Depression among primary care patients with complaints of headache and general fatigue

The prevalence of major depressive episodes among 7029 out-patients based on the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders in a Japanese primary care setting was 1.3%, while the investigated prevalence of subthreshold depression based on interviews was 0.9%. A total of 30 (10.8%) patients among 278 patients who had headache complaints were observed as suffering from major depressive episodes. On the other hand, 33 (21.0%) patients among 157 patients with chronic fatigue problems suffered from major depressive episodes. Complaints of both headaches and general fatigue were identified among 25 patients, while 15 (60%) patients had significant depressive symptoms. A multivariate analysis showed that there was no significant difference between depressed and non-depressed patients with age (odds ratio = 1.00) and males were less likely to suffer from depression (odds ratio = 0.66). Complaints of both headaches and general fatigue showed statistically significant associations with depression (odds ratio = 74.08). Thus, headaches and general fatigue may be important somatic markers for depression in the primary care setting.