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Background Somatization is a widespread clinical phenomenon that cuts across diagnostic categories, both psychiatric and medical. Objective This study investigates whether somatization can be assessed with a comprehensive diagnostic system, the Diagnostic Criteria for Psychosomatic Research (DCPR) in gastroenterology and cardiology (myocardial infarction) patients. Method Authors assessed a group of 343 outpatients, 190 gastroenterology and 153 cardiology outpatients, with functional gastrointestinal disorders and recent first myocardial infarction. Results A total of 146 patients were diagnosed by the DCPR Somatization cluster and 106 by the DCPR Abnormal Illness Behavior cluster; 27 patients who met DSM–IV criteria for somatoform disorders were not classified with any DCPR somatization syndromes, whereas 120 with DCPR Somatization cluster did not satisfy the criteria for DSM–IV somatoform disorders. Conclusion Findings suggest that the DCPR is able to identify clinical and subthreshold psychosomatic syndromes and that it can used jointly with the DSM–IV.

A few studies have investigated the role of psychosocial variables on clinical outcomes in coronary artery bypass grafting patients. The aims of this prospective study were 1) to assess clinical and subclinical distress in a consecutive sample of patients who underwent coronary artery bypass grafting surgery at both a 1-month assessment and a 6- to 8-year follow-up visit; and 2) to investigate the relationship between psychological variables and coronary events. A consecutive series of 47 patients with recent coronary artery bypass grafting surgery was evaluated by means of observer-rated categories (both the Diagnostic and Statistical Manual [DSM] and the new Diagnostic Criteria for Psychosomatic Research [DCPR]), and self-rated scales such as the Psychosocial Index. Survival analysis was used to characterize the clinical course of patients at the 6- to 8-year follow-up. One month after surgery, at the first psychological assessment, 36% of patients received a psychiatric diagnosis, and almost half of the sample met the criteria for a DCPR cluster. At follow-up, only abnormal illness behavior scores varied significantly from those at the first evaluation. Among the variables examined as potential risk factors for coronary events, only minor depression attained statistical significance. Psychological evaluation of patients who underwent coronary artery bypass grafting surgery needs to incorporate both clinical (DSM) and subclinical (DCPR) methods of classification. Furthermore, the data suggest minor depression as a potential cardiac risk factor in coronary artery bypass grafting patients. The clinical approach to coronary artery bypass grafting patients should thus include not only major depressive symptoms but also minor depression.

Background Despite its implications for treatment strategies, the potential role of previous depression on the medical course after coronary heart disease (CHD) has not yet been thoroughly studied. Objective The aim of this study was to determine whether the presence of major and minor depression, dysthymia, and demoralization in the years preceding the first myocardial infarction (MI) or angina, was associated with poor cardiac outcome at 2.5-year follow-up. Method A group of 97 consecutive patients with acute CHD, admitted to a coronary-care unit, were studied while in remission from the acute phase of CHD. Various clinical depression measures were used to assess the occurrence or recurrence of mood disorders preceding the first episode of CHD (baseline visit) and at 2.5 years after the first interview. Results Among the variables examined as potential cardiac risk factors, only dysthymia attained statistical significance. Discussion Further research is needed to identify an effective treatment for dysthymic patients.

Background In the past decade, there has been an increasing awareness of both quality-of-life impairment and the negative prognostic role of depression in congestive heart failure (CHF) patients. Objective The aims of this study were to evaluate distress, psychological well-being, and clinical and subclinical depression in 68 CHF outpatients at Bellaria Hospital in Bologna, Italy, at an initial assessment and at a 2-month routine follow-up visit. Results Patients reported a high prevalence of somatic complaints, depression, and demoralization, and low scores on psychological well-being. Among the variables examined as potential risk factors for cardiovascular outcome events, based on rehospitalization and cardiac death, only minor depression attained statistical significance. Conclusion Clinicians should thus assess minor depression among other psychological variables in these patients.