of symptoms, measures, and illness behavior.METHODS: A search of MEDLINE and PsycLIT/PsycINFO for abstracts from 1980to April 2001 was performed; principal investigators in the field werecontacted and article reference lists were used to retrieve additionalrelevant articles. Two hundred forty-four studies were included on thebasis of consensus ratings if they fulfilled seven of eight inclusioncriteria pertaining to diagnostic accuracy and statisticalappropriateness. Five hundred twenty-two studies were deferred orexcluded. We focused specifically on the four functional somaticsyndromes for which there were sufficient numbers for meta-analyticintegration: irritable bowel syndrome (IBS), nonulcer dyspepsia (NUD),fibromyalgia (FM), and chronic fatigue syndrome (CFS). Data wereextracted independently by two authors according to a prespecified codingmanual with up to 70 parameters per study.RESULTS: Effect sizes for the association of the four functional somaticsyndromes with depression and anxiety were of moderate magnitude but werehighly significant statistically when compared with healthy persons andcontrols with medical disorders of known organic pathology. Moreover,this association was significant whether depression was measured with orwithout somatic items. Chronic fatigue syndrome is characterized byhigher scores of depression, fibromyalgia by lower scores of anxiety thanirritable bowel syndrome. Consulting behavior and severity ofsomatization is related to higher levels of anxiety and depression.CONCLUSIONS: Meta-analytic integration confirms that the four functionalsomatic syndromes (IBS, NUD, FM, CFS) are related to (but not fullydependent on) depression and anxiety. At present, there is only limitedmeta-analytic evidence for the same sort of association for medicallyunexplained physical symptoms in general. In view of the relativeindependence from depression and anxiety, classification and treatment ofthese symptoms and syndromes as "common mental disorders" does not seemfully appropriate. --------------------------------------------- Send posts to mailto:CO-CURE###listserv.nodak.edu Join or leave the list at http://www.co-cure.org/sub.htm Select list topic options at http://www.co-cure.org/topics.htm Co-Cure Archives: http://listserv.nodak.edu/archives/co-cure.html ---------------------------------------------Bada
eter_henningsen###med.uni-heidelberg.deReceived for publication June 6, 2002; revision received October 15,2002.NLM Citation: PMID: 12883101OBJECTIVE: Our objective was to review and compare, with meta-analyticmethods, observational studies on the association of medicallyunexplained physical symptoms, anxiety, and depression with specialemphasis on healthy and organically ill control groups and on differenttypes of symptoms, measures, and illness behavior.METHODS: A search of MEDLINE and PsycLIT/PsycINFO for abstracts from 1980to April 2001 was performed; principal investigators in the field werecontacted and article reference lists were used to retrieve additionalrelevant articles. Two hundred forty-four studies were included on thebasis of consensus ratings if they fulfilled seven of eight inclusioncriteria pertaining to diagnostic accuracy and statisticalappropriateness. Five hundred twenty-two studies were deferred orexcluded. We focused specifically on the four functional somaticsyndromes for which there were sufficient numbers for meta-analyticintegration: irritable bowel syndrome (IBS), nonulcer dyspepsia (NUD),fibromyalgia (FM), and chronic fatigue syndrome (CFS). Data wereextracted independently by two authors according to a prespecified codingmanual with up to 70 parameters per study.RESULTS: Effect sizes for the association of the four functional somaticsyndromes with depression and anxiety were of moderate magnitude but werehighly significant statistically when compared with healthy persons andcontrols with medical disorders of known organic pathology. Moreover,this association was significant whether depression was measured with orwithout somatic items. Chronic fatigue syndrome is characterized byhigher scores of depression, fibromyalgia by lower scores of anxiety thanirritable bowel syndrome. Consulting behavior and severity ofsomatization is related to higher levels of anxiety and depression.CONCLUSIONS: Meta-analytic integration confirms that the four functionalsomatic syndromes (IBS, NUD, FM, CFS) are related to (but not fullydependent on) depression and anxiety. At present, there is only limitedmeta-analytic evidence for the same sort of association for medicallyunexplained physical symptoms in general. In view of the relativeindependence from depression and anxiety, classification and treatment ofthese symptoms and syndromes as "common mental disorders" does not seemfully appropriate. --------------------------------------------- Send posts to mailto:CO-CURE###listserv.nodak.edu Join or leave the list at http://www.co-cure.org/sub.htm Select list topic options at http://www.co-cure.org/topics.htm Co-Cure Archives: http://listserv.nodak.edu/archives/co-cure.html ---------------------------------------------Bada
